PVA is a variable in the negotiation of α-GPC recovery

The NHIS aims to complete 123 item negotiations by July 13

PVA starts in mid-June, including large pharmaceutical companies in action

Re-negotiation on benefit recovery and PVA negotiation related to pharmaceuticals with the brain functional improvement agent "Choline alfoscerate" have emerged as variables.

 

On the 3rd, the MOHW ordered the NHIS to conduct negotiations on 123 items of Choline alfoscerate for 40 days from June 4 to July 13.

 

Choline alfoscerate recovery negotiations, which began on December 14 last year, have been under way four times so far, and 123 items from 58 final companies have not been agreed on.

 

The pharmaceutical industry is questioning the effectiveness of the fourth round of negotiations that will be held again after failing to reach an agreement over the past six months.

 

The NHIS considered the fourth round of negotiations to be the final stage, and says it will ask the MOHW to remove the benefit in the event of a final breakdown.

 

If the NHIS' drug price management department (excluding the generic negotiation department) has been involved in the Choline alfoscerate negotiations due to lack of work and manpower, this time the drug price planning department will be in charge of negotiations.

 

The Pharmaceutical Price System Planning Department is a department led by Lee Young-hee, who was in charge of major negotiations in the past, including high-priced anticancer drugs such as "Keytruda," "Opdivo" and "Spinraza." Based on her experience in negotiating various new drugs, She plans to conclude negotiations on the recovery of Choline alfoscerate.

 

In particular, the inclusion of Choline alfoscerate from a large pharmaceutical company, which is suing the MOHW and the NHIS for suspension of execution, emerged as a variable in the recovery negotiations.

 

Last year, Arlico, Hana, and Kyungbo were lowered as PVA 'Da' type (the amount of drug claims in 2019 increased by more than 60% or increased by more than 10% from 2018 and increased by 5 billion won).

 

The pharmaceutical companies agreed on a contract clause that states that "if permission is revoked as a result of revaluation, the pharmaceutical company must return the full amount of the claim from the date of the MFDS' clinical trial to the NHIS." In the case of PVA negotiations, it is necessary to sign an agreement to return the full amount of the NHIS claim if there are problems with safety and validity such as clinical revaluation as well as drug price reduction.

 

Attention is focusing on what choice pharmaceutical companies with PVA negotiated items will make at a time when the NHIS lowered the recovery rate by up to 50% of health insurance claims in the last third round of negotiations.