DREC to review the COVID-19 drug Paxlovid a week earlier

Schedule has changed from Sept. 5th to Aug.29th…considering reimbursement listing in October

Product photo of Paxlovid.

The Drug Reimbursement Evaluation Committee (DREC) of the Health Insurance Review and Assessment Service (HIRA) will convene a week earlier than scheduled.

 

The DREC review evaluates the appropriateness of new drugs for reimbursement.

 

Industry analysis suggests that the schedule has changed to quickly list the COVID-19 treatment 'Paxlovid (nirmatrelvir·ritonavir, Pfizer Korea)' for reimbursement.

 

Previously, Minister of Health and Welfare Cho KyooHong stated that, due to the COVID-19 resurgence, Paxlovid will be reimbursed beginning in October.

 

According to industry sources on August 22nd, the 9th DREC review for 2024 will convene on August 29th, a week earlier than the initially planned date of September 5th.

 

The date change to the DREC review is likely due to hastening reimbursement process for Paxlovid.

 

There is not much window of time to implement reimbursement by October, as Director Cho suggested.

 

Typically, even if the duration it takes to negotiate with the National Health Insurance Service (NHIS) can be shortened by prior agreement, it takes 30 days to reach the drug price agreement after a drug passes the DREC review.

 

If the drug were to pass the DREC review in early September as initially scheduled, it would be uncertain whether an agreement could be completed before the late September reporting session of the Ministry of Health and Welfare (MOHW)'s Health Insurance Policy Review Committee.

 

As a result, it appears that an earlier DREC review date was set to provide more time for negotiation.

 

Sources said that NHIS and Pfizer have begun discussing a prior agreement for drug price negotiation.

 

During the COVID-19 spread, the government purchased Paxlovid so patients could use it for free.

 

Since May, patients must pay KRW 50,000, which is approximately 5% of the drug price.

 

It is a temporary measure before the implementation of reimbursement.

 

However, due to the recent COVID-19 resurgence, demand for Paxlovid surged beyond the volume purchased by the government, so the drug is not being delivered to patients on time.

 

As a result, the government aims to proceed with the reimbursement process quickly so that patients with severe diseases can receive medications properly.

 

However, some argue that such a measure is inappropriate because once the reimbursement is applied, the co-payment would be much higher than the current KRW 50,000.

 

Seo Youngseok, a member of the Democratic Party of Korea, criticized, " If Paxlovid price were to be set as KRW 700,000 and with 30% co-payment applied, patient's co-payment will be approximately KRW 200,000," and added, "What it means is that the National Insurance finance and patients will have to bear the financial burden of medication.

 

In other words, the Korea Disease Control and Prevention Agency (KDCA) would fail to fulfill its job." Youngmee Jee, Commissioner of the KDCA, said, "Most countries have listed COVID-19 oral treatments for reimbursement, providing the treatments covered by insurance," and added, "Patient co-payments can be adjustable.

 

We will minimize the financial burden on patients." Some expect Paxlovid's co-payment rate to be further reduced from 30%.