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KMID : 1170320170230020061
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Korean Journal of Health Economics and Policy
2017 Volume.23 No. 2 p.61 ~ p.83
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The feasibility of expanding coverage of National Health Insurance for the routine care costs for the participants in the clinical trials in Korea
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Chung Seol-Hee
Cho Jae-Young
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Abstract
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The routine care provided to the participants in the clinical trials has not been covered by National Health Insurance (NHI) in Korea. There have been requests for covering routine care costs associated with care for participants in clinical trials by NHI. This study was performed to secure rationale and define the principles and prerequisites to cover routine care costs of the clinical trials by NHI. For this purpose we studied foreign cases, reviewed literature, surveyed the medical institutions performing clinical trials and consulted experts. We recommend that the routine care costs have to be covered by National Health Insurance for expanding opportunities to care, quality assurance of the care provided to the participants, reduction of health care costs in the NHI, improving of patients` health, and increasing operational efficiency of the NHI. “Routine care” includes the items or services covered by NHI when patients need medical care.
The new system should be designed based on the following principles. First, NHI has to cover the routine care costs needed to treat patients. Second, the benefit coverage of the NHI has to be applied to clinical trials which secure patients` safety. Third, the clinical trials for the academic research have to be covered by NHI. Fourth, management systems are needed which evaluate ethical issues, provide related information and monitor the process and results of the clinical trials covered by NHI. Finally, the existing systems such as Coverage with Evidence Development have to be taken into consideration
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KEYWORD
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routine care costs, clinical trials, benefit coverage, National Health Insurance
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