KAPO-HIRA on Lutathera coverage “Shooting for September”

“Although safety and efficacy were cleared, Novartis has not applied for reimbursement, yet”

A patient group announced a meeting was convened with Health Insurance Review and Assessment Service (HIRA) Pharmaceutical Management Department to talk about granting healthcare reimbursement on Neuro Endocrine Tumor (NET) treatment Lutathera.

 

The group is demanding the Korean government to take into consideration of the patients reluctantly travelling afar to receive treatment in Malaysia amid COVID-19 pandemic for more reasonably priced option.

 

HIRA plans to accept the patient group’s demand as much as possible and to issue revised Lutathera coverage status notice on Sept.

 

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On May 27, Korea Alliance of Patients Organization (KAPO) disclosed the outcome of their meeting with HIRA Pharmaceutical Management Department.

 

KAPO official reported HIRA is fully aware of patients’ agony of inevitably paying for expensive Lutathera as COVID-19 pandemic has blocked them from the overseas treatment the patients received despite the reported cases of medication misadventure.

 

The officials elaborated Novartis is not applying for reimbursement listing, although Ministry of Food and Drug Safety (MFDS) has asked for Novartis Korea’s listing application through approval-reimbursed pricing evaluation linkage system after completing Lutathera’s safety and efficacy review.

 

Moreover, HIRA is currently reviewing National Health Insurance (NHI) reimbursement standard on Lutathera.

 

However, HIRA has reportedly expressed concern over pharmaceutical companies abusing the NHI reimbursement exceptionally granted on urgently approved orphan drug.

 

But as a conclusion, HIRA said the agency would strive to issue the revised Lutathera reimbursement notice on Sept.

 

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KAPO pointed out, “HIRA and Novartis should promptly proceed with the reimbursement listing procedure to lessen the burden of NET patients struggling with overseas treatment and high-cost drugs.”