Insurance not covered if Revlimid prescribed multiple up

of lower dose

The HIRA, add list of reimbursed drug with cost-effective dose, effective March 1

Insurance will not be covered if Revlimid’s lower dose such as 5mg in multiples by Celgene is prescribed instead of Revlimid 10mg, 15mg, 20mg, or 25mg.

 

Reimbursed price of Revlimid 25mg is ₩101,768, whereas Revlimid 2.5mg, 1/10 dose of Revlimid 25mg, is ₩53,904.

 

If 10 tablets of Revlimid 2.5mg is prescribed instead of 1 tablet of Revlimid 25mg, it will cost more than ₩500,000.

 

The Health Insurance Review and Assessment Service recently released the list of reimbursed pharmaceuticals with cost-effective dose in January 2020.

 

The list was made in accordance with the revision of the pharmaceutical list and reimbursed limit table on December 31 of last year.

 

Effective date is from March 1st.

 

The full reimbursed list is subject to automatic computerized checks for DUR information and review of reimbursed payments.

 

Last year, the HIRA was in the process of reconfirming unmanaged items in batches, allowing DUR additions and deletions to be adjusted.

 

In the newly added list of oral prescription with benefit cut in case of prescribing multiple up of lower dose, a total of 200 item combinations were added due to the confirmation of production items, and 92 item combinations were designated as shortage prevention drugs and were removed from the list.

 

In addition, the following combinations of items that were subject to DUR adjustment due to the establishment of low-high doses; Allenaon 10·20mg, Mini Ressin 0.1·0.2mg, Glimedi 2·4mg, DaeWoongBio Atorvastatin 20·40mg, Intrack 6.25·12.5mg, Pitastin 2·4mg, Matiran 20·40mg, Crowon 5·10mg, Litor 10·20mg, Esomedin 20·40mg, Leviepil 0.25·0.5g, 0.25-1g, Eso-mp 20·40mg, Since January 1 of this year, due to the elimination of the low-high doses, Elosuva 10·20mg, Dulota 30·60mg, Lowgan 10·20mg, Omertec 20·40mg, Norvasc ODT 5·10mg , and Cavedia 12.5·25mg have been dropped from the DUR　screening.

 

Injectables include Genpenem 0.5·1g, Cralevo 50·150ml, Astriaxone 1-2g, Samsung Merophenem 0.5·1g, Copenem, 0.5·1g as a result of the product confirmation, Mecapem 0.5·1g and Cifloxin 0.2·0.4g will be automatically cut from DUR when prescribed multiple up of lower dose medication from next month.