JLK's stroke solution 'JBS-01K,' which earned the title of 'the first artificial intelligence (AI) medical device covered by the National Health Insurance,' is entering the market as a non-reimbursable item.
On the 31st, JLK announced that the non-reimbursable cost of JBS-01K under the National Health Insurance has been set at 54,300 KRW. This is somewhat lower than the previously set price of 80,000 KRW, reducing the burden on patients. A company representative stated, "Patients must bear all additional costs," but added, "Considering the importance of stroke as a disease and the time-saving effect, we expect patients to choose the JBS-01K solution."
Stroke is divided into cerebral hemorrhage (hemorrhagic stroke), caused by the rupture of brain blood vessels, and cerebral infarction (ischemic stroke), caused by blockage of brain blood vessels. JBS-01K is an AI solution that can rapidly perform, within one minute, the detection and classification of lesions through magnetic resonance imaging (MRI) interpretation, which previously took a long time, specifically for cerebral infarction.
This decision follows the Ministry of Health and Welfare's preparation of a specific National Health Insurance fee schedule for AI medical devices through discussions at the Health Insurance Policy Deliberation Committee on the 26th. The Ministry set an upper limit of 1,810 KRW for additional fees related to special imaging diagnostics such as MRI, computed tomography (CT), and positron emission tomography (PET). However, JLK applied a non-reimbursable fee set at 54,300 KRW, which is 30 times the upper limit. Although National Health Insurance benefits are not paid, the product has entered the market as a non-reimbursable item with a code generated and managed within the National Health Insurance system, thus meeting patients within the framework of the National Health Insurance system.
The company expects that since stroke requires 2 to 3 additional MRI scans after the initial diagnosis, and the AI solution will have high utilization among general patients suspected of stroke at primary and secondary hospitals as well as during health checkups, it will secure a larger market. In particular, university hospitals will determine costs through the government's non-reimbursable price ceiling system, allowing patients to experience high-tech AI solutions with less financial burden.
According to the Health Insurance Review and Assessment Service, there were 1.17 million patients with cerebrovascular diseases last year, including 630,000 stroke patients, indicating a large number of patients annually. In South Korea, which has already entered a super-aged society, the number of stroke patients, a frequent severe disease, is expected to increase every year. Including suspected stroke patients and health checkup patients undergoing MRI or CT scans at primary and secondary hospitals, which are excluded from the statistics, the stroke diagnosis market is very large.
Additionally, JLK stated that since the Ministry of Health and Welfare plans to apply an additional 10-20% fee increase and recommendations for products that demonstrate significantly improved accuracy or error reduction compared to existing technologies by category, they will closely monitor usage and continuously gather field feedback to improve the system in the future.
JLK said, “Based on a high level of technological expertise, we possess the world's largest number of solutions responding to the entire stroke cycle, and we have completed verification as the first domestic case of AI-based innovative medical technology covered by National Health Insurance,” adding, “We plan to sequentially apply National Health Insurance fees to our 11 solutions and introduce them to the medical field.”
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