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KMID : 0370220220660040161
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Yakhak Hoeji
2022 Volume.66 No. 4 p.161 ~ p.168
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Current Status and Improvement of Reimbursement Policy for Insulin Delivery Device in Korea: Toward Universal Use of Artificial Pancreas
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Yoon E-Zeong
Kim Jae-Hyeon
Jeon Na-Kyung
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Abstract
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Intensive insulin therapy is the primary treatment option for patients with type 1 and uncontrolled type 2diabetes. Insulin pump therapy and multiple daily insulin injections (MDI) are the principal methods of intensive insulintherapy. The clinical utility of an insulin pump is generally greater than an MDI regimen. An artificial pancreas, which isan insulin pump with an integrated continuous glucose monitor (CGM), has recently been introduced on the market withemerging clinical evidence. Although it may offer clinical benefits and reduce the self-management burden among patientswith diabetes, its potential for inappropriate use and unaffordability are the major barriers to its universal utilization.
Despite the medical assistance program offered by the Korean National Healthcare System, which provides coverage forconsumables and devices for diabetes treatment, some patients cannot afford to use an advanced insulin delivery system(i.e., the artificial pancreas). Under the current reimbursement policy, the healthcare system considers an insulin pump anda CGM as separate items for regulatory and reimbursement purposes. In other words, the artificial pancreas is categorizedas an insulin pump and reimbursed at the same amount as a traditional insulin pump. The fundamental operating functionmay be the same between the artificial pancreas and a traditional insulin pump; however, there should be a differentreimbursement pathway to make a novel category for the artificial pancreas instead of categorizing it under insulin pumpsand to differentiate pricing based on the comparative (cost-) effectiveness among insulin delivery devices. Other countriessuch as the United States, the United Kingdom, Germany, and France are moving toward rapid and universal adoption ofthe artificial pancreas supported by their clinical governance and regulatory affairs. In this review, we highlight the needto improve the accessibility and affordability of advanced diabetes technology by discussing the current issues in thereimbursement policy that limit the universal use of advanced insulin delivery devices in Korea.
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KEYWORD
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Artificial pancreas, Diabetes, Insulin pump, Continuous Glucose Monitoring, Reimbursement
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