Price Negotiation for One-shot Treatment Zolgensma

Ultra high price drug in the U.S

Health insurance benefits will be available on August 1st if it is settled within the deadline

Most patients with spinal muscular dystrophy are children

Zolgensma of Novartis, which passed the Drug Reimbursment Evaluation Committee of the HIRA on the 12th of last month, began negotiations on drug prices to register health insurance benefits.

 

Given that Kymriah of the same company, which has attracted attention as a once-in-a-lifetime drug, succeeded in being reimbursed two months after passing the Drug Reimbursment Evaluation Committee, attention is being paid to whether Kymriah will be able to proceed quickly.

 

According to the industry on the 3rd, the NHIS and Korea Novartis will start negotiations on the drug price for the SMA treatment Zolgensma on the 25th of last month and proceed for two months until the 25th of next month.

 

Earlier on the 12th of last month, Zolgensma was recognized as a condition for pre-approval of medical care benefits and application of RSA and caps based on patient performance at the Drug Reimbursement Evaluation Committee.

 

Zolgensma is an ultra-high-priced drug sold in the U.S.

 

for about 2.5 billion won, and it is urgent to register health insurance benefits for patients to relieve their economic burden and receive medication.

 

There are many opinions asking for registration in that most of the patients with SMA, a rare disease, are children.

 

The political community has welcomed the passage of the Drug Reimbursment Evaluation Committee.

 

Choi Hye-young, a member of the Democratic Party of Korea, posted an SNS post titled "We are happy that it passed the Drug Reimbursment Evaluation Committee for SMA treatment," and Lee Jong-sung also said, "The adequacy of health insurance benefits for Zolgensma was recognized at the first review of the Yoon Seok-yeol government." "It is a decision that fits the policy philosophy of the Yoon Seok-yeol government to further protect the people in need," he welcomed.

 

Zolgensma is compared to Kymriah, which previously succeeded in reimbursement for it, in that it is administered once in a lifetime and sold by Novartis.

 

With the registration of Kymriah health insurance, it can be administered at up to 5.98 million won.

 

As political circles and patient groups are paying keen attention, attention is being reimbursed to whether Zolgensma will succeed in making reimbursement as fast as Kymriah.

 

If the drug price is settled within the negotiation period, health insurance benefits will also be available from August 1.

 

As ultra-high-priced drugs appear one after another, health insurance finances are expected to be burdened by rising drug costs.

 

Therefore, it is highly likely to affect the pharmaceutical industry depending on what position the Yoon Seok-yeol administration, which has just started, takes on the issue of drug cost management.

 

Some analysts say that there is a possibility that generic drugs may be considered to be lowered due to the influence of the ultra-high-priced new drug registration.