“Now is the time to reaffirm the identity of the National Evidence-based Healthcare Collaborating Agency (NECA) and to lead changes and innovation. The agency will actively seek efforts to make the healthcare system more efficient.”

Han Kwang-hyub, who recently took office as the fifth president of NECA, said so during an interview with Korea Biomedical Review.

Han vowed to enhance the NECA’s role to support reasonable decision making for healthcare policies through evaluations of healthcare technologies’ safety, efficacy, and feasibility. He also said the NECA would aggressively collaborate with related agencies to establish evidence for Korean healthcare technologies.

To help NECA get recognized better and raise its status, he would also run promotion and cooperation programs actively, he added.

Han is a liver disease expert. He served as the first president of the Asia-Pacific Primary Liver Cancer Expert Association (APPLE), and chairman of the Korean Association for the Study of the Liver. Last year, he became the first Korean president of the International Association for the Study of the Liver (IASL). He has contributed to the government-initiated clinical research advancement since he served as the head of the Liver Cirrhosis Clinical Research Center, designated by the Ministry of Health and Welfare in 2005.

Question: Congratulations on taking office.

Answer: I have received government support for a long time because I have been researching at a university. It is refreshing to be in a position where I provide support. Upon receiving a proposal to serve as NECA president, I sincerely thought about the role of NECA. NECA aims to establish and disseminate a desirable healthcare culture based on scientific evidence. Using my 30 years of clinical experience, I would like to contribute to NECA’s growth and achievement of its goals.

Q: How different is it to be inside NECA from looking at it outside?

A: NECA is not well known to the medical community, from an outsider’s point of view. After I came here, however, I found that NECA was doing more than I thought. The unknown work includes its evaluation of new medical technologies and re-evaluation of medical policies, following the expanded health insurance coverage. I feel sorry that such work of NECA was not promoted well.

NECA aims to use medical resources efficiently and improve public health through the provision of scientific evidence. To put it simply, NECA’s role is to establish and spread a desirable healthcare culture.

Q: Some doctors and healthcare industry officials complain that NECA’s evaluation of new medical technologies overlaps with the work of other government agencies. In contrast, the public seems to want a basis for safer procedures. NECA must find it hard to reach a consensus between these two different voices.

A: Sometimes, the medical community clashes with the government because of conflicting opinions. In those situations, NECA tries to suggest reasonable criteria based on evidence. As I mentioned earlier, NECA is a research institute. So, we don’t make decisions based on the government’s order but evidence. This kind of NECA’s role will become ever more critical.

With the rapid development of medical technologies, new technologies clash with old ones. People will have to decide whether to put money in new technologies or to improve the existing ones. In some cases, a developer will have to make projections about post-marketing situations during a clinical trial stage. Considering these changes, NECA's role, which proposes a desirable standard based on evidence, will grow larger.

Q: To make NECA’s voices better heard, the agency needs to raise its status. Considering many organizations are adopting technologies that utilize AI or big data, do you think the current size of the NECA is enough to manage all those issues?

A: NECA started with 30 to 40 employees but now, the number has grown to more than 160, and the annual budget grew up to 17 billion won ($13.8 million). Considering the entire size of Korea’s healthcare service, our budget is never large. So, we cannot engage in specific healthcare issues.

Q: What kind of projects do you wish to push?

A: I hope NECA could help medical societies review treatment guidelines, update them, and run a training program to create scientific evidence. Medical communities set their standards and make treatment guidelines on their own, but some are ambiguous. NECA can help solve this problem. Such an issue is not only in colleges and academic organizations but in primary clinics. So, we are seeking cooperation with various related institutions.

Q: Medical societies are already running their guidelines, and how can NECA help update them?

A: Korea has already become an aged society, and the advancement of medical technologies generated high-cost drugs and equipment. Patients are making various voices. Physicians, patients, and guardians have different ideas about the extent to which an aggressive treatment is aggressive and old enough to avoid surgery for cancer.

It is not a simple matter to make conclusions by collecting opinions from one or two societies on these vague issues. So, NECA can make reasonable evidence to address these issues. We can conduct a study using big data, not limited data from one or two medical institutions. When necessary, we could consider a prospective study or a cohort investigation.

Q: Do you mean we need data and research that fit in Korean circumstances?

A: Patients with hepatitis B need to take medicine for the rest of their lives, but there are no studies on whether expensive medication is necessary or if it can be stopped. Drug companies do not support this research. However, such studies are costly. Research design is tricky, and recruiting patients is challenging. Thus, such research should be conducted at a national level.

NECA started the “Patient-Oriented Medical Technology Optimization Research Program” last year, in this context. We will spend 184 billion won for eight years until 2026 to support over 380 projects. Through active discussions, we plan to discover and support social agendas and actively support them.