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Delayed Patient Access to Innovative Medical Technologies in South Korea: A Lead-Time Analysis of Reimbursement Coverage Determinations

Part of: Special Collection - Methods

Published online by Cambridge University Press:  20 June 2019

Sang-Soo Lee Open the ORCID record for Sang-Soo Lee [Opens in a new window] ,
Jae-Eun Myung  and
Liesl Strachan
Sang-Soo Lee*
Affiliation:
Graduate School for Medical Device Management and Research, SAIHST (Samsung Advanced Institute for Health Science & Technology), Sung Kyun Kwan University Medtronic Korea Ltd.
Jae-Eun Myung
Affiliation:
Medtronic Korea Ltd.
Liesl Strachan
Affiliation:
Global Health Policy, Reimbursement and Health Economics, Medtronic Australasia Pty Ltd
*
Author for correspondence: Sang-Soo Lee, E-mail: [email protected]
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Abstract

Background and Objectives

Timely access to innovative medical technologies driven by accelerated patient access pathways can substantially improve the health outcomes of patients who often have few therapeutic alternatives. We analyzed lead-times for the medical procedure reimbursement coverage process undertaken in South Korea from 2014 to 2017, which is considered one of the most important factors contributing to delays in patient access to new medical technologies.

Methods

This analysis was performed using the open datasets source of “Medical Procedure Expert Evaluation Committee (MPEEC)” meeting results and medical procedure coverage application information published on the Health Insurance Review and Assessment Service Web site.

Results

From 2014 to 2017, 90 percent of all new coverage determinations took on average >250 days with almost 20 percent taking more than 2 years (>750 days), The average lead-time from the medical procedure coverage application to MPEEC meeting in 2015 was 435.0 ± 214.7 days (n = 26), which was significantly shorter than the average lead-time in 2014 (624.9 ± 290.3 days, n = 16) (p < .05). The average lead-time from application to official enforcement in 2015 was significantly shorter than that of 2014 (540.8 ± 217.4; n = 16 versus 734.1 ± 299.7 days; n = 26, respectively) (p < .05).

Conclusions

While this analysis showed a general trend of a reduction in the time taken to receive a positive coverage determination for a new medical technology, the average lead-time remains well over the government mandated 100 days. To continue this trend and further enhance the patient access pathway for medical procedure coverage determinations, some measures can be applied. In particular, the extended “One-Stop Service” program encompassing coverage determinations is one such recommendation that could be considered.

Keywords

medical technologycoveragelead-timepatient accessSouth Korea
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 3 , 2019 , pp. 229 - 236
Copyright
Copyright © Cambridge University Press 2019 

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