Table 3.

The Evaluation Criteria for the Selective Benefit Program in South Korea ⁽³⁵⁾.

Aspects	Consideration elements
Clinical usefulness	①In case of proven clinical effectiveness:
	-If clinical effectiveness is proven equal or higher as an important clinical indicator when compared to alternative reimbursed items
	-If it is used for direct therapeutic purposes as an essential material in medical technologies
	-If increased diagnostic accuracy is proven and improved therapeutic outcome is expected in a diagnostic test
	②In case of proven improvement in medical process and it is expected to bring improved treatment outcomes:
	-If it is expected to bring improved treatment outcomes with improved medical processes, although there is not enough reasonable evidence when compared to alternative reimbursed items
	-If it is expected to bring improved treatment outcomes with proving improvement of convenience in medical technologies
	-If it is difficult to be expected to bring improved treatment outcomes, but the increase of the diagnostic accuracy is proven
	③In case of proven improvement in medical process, but it is not expected to bring improved treatment outcomes or the improvement in medical processes is not proven:
	-In case of medical technologies, if the improvement of convenience is proven, but it is not expected to bring improved treatment outcomes, or the improvement of convenience is not proven
	-In case of diagnostic tests, if the diagnostic accuracy is not proven
Cost-effectiveness	①In the case it is cost-effective:
	-If its effectiveness is similar or improved compared to alternative reimbursed items with the same costs or reduced costs
	②In the case it is not cost-effective or it is unclear:
	-If its effectiveness is similar or improved compared to alternative reimbursed items with high costs
	-Its effectiveness is low compared to alternative reimbursed items
Replaceability	①Irreplaceable cases:
	-If there are no reimbursed items available for patient
	-If there are no reimbursed items available for patients as an essential material for treatment
	②Replaceable case:
	-If there are reimbursed items that are available for patients
	-If it is implemented for support of existing items
	-If there are reimbursed items available for patients as an essential material for treatment
	-If it is used additionally according to the decision of users but not essential for the treatment
Social demand on reimbursement	①In case there is high social demand on reimbursement:
	-Considering the detailed assessment factors comprehensively, if there are high social interests and great power of influence for reimbursement
	②In case there is low social demand on reimbursement
	-Considering the detailed assessment factors comprehensively, if there is low social interest and great power of influence for the reimbursement