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

Article information

J Korean Med. 2019;40(3):59-75
Publication date (electronic) : 2019 September 30
doi : https://doi.org/10.13048/jkm.19027
Minjung Park1orcid_icon, Youjin Jungorcid_icon, Soo Kyung Son2orcid_icon, Soohyun Kwon1orcid_icon, Nankwen Kim1orcid_icon, Jong Woo Kim1orcid_icon, Dong Ah Park2,orcid_icon, Seok-Hee Chung1,orcid_icon
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 2019 May 28; Revised 2019 August 9; Accepted 2019 August 14.

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

Expert Meeting Questionnaire

Number of Applications According to the Classification of Technology

Results of New Health Technology Assessment in Korean Medicine Field

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

References

1. Lee M, Ahn JH. The current status and future direction of Korean health technology assessment system. J Korean Med Assoc 2014;57(11):906–911.
2. Shin YS. Policy Development for the Management of New Health Technologies Ministry of Health & Welfare; 1999.
3. Lee SM. Status of New Health Technology in Korean. Journal of the Korean Academy of Dental Insurance 2011:9–30.
4. Han CH, Park HJ, Lee BH, Lee YJ, Kwon OM. Study on the Present Status and Developments of New Health Technologies of Traditional Korean Medicine. Korean Journal of Acupuncture 2012;29(2):315–326.
5. Lee YJ, Kim JY. Status of New Health Technology in Korean Medicine Field Since 2007. Journal of Korean Medicine 2017;38(1):21–33.
6. Lee BH, Lee YJ, Park HJ, Kwon OM, Han CH. A Survey on the Actual State of Recognition of New Health Technology. Korean Journal of Acupuncture 2012;29(2):327–342.
7. Lee SN, Lee BH, Lee YJ, Han CH. Telephone Survey for Actual State of Recognition of New Health Technology in Korean Medical Doctors Kor. J Oriental Preventive Medical Society 2013;17(2):89–103.

Article information Continued

Copyright © 2019 The Society of Korean Medicine all rights reserved

Fig. 1

Fig. 1

New Health Technology Process and the Main Content of Analysis

Fig. 2

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

  1. 들어가는 질문

    • - 한의 신의료기술평가와 관련하여 본인의 경험, 생각

  2. 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

  3. 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

  1. 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.

  2. 제도적 측면에 대한 의견

    • - R&D 투자

    • - 한의학 연구개발 지원 인프라

    • - 한의학 연구자에 대한 연구 역량

    • - 근거창출 중개⋅임상연구 지원

    • - 현행 활용 가능한 제도

  3. 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%
조기기술 6 19.4%
안전성 ․ 유효성 평가 대상 연구단계기술 2 6.4%
신의료기술 0 0%
기타 신청 취하 8 25.8%
반려 1 3.2%
합계 31 100%

Table 4

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

Table 4

Table 5

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

Table 5

Table 6

Content Analysis of Expert Opinion

Table 6