The gov will push for a refund on losses from suspension

of execution to restrictions

The MOHW announced a partial amendment to the Health insurance medical benefit standards rules

Including a plan to shorten the negotiation period by 3 times for the original drug price reduction

The government will push for a revision of the law that will put a brake on the suspension of execution filed by pharmaceutical companies in drug price lawsuits.

 

If companies fight against the government over drug prices and finally win the case, the insurer will refund the drug cost equivalent to the loss so far.

 

This is a revision of the legal unit, so it is highly likely to take effect immediately.

 

The revision bill will three times shorten the negotiation period for the reduction of the original drug price of patent expiration, and includes amendments to omit drugs with a history of negotiations in the future.

 

The MOHW announced today (17th) the "Partial Amendment to the Rules on the standards of national health insurance medical benefits" and began inquiring opinions.

 

The revision is a plan already reported by the government to the Health Insurance Policy Deliberation Committee late last month, and is a follow-up to calls by the National Assembly to prevent abuse of execution and rationalize industry negotiations.

 

◆Introduction of the loss refund system according to the outcome of the dispute =The government explained that the purpose of the system is to protect the rights and interests of drug manufacturers and prevent financial losses in health insurance by applying for suspension of execution when pharmaceutical companies file drug lawsuits.

 

The main contents of the amendment stipulate that the chairman of the National Health Insurance Service pays the manufacturer, etc.

 

the loss if the drug manufacturer or the administrative trial's citation ruling is confirmed on whether the Minister of Health and Welfare is eligible, adjustment of upper limit price, and changes in details.

 

On the contrary, if the government wins, a revision is currently pending in the National Assembly to recover the insurer's loss to the pharmaceutical company that filed the lawsuit.

 

◆Regulation of negotiation period and procedure for registered drugs and follow-up measures = The maintenance and measures were designed to prevent confusion in the pharmaceutical industry and secure predictability caused by unclear negotiation procedures and follow-up measures since October 2020.

 

The main contents include allowing negotiations to be omitted for drugs with a history of existing negotiations and reasonably reducing the negotiation period from the current 60 days to the next 20 days in consideration of health insurance finances when the government adjusts the original drug ex officio.

 

However, if the negotiations break down, renegotiation will be allowed after deliberation by the Drug Benefit Evaluation Committee, and if the negotiations break down, the drug will be excluded from medical care benefits.

 

The MOHW plans to conduct an opinion inquiry until March 18 and implement it as originally planned if there is nothing special.