Severe asthma txs Nucala and Cinqair are to be reimbursed

simultaneously on the 1st of next month

Nucala applies RSA and Cinqair is listed as general reimbursement

Jyseleca is also newly established

Jakavi was added graft-versus-host disease benefits

Reimbursement treatment options for the treatment of severe eosinophilic asthma are expanded.

 

GSK Korea's Nucala and Handok Teva Cinqair will be listed on the payroll simultaneously next month.

 

Eisai's JAK inhibitor Jyseleca will also have new insurance coverage standards, and Novartis' JAK1/JAK2 inhibitor Jakavi will have coverage standards for Graft-versus-host reaction or disease (GVHD) added.

 

Recently, the Ministry of Health and Welfare announced the details of the standards and methods for applying such nursing care benefits.

 

We will begin collecting opinions until the 29th for implementation on the 1st of next month.

 

Nucala and Cinqair are used in adult patients with severe eosinophilic asthma who are not adequately controlled despite high-dose inhaled corticosteroids - long-acting inhaled β2 agonists (ICS-LABA) and long-acting muscarinic antagonists (LAMA).

 

In this case, salary is recognized.

 

Benefits are recognized only when ▲the blood eosinophil level is more than 300 cells/㎕ within 12 months before starting treatment, ▲ four or more acute exacerbations of asthma requiring systemic corticosteroids within 12 months prior to starting treatment, or ▲if oral corticosteroids equivalent to 5 mg/day of prednisone have been administered continuously for 6 months prior to starting treatment or, only when the blood eosinophil level is 400 cells/㎕ or more within 12 months before starting treatment and when there have been three or more acute exacerbations of asthma requiring systemic corticosteroids within 12 months before starting treatment.

 

Continued administration is recognized upon evaluating before and every year after drug administration to ensure that the frequency of acute exacerbations of poly asthma has decreased by more than 50% compared to before starting treatment, ▲for patients who require continuous oral corticosteroid treatment, the oral corticosteroid dose is reduced by more than 50% compared to before starting treatment while improving or maintaining asthma symptom control.

 

Nucala is registered with RSA applied, and Cinqair is registered as a general salary.

 

Accordingly, Nucala's sticker price (maximum price) is much higher, but the actual price is known to be similar.

 

If Cinqair had previously been listed as general, it would have been difficult to apply the RSA for Nucala, but with the two drugs being listed at the same time, they were able to be listed under a different reimbursement procedure track.

 

Jyseleca has a new reimbursement standard for rheumatoid arthritis and moderate-to-severe active ulceritis in adults.

 

The standard for benefits is when the patient does not respond appropriately to or is intolerant to common medications for each disease.

 

For those over 65 years of age, benefits may be recognized if the patient does not respond appropriately to or is intolerant to TNF-α inhibitors.

 

Novartis' JAK1/JAK2 inhibitor Jakavi has additional coverage criteria for steroid-refractory GVHD for those aged 12 years or older.

 

Reimbursement is recognized for acute patients for whom a response is confirmed in a monthly evaluation 2, 4, 6, or 8 weeks after the start of Jakavi administration, and for chronic patients for whom a response is confirmed for a monthly evaluation 3 months after the start of Jakavi treatment.

 

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However, only chronic patients who show a more than adequate response to a daily dose of 10 mg or less can be evaluated at a maximum of 3 months, and re-administration is permitted for patients who stopped after improving.

 

The maximum administration period is up to 6 months for acute administration and up to 3 years for chronic administration.

 

Chronic administration after completion of acute administration, cases where acute and chronic symptoms overlap, and cases where a patient who stopped treatment after improvement relapses and administration exceeds the maximum administration period are case-by-case.

 

In addition, if GVHD progresses during administration (symptoms worsen or new symptoms appear), adverse reactions that prevent administration occur, or systemic treatments other than steroids and calcineurin inhibitors are used, supplementation will be discontinued.

 

Meanwhile, a new reimbursement standard for Celebrex and Layla was also established.

 

Reimbursement is permitted within the scope of approval, but concurrent use of other digestive tract medications to prevent symptoms such as gastritis is not permitted.