JLK, Non-Covered Fee for Stroke AI Solution Set at '54,300 Won'

Jeil LK announced on the 31st that the non-reimbursable fee for its stroke artificial intelligence (AI) solution 'JBS-01K' has been set at 53,000 KRW.

On the 26th, the Ministry of Health and Welfare, through the 21st Health Insurance Policy Deliberation Committee, granted the first non-reimbursable health insurance status to Jeil LK's stroke solution ‘JBS-01K’ (ischemic stroke subtype classification) among AI medical devices. Considering it as an unprecedented new medical technology, two options were prepared: selective reimbursement and non-reimbursement.

According to the criteria for selective reimbursement, the specialist reading fee for special imaging diagnostics such as MRI and CT is 1,810 KRW. However, for Jeil LK’s solution classified as a non-reimbursable item, even with the upper limit system applied, a fee up to 54,300 KRW, which is 30 times the reading fee, can be charged.

The non-reimbursable fee for JBS-01K set by the Ministry of Health and Welfare is 54,300 KRW, which is relatively lower than the 80,000 KRW previously set by the company. This reflects the government’s policy to prevent patients from bearing excessive costs in medical settings, thereby reducing the financial burden on patients.

Stroke requires 2 to 3 additional MRI scans even after the initial diagnosis, and the AI solution is expected to have high utilization among general patients suspected of stroke at primary and secondary hospitals, as well as during health check-ups, potentially securing a larger market. Especially in university hospitals, where the government determines costs through the non-reimbursable upper limit system, patients are expected to experience high-tech AI solutions with less financial burden.

According to data from the Health Insurance Review & Assessment Service, as of 2022, there are 1.17 million patients with cerebrovascular diseases and 630,000 stroke patients annually. South Korea, having already entered a super-aged society, is expected to see an increase in stroke patients, a frequent severe disease. Including suspected stroke patients and health check-up patients undergoing MRI/CT scans at primary and secondary hospitals excluded from the statistics, the stroke diagnosis market is very large.

The Ministry of Health and Welfare stated, "If a product is evaluated to have significantly improved accuracy or error reduction compared to existing technologies in each category, an additional 10-20% surcharge and recommendations will be applied depending on the product," adding, "We will closely monitor usage in the future and continuously collect feedback from the field to make improvements."

Jeil LK said, “Based on a high level of technological capability, we possess the world’s largest number of solutions covering the entire stroke cycle, and as the first case of AI innovative medical technology applied to health insurance, we have completed verification as Korea’s first.” They added, “Our corporate competitiveness in the domestic market has already reached an incomparable level, so we plan to sequentially apply health insurance fees to our 11 solutions and introduce them to medical sites.”

This content was produced with the assistance of AI translation services.