Ju Jin Han, Sim Boram, Lee Jeongeun, Lee Jin Yong
HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju, Korea.
Public Healthcare Center, Seoul National University Hospital, Seoul, Korea.
Korean Circ J. 2022 Apr;52(4):265-279. doi: 10.4070/kcj.2022.0014.
Digital health is rapidly growing worldwide and its area is expanding from wellness to treatment due to digital therapeutics (DTx). This study compared DTx in the Korean context with other countries to better understand its political and practical implications. DTx is generally the same internationally, often categorized as software as a medical device. It provides evidence-based therapeutic interventions for medical disabilities and diseases. Abroad, DTx support entailed state subsidies and fundraising and national health insurance coverage. In the case of national health insurance coverage, most cases were applied to mental diseases. Moreover, in Japan, DTx related to hypertension will possibly be under discussion for national health insurance coverage in 2022. In overseas countries, coverage was decided only when the clinical effects were equivalent to those provided by existing technology, and in the UK, real usage data for DTx and associated evaluations were reflected by national health coverage determination. Prices were either determined through closed negotiations with health insurance operating agencies and manufacturers or established based on existing technology. Concerning the current situation, DTx dealing with various diseases including hypertension are expected to be developed near in the future, and the demand for use and compensation will likely increase. Therefore, it is urgent to define and prepare for DTx, relevant support systems, and health insurance coverage listings. Several support systems must be considered, including government subsidies, science/technology funds, and health insurance.
数字健康在全球范围内正迅速发展,由于数字疗法(DTx),其领域正从健康管理扩展到治疗。本研究将韩国背景下的数字疗法与其他国家进行比较,以更好地理解其政治和实际影响。数字疗法在国际上总体相同,通常被归类为医疗器械软件。它为医疗残疾和疾病提供循证治疗干预。在国外,数字疗法的支持包括国家补贴、筹款和纳入国民健康保险。就国民健康保险覆盖而言,大多数情况适用于精神疾病。此外,在日本,与高血压相关的数字疗法可能会在2022年讨论是否纳入国民健康保险。在海外国家,只有当临床效果与现有技术相当时才会决定覆盖,在英国,数字疗法的实际使用数据和相关评估会反映在国家医保覆盖范围的确定中。价格要么通过与医保运营机构和制造商的闭门谈判确定,要么基于现有技术确定。就当前情况而言,预计未来不久将开发出针对包括高血压在内的各种疾病的数字疗法,使用和补偿需求可能会增加。因此,迫切需要对数字疗法、相关支持系统和医保覆盖清单进行定义和准备。必须考虑多种支持系统,包括政府补贴、科技基金和医疗保险。