More rare diseases designated for special case NHI benefit

NHIS named seven more hospitals as one of 28 healthcare institutes to diagnose rare diseases

From Jan.

 

1 this year, the government expanded list of designated rare diseases and healthcare institutes examining rare disease eligible for the special case healthcare benefit.

 

To reduce medical expense and to improve medical access for patients with ultra rare and unknown diseases, National Health Insurance Service (NHIS, President Kim Yong-ik) announced the extended list of rare disease and healthcare institute examining rare disease for special case National Health Insurance (NHI) benefit that came in effect from Jan.

 

1.

 

The objective of the special case benefit system is to reduce patient’s copayment rate on expensive rare and severe disease treatment, which makes a rare disease patient to be responsible for 10 percent of inpatient and outpatient medical expense.

 

Accordingly, the list of designated rare disease receiving special case benefit has been expanded to include 1,014 rare diseases, applying the benefit to around 270,000 patients.

 

Before the change, it used to be approximately 265,000 patients receiving the benefit.

 

Constantly listening to patients, their family, patient groups and related academic societies, NHIS increased the number of designated rare disease for the benefit after a series of deliberation by Rare Disease Management Committee (Korea Centers for Disease Control and Prevention) and Special Case Benefit Committee (NHIS).

 

From last year, the government agency has opened a separate disease group dedicated for unspecified chromosome abnormalities, as patients with the condition could not receive any special benefit without a specific name of diagnosed disease.

 

Rare disease patients with the designated special case disease are expected to access treatment with lessened financial burden, as supported by special case NHI benefit and Rare Disease Patient Medical Aid program.

 

Also the NHIS has added more healthcare institutes to examine and diagnose rare disease.

 

Since 2016, NHIS has appointed qualified healthcare institute to exam ultra rare disease and unspecified chromosome abnormalities to promptly but accurately provide special case benefit to the patients.

 

In December, the agency called for a bidder among tertiary hospitals offering rare disease or genetics clinic, and selected seven more hospitals, making total of 28 hospitals available for rare disease examination from this year.

 

The new appointment was to expedite examination procedure to diagnose increasing number of rare disease eligible for NHI special case benefit, and to resolve inconvenience of patients in regions without the designated institute, such as Jeonnam, Jeonbuk and Chungbuk.

 

A NHIS official stated, “The agency would continue to improve rare disease patient’s access to treatment by providing special case benefit to growing number of newly diagnosed rare diseases found with fast-advancing technology, and by appointing more healthcare institutes capable of examining the diseases for the patients to receive adequate treatment.”