The expansion of health insurance coverage for CAR-T cell therapy, a high-priced blood cancer treatment costing hundreds of millions of won, is controversial. Although this treatment has shown clinical results to be effective for blood cancer patients who do not respond to existing treatments, the review by the Health Insurance Review and Assessment Service (HIRA) is being delayed due to its high price and financial burden. While the medical community argues that early administration can increase treatment efficacy and reduce socioeconomic losses, calling for expanded coverage, authorities maintain that cost-effectiveness and financial impact must be considered. In this situation, a multi-layered model such as a performance-based risk-sharing scheme is being presented as a realistic alternative.
