A study on the current status and development of the new health technology assessment of Korean medicine field

Minjung Park; Youjin Jung; Soo Kyung Son; Soohyun Kwon; Nankwen Kim; Jong Woo Kim; Dong Ah Park; Seok-Hee Chung; Park, Minjung; Jung, Youjin; Son, Soo Kyung; Kwon, Soohyun; Kim, Nankwen; Kim, Jong Woo; Park, Dong Ah; Chung, Seok-Hee

doi:10.13048/jkm.19027

JKM > Volume 40(3); 2019 > Article

Park, Jung, Son, Kwon, Kim, Kim, Park, and Chung: A study on the current status and development of the new health technology assessment of Korean medicine field

Original Article

The Journal of Korean Medicine 2019; 40(3): 59-75.

Published online: September 30, 2019

DOI: https://doi.org/10.13048/jkm.19027

A study on the current status and development of the new health technology assessment of Korean medicine field

Minjung Park¹

, Youjin Jung

, Soo Kyung Son²

, Soohyun Kwon¹

, Nankwen Kim¹

, Jong Woo Kim¹

, Dong Ah Park²^{, *}

, Seok-Hee Chung¹^{, *}

¹Guideline Center for Korean Medicine, National Institute for Korean Medicine Development

²Division of Health Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency

Correspondence to: 박동아 서울특별시 중구 퇴계로 173(충무로 3가) 남산스퀘어 7층 한국보건의료연구원 의료기술평가연구단, Tel: +82-2-2174-2771, Fax: +82-2-747-4918, E-mail: pda124@neca.re.kr

Correspondence to: 정석희 서울시 동대문구 회기동 1번지 경희의료원 한방재활의학과 교실, Tel: +82-2-958-9299, Fax: +82-2-3393-4500, E-mail: omdchung@khu.ac.kr

Received May 28, 2019 Revised August 9, 2019 Accepted August 14, 2019

Abstract

Objectives

The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it.

Methods

We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field.

Results

There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine.

Conclusions

Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

Keywords: Health Technology Assessment, Korean traditional medicine, policy development

Fig. 1

New Health Technology Process and the Main Content of Analysis

Fig. 2

Trends of Application in Korean Medicine New Health Technology Assessment

Table 1

Expert Meeting Questionnaire

구분

내용

1. 한의 신의료기술 평가 관련 질의

들어가는 질문
- - 한의 신의료기술평가와 관련하여 본인의 경험, 생각
장애요인
- - 한의 신의료기술 관련 신의료기술평가 제도 전반에 대한 의견(절차 및 평가 내용 등)
- - 신의료기술평가 시 한방 의료기술과 양방 의료기술의 구분의 필요성
- - 신의료기술평가 시 기존 (양방 위주의) 원칙을 한방 신의료기술에 그대로 적용하는 것에 대한 의견
국내 한의학의 현황을 고려한 신의료기술 평가제도 개선방안 모색
- - 국내 한의학의 현황을 고려한 신의료기술 평가제도 모색 시 고려되어야 하는 사항
- - 국내 한의학의 현황을 고려한 신의료기술 평가제도 개선방안 및 중장기 방안

2. 한의학 임상연구 관련 질의

들어가는 질문
- - 한의계 임상 현장에서 수행되고 있는 여러 의료기술에 대하여 임상연구를 통해 근거를 확보하기 위해서는 다양한 노력이 모색되어야 하는 상황임에 모두 공감하고 있습니다. 이를 위한 구체적인 방안에 대한 의견을 부탁드립니다.
제도적 측면에 대한 의견
- - R&D 투자
- - 한의학 연구개발 지원 인프라
- - 한의학 연구자에 대한 연구 역량
- - 근거창출 중개⋅임상연구 지원
- - 현행 활용 가능한 제도
임상연구 시 고려사항
- - 의과 중심으로 규제되어 있는 임상연구의 제약에서 벗어나 한의계의 임상 연구방법이 달리 모색되어야 하는가? 그렇다면 어떠한 측면이 고려되어야 하는가?
- - 한의학 관련 의료기술의 안전성 평가 시 고려해야 하는 사항
- - 한의학 관련 임상적 효과 평가 시 고려해야 하는 사항
- - 한의학에서 임상연구 수행 시 고려해야 하는 사항

Table 2

Number of Applications According to the Classification of Technology

구분	체외진단검사	기타검사	유전자검사	처치 및 시술	기타 *
전체	667 (31.5%)	320 (15.1%)	389 (18.3%)	724 (34.1%)	21 (1.0%)
한의과	-	18 (42.9%)	-	24 (57.1%)	-

* 기타: 기술별 분류에 포함되지 않는 행위(예, 위험 상담, 목욕치료요법, 스트레스 감소 프로그램 등)

Table 3

Results of New Health Technology Assessment in Korean Medicine Field

구분	분류	건수	비율
안전성 ․ 유효성 평가 비대상	기존기술	14	45.2%
안전성 ․ 유효성 평가 비대상	조기기술	6	19.4%
안전성 ․ 유효성 평가 대상	연구단계기술	2	6.4%
안전성 ․ 유효성 평가 대상	신의료기술	0	0%
기타	신청 취하	8	25.8%
기타	반려	1	3.2%
합계		31	100%

Table 4

Applications to Enter a Medical Market and Be Covered by National Health Insurance

Table 5

Applications for the Purpose of joint-using Western Medicine Technology in Korean Medicine Area

Table 6

Content Analysis of Expert Opinion

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