SGLT2+DPP4 standards expanded, will it be over again?

The MOHW induces voluntary cuts due to the expansion of the scope of use

ach company has a different position, and it cannot be applied within the year due to procedures

from left to left, Forxiga, Jardiance, Xigduo XR, Jardiance Duo

The expanded application of salary standards for the combination of diabetes treatment SGLT-2 inhibitor-based drugs and DPP-4 inhibitor-based drugs is expected to pass another year.

 

Since the Korean Diabetes Association requested expansion in 2016, there have been expectations for application within this year as full-scale discussions have been underway, but in fact, it is unlikely to be applied this year.

 

According to the industry on the 23rd, the Ministry of Health and Welfare is expected to receive a voluntary cut rate from related companies by this week and conduct a financial impact analysis based on it.

 

If the expected financial scope is satisfied by the weak reduction, it will be reflected in the salary through a report by the Health Insurance Policy Review Committee.

 

Analysts say that it is difficult to apply this year because each company has a different position and the constitutional review was held on the 23rd to reflect benefits in December.

 

The Ministry of Health and Welfare held a meeting with pharmaceutical companies last week regarding the expansion of the benefit standards for diabetes treatments and asked each company to suggest ways to voluntarily cut them.

 

As a result, pharmaceutical companies are expected to submit data on how to cut the upper limit through their own analysis to the Ministry of Health and Welfare by this week.

 

The Ministry of Health and Welfare's mention of the option of voluntary cuts is interpreted as a move to quickly conclude that the expansion of salary standards has a greater impact on finances than expected.

 

In June, the HIRA announced that it is currently analyzing the financial direction while reviewing the salary standards for three drugs such as Metformin+SGLT-2+DPP-4, metformin+SGLT-2+TZD, and some items of SGLT-2+sulfonylurea or insulin combination.

 

It was necessary to complete the change in standards and drug price evaluation after completing the financial impact and deliberation by the Drug Benefit Evaluation Committee.

 

The drug price is determined by the standard according to the increase in the expected amount of claims.

 

Drug prices will be lowered by a maximum of 5%.

 

However, the Ministry of Health and Welfare encouraged pharmaceutical companies to voluntarily cut the price before deliberation by the committee.

 

This is because the voluntary reduction drug to expand the scope of use can be applied through the report of the Health Policy Review Committee immediately after skipping the committee's deliberation.

 

Analysts say that this is because even if the upper limit is cut by up to 5% according to the set procedure, it far exceeds the expected fiscal range.

 

Accordingly, it is known that the government plans to reduce the level of fiscal input as much as possible by inducing a larger range of voluntary cuts.

 

In particular, the Ministry of Health and Welfare reportedly ordered pharmaceutical companies with SGLT-2 drugs, which are expected to see a high rise in claims, to make a large cut.

 

The pharmaceutical companies that accepted the proposal are in different positions.

 

It is said that some pharmaceutical companies with low-claimed items have already voluntarily replied that they will not cut drug prices.

 

On the other hand, pharmaceutical companies with large claims are expected to accept voluntary weak cuts and present a cut rate to the Ministry of Health and Welfare.

 

Some analysts say that if the voluntary cut rate falls short of expectations through financial impact analysis, it may be difficult to expand the combined salary.

 

On the other hand, if the cut-rate meets expectations, the pace of salary application is expected to accelerate.

 

The overall atmosphere is that it will be difficult to apply this year.

 

In addition, it is unknown at the moment whether to apply expansion to items that have not chosen voluntary cuts.

 

The HIRA official said, "We know that we will receive voluntary cuts from each company and then examine whether it is appropriate to expand benefits through financial impact analysis." He said, "I understand that nothing has been decided yet about the subsequent procedure."