Pharmaceutical coverage list updated with Xolair and Akave

MOHW issues updated pharmaceutical reimbursement criteria and method effective from July 1

As an allergic asthma treatment Xolair injection (omalizumab) was newly listed, the detailed criteria for healthcare reimbursement was also updated.

 

Also the reimbursement standard on hypertension and hyperlipidemia combination drug added new ‘fimasartan plus atorvastatin’ combination due to the new listing of Akave tablet.

 

Korea’s Ministry of Health and Welfare (MOHW) revised and updated the detailed pharmaceutical reimbursement criteria and method with the said changes coming in effect from July 1.

 

◆Xolair injection: The updated list added detailed standards and method of granting reimbursement for using Xolair injection listed from this month.

 

A patient aged 12 and above with moderate to severe persistent asthma, whose symptoms are inadequately controlled despite administering inhaled-corticosteroid-and-long-acting beta agonist (ICS-LABA) or long-acting muscarinic receptor antagonists (LAMA) should qualify all following criteria to receive reimbursement; demonstrating immunoglobulin E (IgE) level over 161 IU/ mL prior to the treatment, skin test exhibiting positive or in vitro reactivity to a perennial aeroallergen, having a baseline forced expiratory volume in one second (FEV1) less than 80 percent, and has experienced acute asthma attack requiring systemic corticosteroid more than twice in 12 months before the treatment.

 

A pediatric patient from age six to 12 with moderate to severe persistent asthma, whose symptoms are inadequately controlled with ICS-LABA or LAMA should qualify all following criteria to receive reimbursement; demonstrating IgE level over 76 IU/ mL prior to the treatment, skin test exhibiting positive or in vitro reactivity to a perennial aeroallergen, and has experienced acute asthma attack requiring systemic corticosteroid more than twice in 12 months before the treatment.

 

For patients prescribed with Xolair injection before the listing (July 1), the reimbursement would be provided if all the required criteria are met and confirmed by medical record and healthcare provider’s diagnosis.

 

The eligibility would be evaluated, according to the criteria in effect from July 1, by reaction assessment at week 16 followed by a series of continuous reaction assessments in every three to six months.

 

◆Akave tablet: A ‘fimasartan plus atorvastatin’ combination drug Akave tablet is also newly listed from this month, adding a new criteria on reimbursement standard for hyperlipidermia.

 

The four combinations of hyperlipidermia treatments including ‘amlodipine plus atorvastatin,’ ‘amlodipine plus rosuvastatin,’ ‘candesartan plus rosuvastatin,’ and also ‘fimasartan plus atorvastatin’ are now covered.