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Application of the Health Technology Assessment in Korean Traditional Medicines.

卫生技术评估在韩国传统医药中的应用。

  • 影响因子:1.75
  • DOI:10.1089/acm.2020.0359
  • 作者列表:"Kwon HY","Kim HL","Kim J
  • 发表时间:2021-01-01
Abstract

: Background: South Korea is the first Asian country to adopt health technology assessment (HTA) as a tool to support decision-making concerning pricing and reimbursement of drugs in 2007. Korean traditional medicines have been continuously marginalized in the modern paradigm of evidence-based medicine. To nurture Korean medicines, clinical practice guidelines for Korean medicines have been developed through government-led initiatives, and HTAs have been applied for the National Health Insurance coverage of Korean medicines. In this study, 27 diseases were selected for analyzing the evidence development of both clinical and economic values of Korean medicines. Methods: To investigate the status quo in application of HTA in Korean medicines, reports on the cost-effectiveness analysis project comprising 27 Korean medical interventions were reviewed. Results: All the selected studies were trial-based economic appraisals and their effectiveness was estimated with a subjective judgment tool, such as the quality of life measurement or visual analog scale. This study reconfirmed the limitations of Korean medicines, which included a short observation period, nonrandomized controlled trials, small sample size, subjective assessment for efficacy, selection bias, large uncertainty, and lack of evidence. Conclusions: Priorities should be placed on establishing the clinical evidence of Korean medicines, which will serve as the base for expanding the health coverage of Korean medicines and improving satisfaction and reliability of oriental medicines in Korea's health care system. Furthermore, the need to nurture the institutional environment in which both oriental and Western medicines can collaborate in Korea should be emphasized.

摘要

: 背景: 2007年,韩国是第一个采用卫生技术评估 (HTA) 作为支持药品定价和报销决策的工具的亚洲国家。韩国传统药物在循证医学的现代范式中不断被边缘化。为了培育韩国药品,通过政府主导的举措制定了韩国药品的临床实践指南,并将HTAs应用于韩国药品的国家健康保险覆盖范围。在这项研究中,选择了27种疾病来分析韩国药物的临床和经济价值的证据发展。 方法: 为了调查HTA在韩国药品中的应用现状,回顾了包括27项韩国医疗干预措施的成本-效果分析项目的报告。 结果: 所有选定的研究都是基于试验的经济评估,其有效性是用主观判断工具估计的,如生活质量测量或视觉模拟量表。这项研究再次证实了韩国药物的局限性,包括观察期短,非随机对照试验,样本量小,疗效主观评估,选择偏倚,不确定性大,缺乏证据。 结论: 应优先考虑建立韩国药品的临床证据,这将成为扩大韩国药品健康覆盖面和提高东方药品在韩国医疗保健系统中的满意度和可靠性的基础。此外,应强调需要培育东方和西方药物可以在韩国合作的体制环境。

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