HIRA "Reimb application of Wegovy has not been filed"

Once it's filed, we will ensure that it is evaluated fairly and swiftly

Reimbursement appropriateness must be evaluated based on the clinical efficacy and cost-effectiveness of the drug

Rep. Kim Seon-min inquired about HIRA's plans for managing Wegovy under the National Health Insurance reimbursement

Product photo of Wegovy

The Health Insurance Review & Assessment Service (HIRA) announced that it will conduct a fair and swift evaluation if an application for reimbursement is submitted for Novo Nordisk's popular obesity drug, Wegovy (semaglutide).

 

HIRA clarified that since Wegovy's company has not yet applied for reimbursement, HIRA is yet at the stage of determining Wegovy's National Health Insurance reimbursement.

 

HIRA stated recently after a recent inquiry from Rep.

 

Kim Seon-min of the Cho Kuk Innovation Party regarding the reimbursement status of Wegovy.

 

Rep.

 

Kim had asked HIRA for its stance on a plan to transition the non-reimbursed prescription drug Wegovy to National Health Insurance coverage and management.

 

Rep.

 

Kim likely inquired about the management plan related to the significant prescription volume of Wegovy, which has garnered immense popularity since its launch in Korea.

 

According to data from the Drug Utilization Review (DUR) system, approximately 400,000 prescriptions for Wegovy have been issued in the roughly eight months since its launch in October 2024, which translates to about 80,000 prescriptions per month.

 

The non-reimbursed prescription price for Wegovy ranges from KRW 200,000 to 300,000 for the 0.25mg, 0.5mg, and 1.00mg doses, and over KRW 400,000 for the 1.70mg and 2.40mg doses.

 

Related to this, Rep.

 

Kim has raised the need for managing the side effects that arise from people who are not overweight or obese using these drugs for cosmetic purposes.

 

The medical community has also pointed out that some doctors are prescribing Wegovy and other obesity drugs for cosmetic, rather than therapeutic, purposes.

 

This practice, they argue, can lead to repeated prescriptions and illegal trading of excessively prescribed medicines on online platforms.

 

To address these issues, the medical community is proposing that obesity treatments be brought under the National Health Insurance system, subjecting them to a public monitoring and management system.

 

In response to these concerns, Rep.

 

Kim asked HIRA for its plan to manage the side effects of Wegovy through reimbursement.

 

However, HIRA's response was general and procedural.

 

HIRA explained, "For a new drug to be listed for reimbursement, the pharmaceutical company must first apply for reimbursement to the Minister of Health and Welfare and the head of HIRA, along with the necessary documentation," and added, "Then, this is followed by HIRA will evaluate the drug's clinical utility and cost-effectiveness, followed by drug price negotiations with the National Health Insurance Service.

 

Finally, a notification is issued by the Ministry of Health and Welfare." HIRA said, "Wegovy's manufacturer had not yet submitted a reimbursement application after its approval by the Ministry of Food and Drug Safety," and added, "If an application for this drug is submitted in the future, we will ensure that it is evaluated fairly and swiftly." Meanwhile, the decision on National Health Insurance reimbursement for new obesity drugs, such as Wegovy, will be based on South Korea's health insurance finances, reimbursement equity, and the cost-effectiveness of these drugs.