<![CDATA[
<div class="figure-file" data-ke-type="file" data-file-src="https://t1.daumcdn.net/cafeattach/1Yuf4/d1e138f86f8b6f80fc795ccb72147db0f6fa7de2?download" data-file-name="[2.25.금.건정심_종료(시간추후_문자공지)이후]_2022년_제5차_건강보험정책심의위원회_개최(2.25).hwp" data-file-size="166400" data-mimetype="application/haansofthwp" data-ke-align="alignCenter"><a href='javascript:fileFilterViewer("https://t1.daumcdn.net/cafeattach/1Yuf4/d1e138f86f8b6f80fc795ccb72147db0f6fa7de2?download", "/cafeattach/1Yuf4/d1e138f86f8b6f80fc795ccb72147db0f6fa7de2", "[2.25.금.건정심_종료(시간추후_문자공지)이후]_2022년_제5차_건강보험정책심의위원회_개최(2.25).hwp", "grpid%3D1Yuf4%26fldid%3DDRP7%26dataid%3D1175%26fileid%3D4%26regdt%3D20220226220730&url=https%3A%2F%2Ft1.daumcdn.net%2Fcafeattach%2F1Yuf4%2Fd1e138f86f8b6f80fc795ccb72147db0f6fa7de2")'><div class="image"></div><div class="desc"><div class="filename"><span class="name">[2.25.금.건정심_종료(시간추후_문자공지)이후]_2022년_제5차_건강보험정책심의위원회_개최(2.25)</span><span class="type">.hwp</span></div><div class="size">162.50KB</div></div></a></div><p> </p><p> </p><p> </p><p> </p><p><span style="color: #000000; background-color: #ebdef1;"><</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">약제</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">급여적정성</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">재평가</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">추진상황</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">및</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">향후</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">계획</span><span style="color: #000000; background-color: #ebdef1;"> </span><span style="color: #000000; background-color: #ebdef1;">></span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">□</span><span style="color: #000000;"> </span><span style="color: #000000;">보건복지부는</span><span style="color: #000000;"> </span><span style="color: #000000;">제</span><span style="color: #000000;">1</span><span style="color: #000000;">차</span><span style="color: #000000;"> </span><span style="color: #000000;">국민건강보험종합계획</span><span style="color: #000000;">(2019</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">5</span><span style="color: #000000;">월</span><span style="color: #000000;">)</span><span style="color: #000000;">에</span><span style="color: #000000;"> </span><span style="color: #000000;">따라</span><span style="color: #000000;">, 2022</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">2023</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">약제</span><span style="color: #000000;"> </span><span style="color: #000000;">급여</span><span style="color: #000000;"> </span><span style="color: #000000;">적정성</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가</span><span style="color: #000000;"> </span><span style="color: #000000;">대상</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">을</span><span style="color: #000000;"> </span><span style="color: #000000;">선정</span><span style="color: #000000;">*</span><span style="color: #000000;">하고</span><span style="color: #000000;"> </span><span style="color: #000000;">각각</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가</span><span style="color: #000000;">를</span><span style="color: #000000;"> </span><span style="color: #000000;">추진한다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;"> </span><span style="color: #000000;">○</span><span style="color: #000000;"> </span><span style="color: #000000;">급여</span><span style="color: #000000;"> </span><span style="color: #000000;">적정성</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가는</span><span style="color: #000000;"> </span><span style="color: #000000;">보험</span><span style="color: #000000;"> </span><span style="color: #000000;">약제</span><span style="color: #000000;"> </span><span style="color: #000000;">사후관리의</span><span style="color: #000000;"> </span><span style="color: #000000;">일환</span><span style="color: #000000;">으로</span><span style="color: #000000;">,</span><span style="color: #000000;"> </span><span style="color: #000000;">건강보험</span><span style="color: #000000;"> </span><span style="color: #000000;">약제비</span><span style="color: #000000;"> </span><span style="color: #000000;">지출</span><span style="color: #000000;">을</span><span style="color: #000000;"> </span><span style="color: #000000;">효율화</span><span style="color: #000000;">하기</span><span style="color: #000000;"> </span><span style="color: #000000;">위해</span><span style="color: #000000;"> </span><span style="color: #000000;">2020</span><span style="color: #000000;">년</span><span style="color: #000000;">부터</span><span style="color: #000000;"> </span><span style="color: #000000;">추진</span><span style="color: #000000;">되었다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">    </span><span style="color: #000000;">* </span><span style="color: #000000;">재평가 대상 품목 선정기준 </span><span style="color: #000000;">: </span><span style="color: #000000;">①청구현황</span><span style="color: #000000;">(</span><span style="color: #000000;">청구금액 연간 총 청구액의 </span><span style="color: #000000;">0.1% </span><span style="color: #000000;">이상</span><span style="color: #000000;">(</span><span style="color: #000000;">약 </span><span style="color: #000000;">191</span><span style="color: #000000;">억 원</span><span style="color: #000000;">) </span><span style="color: #000000;">및 최근 증가율</span><span style="color: #000000;">) </span><span style="color: #000000;">②제외국</span><span style="color: #000000;">(A8) </span><span style="color: #000000;">허가 및 급여현황 ③정책적·사회적 요구도</span><span style="color: #000000;"> ④기타 약제급여평가위원회가 필요하다고 인정하는 경우 등 고려</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">□</span><span style="color: #000000;"> </span><span style="color: #000000;">2020</span><span style="color: #000000;">년</span><span style="color: #000000;">에는</span><span style="color: #000000;"> </span><span style="color: #000000;">뇌</span><span style="color: #000000;"> </span><span style="color: #000000;">대사</span><span style="color: #000000;"> </span><span style="color: #000000;">개선제인</span><span style="color: #000000;"> </span><span style="color: #000000;">‘</span><span style="color: #000000;">콜린알포세레이트’</span><span style="color: #000000;"> </span><span style="color: #000000;">약제</span><span style="color: #000000;">를</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가하여</span><span style="color: #000000;"> </span><span style="color: #000000;">치매를</span><span style="color: #000000;"> </span><span style="color: #000000;">제외한</span><span style="color: #000000;"> </span><span style="color: #000000;">뇌</span><span style="color: #000000;"> </span><span style="color: #000000;">대사</span><span style="color: #000000;"> </span><span style="color: #000000;">관련</span><span style="color: #000000;"> </span><span style="color: #000000;">상병은</span><span style="color: #000000;"> </span><span style="color: #000000;">임상적</span><span style="color: #000000;"> </span><span style="color: #000000;">유용성이</span><span style="color: #000000;"> </span><span style="color: #000000;">미흡함에</span><span style="color: #000000;"> </span><span style="color: #000000;">따라</span><span style="color: #000000;"> </span><span style="color: #000000;">환자부담률</span><span style="color: #000000;">을</span><span style="color: #000000;"> </span><span style="color: #000000;">30%</span><span style="color: #000000;">에서</span><span style="color: #000000;"> </span><span style="color: #000000;">80%</span><span style="color: #000000;">로</span><span style="color: #000000;"> </span><span style="color: #000000;">변경</span><span style="color: #000000;">하였다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">    </span><span style="color: #000000;">* </span><span style="color: #000000;">임상적 유용성 평가</span><span style="color: #000000;">: </span><span style="color: #000000;">관련 교과서</span><span style="color: #000000;">, </span><span style="color: #000000;">임상 진료 지침</span><span style="color: #000000;">, </span><span style="color: #000000;">임상 문헌 등을 기반으로 치료 효과성 등에 대한 일관적인 의학적 근거 존재 여부 평가</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;"> </span><span style="color: #000000;">○</span><span style="color: #000000;"> </span><span style="color: #000000;">2021</span><span style="color: #000000;">년</span><span style="color: #000000;">에는</span><span style="color: #000000;"> </span><span style="color: #000000;">건강기능식품과</span><span style="color: #000000;"> </span><span style="color: #000000;">혼용되는</span><span style="color: #000000;"> </span><span style="color: #000000;">5</span><span style="color: #000000;">개</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;"> </span><span style="color: #000000;">약제를</span><span style="color: #000000;"> </span><span style="color: #000000;">평가하여</span><span style="color: #000000;">,</span><span style="color: #000000;"> </span><span style="color: #000000;">‘</span><span style="color: #000000;">실리마린’과</span><span style="color: #000000;"> </span><span style="color: #000000;">‘빌베리</span><span style="color: #000000;"> </span><span style="color: #000000;">건조엑스’</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">은</span><span style="color: #000000;"> </span><span style="color: #000000;">임상적</span><span style="color: #000000;"> </span><span style="color: #000000;">유용성</span><span style="color: #000000;">이</span><span style="color: #000000;"> </span><span style="color: #000000;">부족하여</span><span style="color: #000000;"> </span><span style="color: #000000;">보험급여</span><span style="color: #000000;"> </span><span style="color: #000000;">대상</span><span style="color: #000000;">에서</span><span style="color: #000000;"> </span><span style="color: #000000;">제외</span><span style="color: #000000;">한</span><span style="color: #000000;"> </span><span style="color: #000000;">바</span><span style="color: #000000;"> </span><span style="color: #000000;">있다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">□</span><span style="color: #000000;"> </span><span style="color: #000000;">2022</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">2023</span><span style="color: #000000;">년</span><span style="color: #000000;">에는</span><span style="color: #000000;"> </span><span style="color: #000000;">선정기준</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">전문가</span><span style="color: #000000;"> </span><span style="color: #000000;">자문</span><span style="color: #000000;"> </span><span style="color: #000000;">등을</span><span style="color: #000000;"> </span><span style="color: #000000;">통해</span><span style="color: #000000;">, </span><span style="color: #000000;">등재</span><span style="color: #000000;"> </span><span style="color: #000000;">시기가</span><span style="color: #000000;"> </span><span style="color: #000000;">오래된</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">2021</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가</span><span style="color: #000000;"> </span><span style="color: #000000;">과정에서</span><span style="color: #000000;"> </span><span style="color: #000000;">평가</span><span style="color: #000000;"> </span><span style="color: #000000;">필요성이</span><span style="color: #000000;"> </span><span style="color: #000000;">제기</span><span style="color: #000000;">된</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">으로서</span><span style="color: #000000;"> </span><span style="color: #000000;">임상적</span><span style="color: #000000;"> </span><span style="color: #000000;">유용성</span><span style="color: #000000;"> </span><span style="color: #000000;">등에</span><span style="color: #000000;"> </span><span style="color: #000000;">대한</span><span style="color: #000000;"> </span><span style="color: #000000;">재검토가</span><span style="color: #000000;"> </span><span style="color: #000000;">필요한</span><span style="color: #000000;"> </span><span style="color: #000000;">6</span><span style="color: #000000;">개</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">(2022</span><span style="color: #000000;">년</span><span style="color: #000000;">)</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">8</span><span style="color: #000000;">개</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">(2023</span><span style="color: #000000;">년</span><span style="color: #000000;">)</span><span style="color: #000000;">을</span><span style="color: #000000;"> </span><span style="color: #000000;">대상</span><span style="color: #000000;">으로</span><span style="color: #000000;"> </span><span style="color: #000000;">선정</span><span style="color: #000000;">하였다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p> </p><p><span style="color: #000000;"> </span></p><div class="figure-img" data-ke-type="image" data-ke-style="alignCenter" data-ke-mobilestyle="widthOrigin"><img src="https://t1.daumcdn.net/cafeattach/1Yuf4/c5e1edf14f2c23e2bc69ef3b769eb378bea674e7" class="txc-image" data-img-src="https://t1.daumcdn.net/cafeattach/1Yuf4/c5e1edf14f2c23e2bc69ef3b769eb378bea674e7" data-origin-width="335" data-origin-height="129"></div><p><span style="color: #000000;">  </span><span style="color: #000000;">                                                      </span></p><div class="figure-img" data-ke-type="image" data-ke-style="alignCenter" data-ke-mobilestyle="widthOrigin"><img src="https://t1.daumcdn.net/cafeattach/1Yuf4/755acd04a74dd4ce5570bcb50bbc2705228170aa" class="txc-image" data-img-src="https://t1.daumcdn.net/cafeattach/1Yuf4/755acd04a74dd4ce5570bcb50bbc2705228170aa" data-origin-width="218" data-origin-height="67"></div><div class="figure-img" data-ke-type="image" data-ke-style="alignCenter" data-ke-mobilestyle="widthOrigin"><img src="https://t1.daumcdn.net/cafeattach/1Yuf4/8c673d004e53b10b8f8007fb6b8991fc32faf079" class="txc-image" data-img-src="https://t1.daumcdn.net/cafeattach/1Yuf4/8c673d004e53b10b8f8007fb6b8991fc32faf079" data-origin-width="1280" data-origin-height="127"></div><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;"><2022</span><span style="color: #000000;">년</span><span style="color: #000000;">, 2023</span><span style="color: #000000;">년</span><span style="color: #000000;"> </span><span style="color: #000000;">급여적정성</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가</span><span style="color: #000000;"> </span><span style="color: #000000;">대상</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">(</span><span style="color: #000000;">성분명</span><span style="color: #000000;"> </span><span style="color: #000000;">기준</span><span style="color: #000000;">)</span><span style="color: #000000;">></span></p><div class="table-wrap"><table data-ke-type="table" data-ke-align="alignLeft" style="width: 100%;" border="1"><tbody><tr><td><span style="color: #000000;">연번</span></td><td><span style="color: #000000;">2022</span><span style="color: #000000;">년</span></td><td><span style="color: #000000;">2023</span><span style="color: #000000;">년</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">1</span></td><td><span style="color: #000000;">스트렙토키나제·스트렙토도르나제</span><br><span style="color: #000000;">(streptokinase</span><span style="color: #000000;">·</span><span style="color: #000000;">streptodornase)</span></td><td><span style="color: #000000;">레바미피드</span><br><span style="color: #000000;">(rebamipide)</span></td></tr><tr><td><span style="color: #000000;">효소제제</span></td><td><span style="color: #000000;">소화성</span><span style="color: #000000;"> </span><span style="color: #000000;">궤양용제</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">2</span></td><td><span style="color: #000000;">알마게이트</span><br><span style="color: #000000;">(almagate)</span></td><td><span style="color: #000000;">리마프로스트알파덱스</span><br><span style="color: #000000;">(limaprost)</span></td></tr><tr><td><span style="color: #000000;">제산제</span></td><td><span style="color: #000000;">순환계용약</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">3</span></td><td><span style="color: #000000;">알긴산나트륨</span><br><span style="color: #000000;">(sodium alginate)</span></td><td><span style="color: #000000;">옥시라세탐</span><br><span style="color: #000000;">(oxiracetam)</span></td></tr><tr><td><span style="color: #000000;">소화성</span><span style="color: #000000;"> </span><span style="color: #000000;">궤양용제</span></td><td><span style="color: #000000;">중추신경계용약</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">4</span></td><td><span style="color: #000000;">에페리손염산염</span><br><span style="color: #000000;">(eperisone hydrochloride)</span></td><td><span style="color: #000000;">아세틸엘카르니틴염산염</span><br><span style="color: #000000;">(acetyl L-carnitine hydrochloride)</span></td></tr><tr><td><span style="color: #000000;">골격근</span><span style="color: #000000;"> </span><span style="color: #000000;">이완제</span></td><td><span style="color: #000000;">순환계용약</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">5</span></td><td><span style="color: #000000;">티로프라미드염산염</span><br><span style="color: #000000;">(tiropramide hydrochloride)</span></td><td><span style="color: #000000;">록소프로펜나트륨</span><br><span style="color: #000000;">(loxoprofen sodium)</span></td></tr><tr><td><span style="color: #000000;">진경제</span></td><td><span style="color: #000000;">해열ㆍ진통ㆍ소염제</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">6</span></td><td><span style="color: #000000;">아데닌염산염</span><span style="color: #000000;"> </span><span style="color: #000000;">외</span><span style="color: #000000;"> </span><span style="color: #000000;">6</span><span style="color: #000000;">개</span><span style="color: #000000;"> </span><span style="color: #000000;">성분</span><span style="color: #000000;">(</span><span style="color: #000000;">복합제</span><span style="color: #000000;">)</span><br><span style="color: #000000;">(adenine hydrochloride 2.5mg etc.)</span></td><td><span style="color: #000000;">레보설피리드</span><br><span style="color: #000000;">(levosulpiride)</span></td></tr><tr><td><span style="color: #000000;">간장질환용제</span></td><td><span style="color: #000000;">소화기관용약</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">7</span></td><td rowspan="2"><span style="color: #000000;"> </span></td><td><span style="color: #000000;">에피나스틴</span><span style="color: #000000;"> </span><span style="color: #000000;">염산염</span><br><span style="color: #000000;">(epinastine hydrochloride)</span></td></tr><tr><td><span style="color: #000000;">알레르기용약</span></td></tr><tr><td rowspan="2"><span style="color: #000000;">8</span></td><td rowspan="2"><span style="color: #000000;"> </span></td><td><span style="color: #000000;">히알루론산</span><span style="color: #000000;"> </span><span style="color: #000000;">나트륨</span><span style="color: #000000;">(</span><span style="color: #000000;">점안제</span><span style="color: #000000;">)</span><br><span style="color: #000000;">(sodium hyaluronate)</span></td></tr><tr><td><span style="color: #000000;">안과용제</span></td></tr></tbody></table></div><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">□</span><span style="color: #000000;"> </span><span style="color: #000000;">보건복지부는</span><span style="color: #000000;"> </span><span style="color: #000000;">대상</span><span style="color: #000000;"> </span><span style="color: #000000;">성분의</span><span style="color: #000000;"> </span><span style="color: #000000;">임상적</span><span style="color: #000000;"> </span><span style="color: #000000;">유용성</span><span style="color: #000000;">, </span><span style="color: #000000;">비용</span><span style="color: #000000;"> </span><span style="color: #000000;">효과성</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">사회적</span><span style="color: #000000;"> </span><span style="color: #000000;">요구도</span><span style="color: #000000;"> </span><span style="color: #000000;">등을</span><span style="color: #000000;"> </span><span style="color: #000000;">종합적</span><span style="color: #000000;">으로</span><span style="color: #000000;"> </span><span style="color: #000000;">고려</span><span style="color: #000000;">하여</span><span style="color: #000000;"> </span><span style="color: #000000;">재평가를</span><span style="color: #000000;"> </span><span style="color: #000000;">추진</span><span style="color: #000000;">하고</span><span style="color: #000000;">,</span><span style="color: #000000;"> </span><span style="color: #000000;">평가결과에</span><span style="color: #000000;"> </span><span style="color: #000000;">따라</span><span style="color: #000000;"> </span><span style="color: #000000;">보험급여</span><span style="color: #000000;"> </span><span style="color: #000000;">유지</span><span style="color: #000000;"> </span><span style="color: #000000;">여부</span><span style="color: #000000;"> </span><span style="color: #000000;">결정</span><span style="color: #000000;"> </span><span style="color: #000000;">및</span><span style="color: #000000;"> </span><span style="color: #000000;">환자</span><span style="color: #000000;"> </span><span style="color: #000000;">부담율</span><span style="color: #000000;"> </span><span style="color: #000000;">조정</span><span style="color: #000000;"> </span><span style="color: #000000;">등을</span><span style="color: #000000;"> </span><span style="color: #000000;">실시</span><span style="color: #000000;">할</span><span style="color: #000000;"> </span><span style="color: #000000;">예정이다</span><span style="color: #000000;">.</span></p><p><span style="color: #000000;"> </span></p><p><span style="color: #000000;">    </span><span style="color: #000000;">* </span><span style="color: #000000;">평가기준</span><span style="color: #000000;">: </span><span style="color: #000000;">①임상적 유용성</span><span style="color: #000000;">(</span><span style="color: #000000;">교과서</span><span style="color: #000000;">, </span><span style="color: #000000;">진료지침</span><span style="color: #000000;">, HTA</span><span style="color: #000000;">보고서</span><span style="color: #000000;">, </span><span style="color: #000000;">임상문헌 등</span><span style="color: #000000;">) </span><span style="color: #000000;">②</span><span style="color: #000000;">비용효과성</span><span style="color: #000000;">(</span><span style="color: #000000;">대체가능성 및 투약비용</span><span style="color: #000000;">) </span><span style="color: #000000;">③사회적 요구도</span><span style="color: #000000;">(</span><span style="color: #000000;">재정영향</span><span style="color: #000000;">, </span><span style="color: #000000;">환자부담 등</span><span style="color: #000000;">) </span><span style="color: #000000;">등</span></p>
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자료모음 5
약제 급여적정성 재평가 추진상황 및 향후 계획
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22.02.26 22:07
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