JW’s ‘Actemra’ reviewed for reimbursement as COVID-19 Tx

The arthritis treatment is being widely used off-label to treat severe COVID-19

NHIS starts negotiations to reduce patient burden of paying ₩340,000 per shot

The government is reviewing providing nsurance benefits to JW Pharmaceutical’s rheumatoid arthritis treatment ‘Actemra’ (tocilizumab)’ for the treatment of COVID-19.

 

This is because the drug, which is being often used in Korea off-label to treat patients with severe COVID-19, is increasing patient burden due to its non-reimbursed cost unlike other insured COVID-19 treatments like Remdesivir or Regkirona.

 

Also, due to its shortage in supply, the medical community has asked the government to purchase Actemra like other COVID-19 treatments.

 

According to the NHIS webpage on the 23rd, the authorities have conducted negotiations with JW Pharmaceutical on providing health insurance coverage for ‘Actemra.’ The negotiation has been conducted to lower the burden borne by patients by reimbursing ‘Actemra,’ which is currently widely used in patients with severe COVID-19.

 

However, the negotiation results have not been disclosed yet.

 

An NHIS official said, “the NHIS had conducted negotiations for Actemra recently, but did not share details of the negotiation or its results.

 

The industry believes that discussions on providing insurance support would have been conducted for Actemra for equity with other COVID-19 treatments as the drug is being widely used off-label for patients with severe COVID-19 without reimbursement.

 

Off-label prescriptions of Actemra has increased for the treatment of severe cases of COVID-19 last year, to make YoY growth of 24.9% and record ₩20 billion in sales last year Other COVID-19 treatments such as Remdesivir, Regkirona, and Paxlovid have been fully purchased by the Korea Disease Control and Prevention Agency and are provided free for the patients’ use.

 

However, in the case of Actemra, as the drug was not approved as a COVID-19 treatment, the cost needs to be solely borne by the patient.

 

Actemra, which is used for the treatment of rheumatoid arthritis in adults, costs ₩345,682 per shot without reimbursement, bringing an immense burden on the patients.

 

Regarding the matter, the Korean Society of Infectious Diseases and other medical societies have submitted an opinion to the government to ask for the use of Actemra as a treatment for severe COVID-19.

 

The industry believes it is highly likely that the government would temporarily apply insurance benefits to Actemra until the drug is approved as a COVID-19 treatment in Korea.

 

Actemra is already being used with temporary or official approval as a COVID-19 treatment abroad.

 

The US FDA granted Actemra Emergency Use Authorization (EUA) as a treatment for COVID-19.

 

The European Commission also approved the drug as a treatment for COVID-19 in December last year.

 

The WHO had also recently added Actemra to the prequalified COVID-19 treatment list' for reference by low- and middle-income countries that may have difficulty conducting independent reviews.

 

Recently, the community has been suffering a supply shortage of Actemra with its increased use in patients with severe COVID-19.

 

Due to this, the company is working to change its license to expand manufacturers of the drug that is currently limited to Japan.

 

Also, the authorities are known to be reviewing Actemra for emergency use in treating COVID-19.