Health Insurance Policy Deliberation Committee Revises Coverage Criteria for Root Canal Treatment
Coverage for Bavencio Injection and CPAP Device Criteria Also Adjusted
Photo by Asia Economy DB
[Asia Economy Reporter Choi Dae-yeol] Health insurance coverage for dental nerve treatment (root canal treatment) will be expanded.
The Ministry of Health and Welfare announced on the 25th that at the 17th Health Insurance Policy Deliberation Committee meeting held this year, they discussed a proposal to change the health insurance benefit standards for dental root canal treatment. Root canal treatment has the advantage of preserving natural teeth instead of extraction treatments like dentures or implants, but due to pain during treatment and the need for frequent treatments, the number of procedures has been decreasing recently.
According to related academic societies, the number of root canal treatments decreased from about 8.06 million cases in 2014 to about 7.88 million cases in 2018. Meanwhile, the number of extractions increased from 5.66 million to 6.14 million during the same period. Chronic diseases such as diabetes have made root canal treatment more difficult, and the failure rate has also increased to about 20%, which has had an impact.
The area where health insurance benefit standards are being expanded this time is the examination to accurately measure the length of the root canal, which will increase from once to three times. The root canal length is the length of the canal inside the tooth through which nerves or blood vessels pass. Root canal shaping, which inserts filling material to completely eliminate gaps inside the root canal, will also increase from once to twice.
Root canal cavity shaping will also be recognized in difficult retreatment cases. This is a treatment method that uses high-speed rotary instruments to remove the upper part of the tooth (enamel and dentin) of the root canal and create space. This health insurance coverage expansion plan will be implemented from November by revising the Ministry of Health and Welfare notice. The ministry also stated that benefit standards may be adjusted if necessary after implementation.
In addition, the upper limit price for the metastatic Merkel cell carcinoma treatment drug Bavencio Injection (Korea Merck) will be set at 1,226,243 KRW per vial, reducing the patient burden from about 4 million KRW to about 180,000 KRW. This notice will be applied starting next month on the 1st. Regarding positive airway pressure devices used for snoring and sleep apnea treatment, due to concerns that mild patients are receiving insurance coverage without proper use, the apnea-hypopnea index criteria will be raised and the patient co-payment rate during the compliance period will be increased. This strengthens the management system so that only patients who truly need it can receive benefit coverage.
For continuous glucose monitoring electrodes mainly used by pediatric diabetes patients, the benefit standard amount was set weekly, but will now change to a method that considers the number of usage days per product. A registration procedure for beneficiaries of automatic peritoneal dialysis consumables and oxygen therapy services will be newly established, and those with a history of receiving benefits will be registered as beneficiaries collectively by the National Health Insurance Corporation.
© The Asia Business Daily(www.asiae.co.kr). All rights reserved.
