NHIS expects avg 322 generic pricing negotiations per month

NHIS expands to two-team Drug Pricing System Improvement Division

Preliminary consultation to minimize delay in listing process

Korea’s National Health Insurance Service (NHIS) is to start negotiating with generics over healthcare reimbursement contracts from the second half of the year.

 

At a press conference convened on July 7, NHIS Reimbursement Executive Director Kang Chung-hee stated, “For the pricing negotiation on generics to be conducted from August to September, the Drug Pricing System Improvement Division previously operated under one team of six staffs in one division would be expanded to two teams of nine staffs in one division.” According to the deliberations done by Health Insurance Policy Deliberation Committee (HIPDC) from last year January to last March, average 322 generic items would be negotiated for pricing every month.

 

When NHIS initiates pricing negotiation with generic, pharmaceutical companies would have a preliminary consultation with NHIS regarding negotiation and contract compliance as they submit an application for reimbursement listing to Health Insurance Review and Assessment Service (HIRA).

 

After HIRA calculates drug pricing, the pursuing company should engage in a pricing negotiation with NHIS for 60 days and a deliberation by HIPDC before the final announcement of listing and pricing is made.

 

Director Kang said, “The negotiation process would be streamlined through preliminary consultation with pharmaceutical companies,” and “the contract would become the focal point of the generic supply and quality management.”

For the process, NHIS held a meeting on July 8 with Korea Pharmaceutical and Bio-Pharma Manufacturers Association (KPBMA), Korea Biomedicine Industry Association (KoBIA) and Korean Research-based Pharmaceutical Industry Association (KRPIA).

 

At the meeting, NHIS explained about detailed guidelines of revised ‘Regulations on National Health Insurance Reimbursement Criteria’ and ‘Pharmaceutical Decision and Adjustment Standards,’ which mandate a 60-day drug pricing negotiation on generics listed through authorized pricing calculation, instead of pricing negotiation.

 

Answering the industry representatives’ concern on the pricing negotiation delaying the listing process, Director Kang said, “The Ministry of Health and Welfare would decide on the detailed guideline,” and “the delay would be minimized by conducting a preliminary consultation first.”