NHIS negotiations complete for Erbitux·Zerbaxa·Eylea

and other drugs

Erbitux renews RSA, antibiotic Zerbaxa newly reimbursed

Reimbursement for the drugs may be confirmed at the HIPDC meeting this month

The National Health Insurance Service’s pricing negotiations for Merck’s anticancer drug Erbitux and MSD’s next-generation antibiotic Zerbaxa among others have been completed.

 

In the case of Erbitux, Merck has been conducting drug pricing negotiations with the NHIS upon the expiry of its risk-sharing agreement (RSA) contract.

 

For Zerbaxa, its company, MSD, had been conducting pricing negotiations for its new reimbursement.

 

As both agendas were not listed for deliberation at the MOHW’s Health Insurance Policy Deliberative Committee (HIPDC) meeting last month, industry analysis is that the agendas may likely receive reimbursement approvals at the HIPDC meeting this month.

 

Merck’s Erbitux and Zerbaxa were included in the drug pricing negotiation completion list that NHIS disclosed on its webpage on August 31st.

 

Erbitux (cetuximab) is an anticancer drug indicated for metastatic colorectal cancer and head and neck squamous cell cancer that was approved for reimbursement in March 2014 under the Refund-type RSA in Korea.

 

The company had already succeeded in renewing the agreement once in 2018.

 

Upon its expiry in June this year, Merck has been in negotiations with the NHIS to renew its agreement for the third time.

 

Industry’s prospects on the possibility of RSA renewal have been increasing as Erbitux was included in the negotiation completion list of the NHIS, In the case of Zerbaxa, news of its negotiation completion had already been announced last month.

 

As a result, it is expected that the drug will be added to the reimbursement list after going through the HIPDC review this month.

 

The drug had attempted reimbursement since it was approved in April 2017 in Korea, but had difficulty being listed, being unable to demonstrate adequacy of its reimbursement.

 

However, the government’s coverage expansion plan allowed antibiotics like Zerbaxa to also be included and be eligible to waive pharmacoeconomic evaluations, based on which Zerbaxa was recognized adequate for reimbursement at HIRA’s Drug Reimbursement Evaluation Committee meeting in June.

 

Since then, MSD had been conducting drug pricing negotiations with the NHIS, which were successfully concluded at the end of last month.

 

The NHIS’s disclosure of such has made the negotiation completion official.

 

Zerbaxa is a next-generation antibiotic indicated for use in combination with metronidazole for complicated intra-abdominal infections (cIAI) and complicated urinary tract infections.

 

The antibiotic is receiving particular attention as a ‘super antibiotic’ that can be used against multidrug-resistant bacteria.

 

In addition, the NHIS also announced the completion of drug price negotiations for Takeda's anticancer drug 'Adcetris (brentuximab vedotin)' and Bayer's age-related macular degeneration drug ‘Eylea.’ The drugs have been in negotiations with the NHIS since June under category ‘Type B’ of the Price-Volume Agreement.

 

PVA negotiations under Type B are applied every year when the claims amount increases by over 60% from the previous year, or the rate of increase is over 10% and exceeds KRW 5 billion for drugs in the same therapeutic class for which the maximum amount had already been adjusted according to type A or exceeded 4 years since its initial listing but had not undergone type A negotiations.

 

The price of subject drugs are discounted within the 10% range after pricing negotiations with the NHIS.