16 drugs including Venclexta receive reimbursement in 1H

Current status of new·expanded criteria drugs listed on the drug benefit list as of 1H 2021

14 new drugs listed… 2 products receive enhanced coverage through expanded standards

Drug accessibility of 76,769 patients will improve with the change… will cost 115.6 billion won per year

A total of 14 products were newly listed on the insurance benefit list to improve patient access in the first half of this year.

 

Also, two drugs benefited from the reimbursement criteria expansion that was applied to already-listed new drugs.

 

This expanded coverage is interpreted as a result of the government’s decision to flexibly apply coverage for drugs according to the patients’ needs and social importance.

 

The government estimates that around 760,000 patients in Korea will be benefiting from the change.

 

The coverage will financially cost around 115.6 billion won per year, which indicates that the coverage expansion for drugs is being carried out faster than the previous year.

 

During the first half of this year, from January to June, a total of 16 drugs (based on each drug’s representative strengths) were listed on the drug benefit list.

 

These include new drugs that were newly listed and those whose criteria (indication, administration criteria, etc) were expanded to enhance coverage.

 

New drugs that were newly listed this month include the hemophilia A treatment Afstlya inj.; bacteremia treatment Daptocin inj., Boryung Daptomycin inj., and Dapto Inj.; nocturnal hemoglobinuria treatment Ultomiris inj.; and hyperlipidemia treatment Praluent Pen inj..

 

Also, the reimbursement criteria for the already-listed choric lymphocytic leukemia treatment Venclexta tab.

 

was expanded to enhance coverage.

 

The number of domestic patients expected to use the drugs that were newly listed or received expanded reimbursement varies greatly by product.

 

For the Venclexta tab., the number of patients that will benefit from the expanded reimbursement is expected to be around 75.

 

Also, the number of patients to benefit from the newly listed Ultomiris is 92.

 

Contrary to such drugs that are expected to benefit less than 100 patients, the glaucoma treatment Eybelis Eye Drops is expected to benefit around 45,000 patients.

 

Also, the blood sugar regulator Xultophy Flex Touch inj.

 

that was newly listed in May is expected to benefit 12,756 patients, and Parkinson treatment Equfina Film Coated tab.

 

that started its reimbursement process in January this year is expected to benefit 7,000 patients.

 

The number of beneficiaries greatly varies due to policies that now allow flexible expansion of NHI coverage to high-price drugs that are used for a small number of rare diseases, that were established based on the increased social maturity that can now accept such policies.

 

Due to the new listings and expanded benefit criteria, the government and payer are expected to spend around 115.6 billion won a year to grant access to around 76,769 patients.