Reimb of antidiabetic SGLT-2+DPP-4 combo near

Amount of voluntary price cuts remains the key focus of interest

All 10 companies agree on making voluntary price cuts

MOHW explains its strengthened fiscal sharing plan to companies

Procedures such as quality supply contract and reports to Health Insurance Policy Deliberation Committee remains even without drug pricing negotiations

Reimbursement of antidiabetic SGLT-2+DPP-4 class combinations near

Expanding reimbursement to the combined use of SGLT-2 inhibitors and DPP-4 inhibitors as treatment for diabetes has entered its final stages.

 

As the reimbursement will be carried out through voluntary price cuts by pharmaceutical companies as intended by the government, the process may proceed faster than when companies take the drug price negotiation track.

 

However, the fiscal burden on NHI finances, which remains the biggest issue, depends on the size of the voluntary price cuts that will be made by pharmaceutical companies.

 

Therefore, agreeing on the amount of the price cuts may continue for several months.

 

Extending reimbursement to the combined use of three ingredients including SGLT-2 inhibitor class and DPP-4 inhibitor class drugs had been deferred several years due to various reviews and procedures, such as integrating the opinions of the Korean Diabetes Association, analyzing their fiscal impacts, and revising phrases for reimbursement standards.

 

Chang-Hyun Oh, Director of the Pharmaceutical Benefits Division of the Ministry of Health and Welfare explained to the multinational pharmaceutical company press corps, “We have completed analysis on the fiscal impact and selected drugs that will be sharing finances with the reimbursement expansion, and explained to the 10 companies that will be affected on how they will be required to share finances.

 

We are currently collecting opinions from the companies.” As the reimbursement requires changes in the drug price, both the payer and the supplier must agree on the price cut.

 

According to MOHW, all the companies have agreed on making voluntary price cuts and will be subject to voluntary price cuts rather than drug pricing negotiations.

 

The time required for reimbursement can be shortened with voluntary price cuts, as it is a sort of fast track system that allows the omittance of pricing negotiations.

 

This is beneficial for both the government and the payers as it can reduce the financial burden on NHI finances and the company can also raise more sales with extended reimbursement standards.

 

However, the government and the companies still need to reach an agreement after comparing the scale of voluntary price cuts and the amount of NHI finances the government is willing to share.

 

Even afterward, the agenda needs to undergo remaining administrative procedures including signing the quality supply contract and making reports to Health Insurance Policy Deliberation Committee.

 

Therefore, the government explained that it is unsure how long it would take for reimbursements to be extended.

 

Director Oh said, “I can't guarantee that the remaining procedures (such as the opinion collection from companies and other follow-up procedures) will be completed within the month.

 

All companies must sign quality supply contracts with NHIS and complete other procedures.

 

The reimbursement extension can be implemented quicker if its fiscal impact is not so large, but if the parties involved do not reach a complete agreement, the implementation may be further delayed.