Global pharma proposes 'indication-based pricing system'

to presidential candidates

Rep. Seo Mi-hwa announces a forum to discuss delayed reimbursement of innovative new drugs·strengthening patient access

KRPIA has submitted policy proposals to presidential candidates and requested a pilot project to the MOHW

Overseas global pharmaceutical companies with subsidiaries in Korea are currently voicing the adoption of policies aimed at resolving 'reimbursement inequities' for therapies for severe and rare diseases and implementing an 'indication-based pricing system' amid an early presidential election.

 

While the Korean government maintains that an indication-based pricing system should be carefully reviewed over the long term due to various potential challenges, global pharmaceutical companies have begun gathering public opinion on the issue at a parliamentary forum.

 

On the 15th, Rep.

 

Seo Mi-hwa of the Democratic Party, a National Assembly's Public Healthcare Committee member, is preparing to hold a 'Discussion Forum on Resolving Inequalities in Innovative New Drugs and Regulatory Reforms.' It is intended to highlight that only 22% of innovative new drugs, such as those changing the treatment paradigm for severe and refractory diseases like cancer drugs, are reimbursed in Korea, leaving patients without timely access to therapies.

 

In particular, the forum will also discuss measures to introduce an indication-based pricing system in Korea to expand reimbursement for new drugs.

 

The introduction of an indication-based pricing system was an issue raised by the Korea Research-Based Pharma Industry Association (KRPIA), which requested a pilot project from the Ministry of Health and Welfare (MOHW) and other government agencies overseeing national health insurance.

 

The KRPIA requested that the government initiate a pilot project applying a 'weighted average price by indication' and 'differentiated reimbursement rates by indication' for drugs under risk-sharing agreements (RSA).

 

Furthermore, KRPIA is reportedly planning to propose to the candidate camps of parties such as the Democratic Party and the People Power Party policies to expand patient treatment opportunities through the implementation of an indication-based pricing system during this early presidential election cycle.

 

The request is based on the fact that some overseas countries, including Italy, France, and Switzerland, are already implementing policies that evaluate the therapeutic value of drugs with multiple indications separately by indication, by determining different insurance prices or applying differential discounts at reimbursement.

 

The KRPIA is urging these measures to be adopted as a commitment to enhancing patient access to medications.

 

The request aligns with a presidential policy proposal that will coincide with a parliamentary debate later this month.

 

However, the MOHW has stated that the indication-based pricing system should be carefully reviewed from a long-term perspective.

 

While they agree with the rationale for introducing the system, the MOHW believes that further long-term discussions are necessary, such as financial impact analysis, establishment of legal grounds, and development of billing and settlement systems to prevent circumvention and distorted prescribing practices among some patients, must be addressed first.

 

The rep.

 

office responsible for preparing for the forum stated, "At the discussion forum, we will look for solutions to the prolonged processing period following reimbursement listing and the delays in reimbursement payments occurring within the approved indications," and added, "We will review the regulatory improvement policy agenda from the perspective of treatment disparities among patients."