|
KMID : 1040120170030020078
|
|
Evidence and Values in Healthcare
2017 Volume.3 No. 2 p.78 ~ p.83
|
|
|
Implementation of value-based coverage decision
|
|
Yun Yu-Jin
Lee Sang-Moo
|
|
|
Abstract
|
|
|
Introduction: Universal health coverage (UHC) has been an important principle of global health policy to achieve the Alma-Ata declaration of WHO that is health is human right. The current government’s health policy is in line with this global stream. 30 billion$ will be added for 5years to strengthen coverage. All medically necessary health technologies will be covered except technologies with cosmetic purpose. To make this strategy be successful, rational coverage decision making system should be reinforced because wasteful healthcare spending is another issue to achieve the goal of UHC.
Main text: The decision makings in NHI (national health insurance) have had profound impact on medical profession and industries in South Korea because the NHI is unique public health insurance in our country. To increase the acceptance of stakeholder in decision making, robustness, transparency and consistency is very important matter. Coverage decision science may necessary for this process, which consists of evidence, cost, value and decision methodology in the context of the principles of NHI coverage. The benefit should be evaluated in the context of not only the balance of benefit and harm but also clinically meaningful effect size. Value frameworks of ASCO (American society of clinical oncology) and ESMO(European society of medical oncology) and the concept of MCID(minimal clinical important difference) are good examples. The appraisal process for deliberation of the benefit, cost and cost-effectiveness of the health technologies with other social value should be standardized and supported by well formed guideline for decision making, which consist of principle of coverage decision, methodology of preparing of information related to evidence and value, desirable composition of the committee and decision methodologies.
Conclusion: Evidence informed value based decision making process may have critical role in making coverage decision to strengthen public coverage rate. According to the principles in NHI, evidence, cost and value of the health technologies should be appraised and the method to make decision also should be standardized for transparent and consistent decision making. We need decision guideline for NHI coverage decision making process. Professional autonomy and responsibility should also be emphasized.
|
|
|
KEYWORD
|
|
|
Evidence-based medicine, Value-based decision, Benefit, Value, Decision
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|