Five drugs all pass DREC's reimb review in February

companies start drug pricing negotiations with the NHIS

Includes Bimzelx, Ebglyss, and Cabometyx, which received conditional approval

All five products, including new drugs and drugs that sought expanded indications, which were reviewed by the Health Insurance Review and Assessment Service's Drug Reimbursement Evaluation Committee in February, have passed review and will be negotiating the drug’s price with the National Health Insurance Service.

 

Drugs that are subject to conditions of acceptance below the evaluated amount are also moving on to the negotiation process and are awaiting reimbursement.

 

According to industry sources on the 14th, the National Health Insurance Service updated its negotiation subjects to include 5 drugs - Trodelvy Inj (sacituzumab govitecan-hziy), Cabometyx Tab (cabozantinib), Ebglyss Autoinjector Inj (lebrikizumab), Adempas Tab (riociguat), and Bimzelx Autoinjector Inj (bimekizumab).

 

These five drugs are new drugs and drugs with expanded indications that were deliberated at the 2nd Drug Reimbursement Evaluation Committee meeting held on February 6.

 

At the DREC meeting, Adempas Tab (for pulmonary arterial hypertension only) and Trodelvy Inj (for triple-negative breast cancer) were recognized as adequate for reimbursement.

 

As such, drug pricing negotiations were expected.

 

However, as new drugs such as Bimzelx (psoriasis) and Ebglyss (atopic dermatitis), and Cabometyx, which has applied for an expansion of its indication to clear cell renal cell carcinoma, will only be deemed adequate for reimbursement when the companies accept an amount below the evaluated amount, their negotiation results were expected to be unclear.

 

This is because these companies must accept the evaluation amount set by DREC or below (less than the weighted average price of the alternative drug) for negotiations to proceed.

 

For products that accept the results of the DREC deliberation, the Ministry of Health and Welfare will issue a negotiation order to proceed with negotiations with the NHIS on drug prices and expected claims amount.

 

Accordingly, the 3 products that received conditional approval from DREC would have accepted DREC’s deliberation results to proceed with the pricing negotiations.

 

In the case of Ebglyss, a drug for atopic dermatitis, it accepted a price below that of competing products such as Dupixent and Adtralza.

 

Bimzelx, a psoriasis treatment, is also expected to cost less than Stelara or Cosentyx.

 

The negotiation period is 60 days.

 

Negotiations are expected to be completed before the Ministry of Health and Welfare's Health Insurance Policy Deliberation Committee (HIPDC) meeting in May, so it is expected that some of the drugs will be reimbursed as early as June 1.

 

All three drugs, Tepmetko Tab and Vocabria Tab+ Vocabria Inj+ Rekambys inj, which passed DREC review in December last year and proceeded with drug price negotiations, have completed negotiations with the NHIS are likely to be reviewed by HIPDC this month.