Reimbursement on Ibrance-Faslodex available from June

HIPDC finalized the expanded indication on Ibrance on May 15, contracted under refund RSA

From June 1, the healthcare reimbursement would be granted on the combined use of Pfizer Pharmaceutical Korea’s HER2-negative breast cancer treatment Ibrance (palbociclib) capsule and Faslodex (fulvestrant).

 

National Health Insurance Service (NHIS) has settled on a negotiation over an indication expansion of the already listed drug and listed Ibrance 75 mg, 100 mg and 125 mg under refund type risk sharing agreement (RSA).

 

Each capsule would be priced at 125,900 won with the healthcare benefit.

 

On May 15, Korea’s Ministry of Health and Welfare (MOHW) held the seventh Health Insurance Policy Deliberation Committee (HIPDC) meeting of the year.

 

Convened for the first time in the year, the HIPDC members passed the Ibrance listing as a part of the revised list of reimbursed drugs and maximum reimbursement price.

 

The negotiation on Ibrance was not a new drug pricing negotiation, but a reimbursement standard expansion according to the change in indication.

 

Initially indicated to treat postmenopausal female patients with hormone receptor positive (HR+) or human epidermal growth factor receptor 2-positive (HER2+) advanced or metastatic breast cancer as an endocrine therapy, Ibrance is additionally indicated to treat, in combination with Faslodex, female patients with hormone receptor positive (HR+) or human epidermal growth factor receptor 2-positive (HER2+) advanced or metastatic breast cancer who has been treated with endocrine therapy.

 

The indication expansion on Ibrance’ combination therapy has been demanded for over three years, as its indication was expanded to a first-line endocrine therapy combined with letrozole to treat postmenopausal women in 2017.

 

Since Pfizer applied for the new indication to treat female patient with advanced breast cancer after endocrine therapy as a combination therapy with Faslodex on Apr.

 

26 last year, Health Insurance Review and Assessment Service (HIRA) has been reviewing the revised reimbursement standard.

 

The revised reimbursement standard on Ibrance has undergone deliberations by Cancer Deliberation Committee in last September and Drug Reimbursement Evaluation Committee (DREC) in last February, and was negotiated for reimbursement pricing with NHIS from Mar.

 

7 to May 6.

 

Due to the cost-effectiveness issue raised by NHIS, Pfizer has agreed to refund a set ratio of claimed cost of Ibrance to NHIS, and also to lower the reimbursed price by 10.8 percent to lessen the financial impact.

 

The Korean health authority projected the expanded reimbursement standard on Ibrance, in effect from June 1, would additionally cost them 16.5 billion won a year.