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Company
Anemia drug ‘Vadanem’ makes 2nd attempt at reimb listing
by
Nho, Byung Chul
Mar 08, 2024 05:18am
Mitsubishi Tanabe Pharma Vadanem, Mitsubishi Tanabe Pharma’s new tablet anemia drug, will likely receive approval from the U.S. Food and Drug Administration by early April and make a second attempt at getting a reimbursement listing in Korea. If the company gets the drug reasonably priced comparable to a weighted average price of the substitute during drug pricing negotiation with the Health Insurance Review and Assessment Service (HIRA), the drug will be recorded as the first new anemia drug in tablet form to be commercialized in Korea. According to the pharmaceutical industry, Vadanem (vadadustat) has been re-submitted for U.S. approval for the indication of ‘Treating anemia in adult patients with chronic kidney disease who are receiving dialysis.’ The FDA is conducting a positive review of the submission. Furthermore, listing Vadanem, which received European approval in May 2023, for EU drug pricing is proceeding smoothly. Considering its ongoing FDA approval and European listing schedule, Mitsubishi Tanabe Pharma aims to negotiate with the HIRA for drug pricing within May. However, insurance reimbursement will be available for its known original efficacy in treating anemia in dialysis patients but not in non-dialysis patients. EPO ingredient, developed 30 years ago, is the only new anemia drug available. The products are available as third-generation injection forms with longer administration duration. Increasing demand for new mechanism-based treatments arose due to patients' unresponsiveness to conventional drugs and side effects such as changes in blood pressure and vomiting. Vadanem, which acquired the BLA from the Ministry of Food and Drug Safety (MFDS), is an anemia drug for treating adult patients with chronic kidney disease who are receiving dialysis. It inhibits Hypoxia-inducible factor (HIF) prolyl hydroxylase and promotes Erythropoiesis. HIF is a protein that responds to decreased oxygen supply in cells. When starting Vadanem treatment, patients must have sufficient storage ions and be checked for levels of transferrin saturation (TSAT) and ferritin. The starting reference dose is below 10 g/dL hemoglobin (Hb) for patients who had not previously been treated with erythropoiesis-stimulating agents (ESA). It is possible to switch patients who are receiving ESA to this medication. Vadadustat is orally administered at an initial dose of 300 mg once daily, and after treatment, the dose can be gradually increased depending on the patient's condition. The maximum dose is 600 mg once daily. The need for expedited approval processes for innovative drugs related to kidney disease is driven by the necessity to expand treatment options for patients and reduce health insurance expenses. The number of chronic kidney disease patients in Korea increased by 36.9% from 206,061 in 2017 to 282,169 in 2021, according to data from the National Health Insurance Service (NHIS). Particularly noteworthy is the 82.8% surge among individuals in their 80s during the same period. The number of patients undergoing dialysis is increasing exponentially. The NHIS spends nearly KRW 3 trillion on approximately 100,000 patients. Moreover, patient adherence is expected to increase as Vadanem is an oral tablet, unlike conventional erythropoiesis-stimulating agents that are administered only via injection. Another oral formulation erythropoiesis-stimulating agent similar to Vadanem is JW Pharmaceutical's Enaroy Tab (enarodustat, approved in Korea in 2022). Enaroy Tab is scheduled to undergo reimbursement listing based on the weighted average price of the substitute drug. AstraZeneca's new erythropoiesis-stimulating agent Evrenzo Tab, containing the active ingredient roxadustat, received approval in Korea in 2021. However, due to the company's policy of pricing orphan drugs at a high cost, it seems they have stopped conducting economic evaluations and proposals for a weighted average price of the substitute drug.
Policy
2yr use restriction lifted for Alimta+Keytruda combo reimb
by
Lee, Tak-Sun
Mar 08, 2024 05:18am
The reimbursement period for the Alimta+Keytruda+platinum-based chemotherapy is set to be extended. Previously, the 3-drug combination was covered for up to 2 years, but the Cancer Disease Deliberation Committee decided to remove this restriction from the reimbursement standards. The Health Insurance Review and Assessment Service announced that it had made the decision above at the 2nd 2024 Cancer Disease Review Committee meeting that was held on March 6. After deliberations, the CDDC decided to remove the maximum 2-year coverage restriction set for pemetrexed drugs such as Alimta Inj used in combination with pembrolizumab and platinum-based chemotherapy as first-line treatment for patients with metastatic non-squamous NSCLC without EGFR or ALK mutations. This is expected to reduce the financial burden borne by patients who use the regimen for a longer period of time. The reimbursement standards for Clinigen Korea’s Erwinase Inj will also be changed, and its use as ‘a component of a chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to E. coli-derived asparaginase’ that was allowed for patients with level 3 or higher allergic reactions will be changed to level 2. Reimbursement standards for Zavedos Inj (idarubicin), which Pfizer Korea applied to extend reimbursement as an idarubicin monotherapy for transarterial chemoembolization (TACE) in liver cancer, were not set, however, off-label use with partial copayment 5/100 was approved. Also, reimbursement extension requests for Lonquex Pre-filled Inj (lipegfilgrastim, Teva-Handok), Taxotere 1 Vial Inj (docetaxel trihydrate, Sanofi), Verzenio Tab (abemaciclib, Lilly) were not accepted, and were not set. Also, all 3 drugs that applied for new reimbursement listings - Tepmetko Tab (tepotinib, Merck), Pemazyre Tab (pemigatinib, Handok), and Tevimbra (tiselizumab, Beigene) – were unable to pass the CDDC stage. For the second year, the reimbursement progress for Tepmetko Tab has remained stalled at the CDDC stage.
Policy
DPK urges doctors to return to work
by
Lee, Jeong-Hwan
Mar 07, 2024 07:16am
Rep. Kim Min-seok, the head of the Democratic Party’s situation room. The Democratic Party of Korea (DPK) urged trainee doctors who walked off the job en masse to return to their medical sectors. Furthermore, the DPK suggested that medical community negotiate a reasonable capacity of medical school admissions. The ruling party has temporarily allowed non-face-to-face medical treatment to address the current absence of trainee doctors in hospitals. In response, the DPK has officially requested the government allow additional supportive systems, including active ingredient prescribing and prescription refills, also temporarily. “We understand the concerns regarding the medical crisis. In response, the Democratic Party has established an emergency situation team, affiliated with the party’s situation room, for medical crisis,” Rep. Kim Min-seok, the head of the Democratic Party’s situation room, announced on the 3rd during the press conference at the National Assembly’s communication building. The DPK has acknowledged that expanding medical school quotas is a timely issue for the medical community. They suggest that the reasonable capacity of expansion should be determined through dialogue. "With my expereince serving as the chair of the Ministry of Health and Welfare (MOHW), I will personally oversee the development of measures by communicating with medical community," Kim added, "I am already communicating with various medical professional organizations, including not only doctors but also nurses and pharmacists," Kim said. "We must be cautious about expanding the medical school enrollment quota, as it might increase non-insured doctors in the metropolitan area. Therefore, we should consider implementing supportive systems like regional doctor quotas," Kim said. "The government should also discuss with the medical community, including the possibility of introducing regional doctors quotas along with the issue of medical school." The DPK proposed the temporary allowance of active ingredient prescribing and prescription refills in order to reorganisze the non-face-to-face medical treatment pilot project, which is being implemented without legal basis. "The government has announced measures to temporarily allow non-face-to-face medical treatment without legal basis, unrelated to the current crisis," Kim emphasized. He added, "If such measures are necessary, implementing supportive systems like active ingredient prescribing and prescription refills, even temporarily, will ensure integrity." Kim also argued, "The government's proposal to allow Physician Assistants (PAs), which is currently illegal under existing laws, citing medical crises and treatment disruptions, would ultimately shift responsibility onto medical institutions and nurses, resulting in irresponsible consequences." "The government must clearly outline the legal basis for implementing nursing law," Kim said. "If the Nursing Act, promoted in the National Assembly, had been passed earlier without the president's veto, it would have helped deal with the PA issue more stably in the current situation. I hope that the government takes note of this," Kim added. Kim continued, "There is a need to reconsider the government's stance of not communicating with the Korean Medical Association as a channel for dialogue and communication." "The DPK will do its best to alleviate the damage to patients and the anxiety of the public due to the confusion in the medical field," Kim added.
Policy
High-strength Ebixa generics start receiving approval again
by
Lee, Hye-Kyung
Mar 07, 2024 07:16am
Approvals for generic versions of the high-strength Ebixa 20mg (memantine hydrochloride), a treatment for severe Alzheimer's, that had been slowing down lately, have begun to gain momentum again. On March 5, the Ministry of Food and Drug Safety approved Dongkook Pharmaceuticals 'Memantine Tab 20mg.' Eighteen years after the 10mg formulation of the original memantine drug Ebixa (company: Lundbeck Korea) was approved in September 2003, the 20mg formulation that offers improved patient convenience had been released in November 2021. Unlike how patients had to take the 10mg formulation twice daily, the higher-strength 20mg tablet formulation can be taken only once a day, significantly improving dosing convenience. In particular, the release of such high-strength products by the market leader Eisai Korea’s ‘Aricept (donepezil hydrochloride)’ and the runner-up Ebixa has attracted the attention of domestic pharmaceutical companies. According to UBIST, outpatient prescription sales of Aricept were KRW 86.1 billion and Ebixa KRW 16.9 billion in 2021. Eleven months after the approval of Ebixa 20mg, Hyundai Pharm’s ‘Dimantine Tab’ became the first high-strength generic to receive approval in Korea. Launching the first 20mg generic version in addition to the existing Dimantine 5mg and 10mg, the company promoted the release of a new treatment option. Last year, 3 Korean pharmaceutical companies made a bid into the high-strength Ebixa market: Myung In Pharmaceutical’s ‘Fello OD Tab,’ Korean Drug Co’s ‘Admed Tab,’ and Huons’ ‘Easymantine Tab.’ In particular, only Whan In Pharm and Myung In Pharmaceutical had approvals for low-strength oral disintegrating tablet formulations of Ebixa. Orally disintegrating tablets are more convenient than capsules or tablets, and in the case of memantine, which is used to treat dementia, it was evaluated to be more effective as many patients have swallowing disorders. Due to this, Myung In Pharmaceutical first gained competitiveness with its high-strength Fello OD. With Dongkook Pharmaceutical also waiting to enter Ebixa’s high-strength generic market, which has been sluggish since Huons received approval for its Easymantine Tab 20mg in October last year, 6 companies are set to compete in the market from now on. Use of high-dose memantine must be initiated by a physician experienced in the diagnosis and treatment of Alzheimer's disease, and only if a caregiver is available to regularly check the patient's compliance with the medication. The drug is administered orally once daily, and the recommended dose is 20 mg per day in elderly patients over the age of 65.
Policy
Once-weekly growth hormone Sogroya is approved in Korea
by
Lee, Hye-Kyung
Mar 07, 2024 07:16am
A growth hormone that can be administered once weekly was approved in Korea. The Ministry of Food and Drug Safety approved Novo Nordisk’s ‘Sogroya Prefilled Pen (somapacitan-beco)’ 5mg, 10mg, and 15mg on June 6. Sogroya is a once-weekly treatment for adult hormone deficiency and is indicated for the replacement of endogenous growth hormone (GH) in children aged 3 years and above, and in adults with growth hormone deficiency (adult GHD) in Korea. As a type of human growth hormone analogue that is injected subcutaneously once a week, Sogroya offers better dosage convenience over existing growth hormone formulations that require daily dosing. The drug was approved by the US FDA in 2020 based on results from a comprehensive clinical development program, including those from the REAL 1 trial. The Real 1 trial was a Phase III, randomized, parallel-group, double-blind, placebo-controlled trial that was conducted on treatment-naïve patients with adult GHD for 35 weeks. In the trial, a total of 300 adult patients with adult GHD were recruited and randomized to treatment with once-weekly Sogroya, once-weekly placebo, or once-daily somatropin. Results showed that patients treated with Sogroya demonstrated a mean reduction of 1.06% in truncal fat at week 34, a significant difference compared with the 0.47% increase found with the use of placebo. Patients treated with daily somatropin achieved a change in truncal fat % of -2.23% after 34 weeks. Sogroya was approved and released in Japan in 2021, at a price of JPY 26,107 for the 5mg vial and JPY 52,214 for the 10mg vial.
Company
Oral PNH drug Fabhalta to soon be released in Korea
by
Eo, Yun-Ho
Mar 07, 2024 07:15am
Novartis' new PNH drug Fabhalta is set to land in Korea. According to industry sources, Novartis Korea has submitted an application for the marketing authorization of its Paroxysmal Nocturnal Hemoglobinuria (PNH) drug Fabhalta (iptacopan) to the Ministry of Food and Drug Safety. Therefore, the drug is expected to be approved within this year. After receiving approval from the US Food and Drug Administration (FDA) at the end of the past year, the company is also undergoing review processes for Fabhalta’s approval in Europe and Japan. Fabhalta is a Factor B inhibitor that acts proximally in the alternative complement pathway of the immune system, providing comprehensive control of red blood cell (RBC) destruction within and outside the blood vessels (intra- and extravascular hemolysis [IVH and EVH]). As an oral formulation, the drug offers better dosing convenience over existing intravenous formulations like Soliris and Ultomiris. The drug’s efficacy was confirmed through the Phase III APPLY-PNH trial in patients with residual anemia despite prior anti-C5 treatment who switched to Fabhalta and the Phase III APPOINT-PNH study in complement inhibitor-naïve patients. During the 24-week core treatment periods in the APPLY-PNH and APPOINT-PNH trials 82.3% of anti-C5-experienced Fabhalta patients, 0% of anti-C5-treated patients, and 77.5% of complement inhibitor-naïve patients showed sustained increase of hemoglobin levels of 2 g/dLa or higher from baseline in the absence of transfusions. Also, 67.7% of anti-C5-experienced Fabhalta patients and 0% of anti-C5 patients sustained a hemoglobin level of 12 g/dLa or higher without transfusion. The rate of patients avoiding transfusion was 95.2% for anti-C5-experienced Fabhalta patients and 45.7% for anti-C5-treated patients. The most commonly reported adverse reactions with Fabhalta were headache, diarrhea, abdominal pain, viral infection, and nasopharyngitis. However, a black box warning was included on the risk of serious infections caused by encapsulated bacteria. Meanwhile, competition in the PNH market is expected to intensify in the coming years. AstraZeneca launched Ultomiris (ravulizumab) as a follow-on to Soliris (eculizumab), and Soliris’s patent is due to expire in Europe in 2023 and in the US in 2027. Ultomiris is given intravenously every 2 weeks whereas Soliris is administered every 8 weeks. Roche is also preparing to commercialize crovalimab, which has shown promise in a head-to-head trial with Soliris. The drug recently received the first approval in China and has been designated an orphan drug in Korea. In addition, Samsung Bioepis's Soliris biosimilar ‘Episcli’ recently received approval in Korea. This is the first Soliris biosimilar approved in Korea, and Samsung Bioepis also received approval for the drug in Europe last year.
Policy
The RSA track to include drugs for chronic diseases, asthma
by
Lee, Tak-Sun
Mar 07, 2024 07:15am
The Risk Sharing Agreement (RSA) will cover chronic and severe diseases that cannot be treated with substitute drugs and result in irreversible deterioration in the quality of life. It was announced last year as part of ‘The drug pricing system to ensure fair-value compensation for innovative new drugs.’ Since the announcement, the RSA has covered several drugs to treat chronic and severe disorders. The committee will now develop detailed guidelines to ensure the implementation of these measures. The Drug Reimbursement Evaluation Committee (DREC) of the Health Insurance Review and Assessment Service (HIRA) will hold a meeting on the 7th to review the guidelines, according to the industry sources on the 6th. The current RSA only applies to anticancer and orphan drugs treating life-threatening severe diseases without substitute drugs. However, there were cases where the RSA covered other severe diseases besides orphan drugs. For instance, ‘Dupixent inj,’ a drug used to treat severe atopic dermatitis, and the severe asthma drug ‘Nucala’ have been covered by health insurance reimbursement via RSA. The government will additionally apply RSA to drugs treating chronic and severe diseases to provide better patient insurance benefits. The government will promptly implement this measure because RSA has already covered several drugs for treating severe diseases, and the administrative work only includes developing detailed guidelines. This is the first measure to implement ‘The drug pricing system to ensure fair-value compensation for innovative new drugs,’ announced last year. Therefore, once the DREC reaches an agreement, it is expected that drugs for treating chronic and severe diseases causing irreversible deterioration in the quality of life, including generalized pustular psoriasis, interstitial lung disease, hereditary angioedema, and severe asthma, will be covered by RSA and later, those drugs will likely be reimbursement listed. The DREC, which will be held on the 7th, will also review the reimbursement appropriateness of Fasenra Pre-filled Syringe Inj. (benralizumab, AZ), used for treating severe eosinophilic asthma. Fasenra Pre-filled Syringe Inj. received a reimbursement status via RSA at the DREC last September. However, it did not receive a non-reimbursement decision. On the other hand, Nucala (mepolizumab, GSK), a severe eosinophilic asthma treatment similar to Fasenra, was successfully listed for reimbursement via RSA. Whether Fasenra will clear the reimbursement appropriateness and the expansion of the RSA measure is to be watched.
Opinion
[Reporter’s View] On MFDS’s new drug management team
by
Lee, Hye-Kyung
Mar 06, 2024 06:03am
A new drug management support team will be established under the Ministry of Food and Drug Safety’s Pharmaceutical Safety Bureau. According to the 'Partial Amendment of the Enforcement Rules of the Ministry of Food and Drug Safety and its Affiliated Institutions' that was released by the MFDS on February 7, the MFDS will newly establish a drug safety management team using the total payroll costs system. As such, the MFDS is expected to reorganize and make personnel appointments to reflect the amendments in the near future. The role of the Pharmaceutical Management Support Team will focus on managing items with unstable supply and demand. The duties of the head of the Pharmaceutical Management Support Team include overseeing the procurement policies for medical products in response to public health crises, operating the Safety Management and Supply Committee, establishing and operating information systems, approving emergency use of drugs, designating, managing, and stabilizing the supply of national essential medicines, operating the drug supply forecast system, managing the targets for reporting production and supply interruptions, and managing Korea Orphan & Essential Drug Center projects. The Pharmaceutical Management Support Team will also take over some of the tasks currently handled by the Pharmaceutical Policy Division. The team will also represent the MFDS at the public-private consultative meetings held to respond to unstable drug supply and demand, which have been held 13 times so far. The imbalance in the supply and demand of medicines has intensified since COVID-19, and through the public-private consultative meeting, measures for distribution management and administration are being explored. The MFDS monitors the unstable supply and demand items and simultaneously requests pharmaceutical companies to cooperate with production while seeking measures to support drugs that have supply disruptions due to problems such as unavailability. As such, there is consensus on the need to separately manage drug supply and demand instabilities. It is a positive sign that the MFDS plans to separate the Pharmaceutical Management Support Team from the Pharmaceutical Policy Division to manage items with unstable supply and demand. However, unlike the Narcotics Prevention and Rehabilitation Team, whose team leader is appointed from 4th Grade or above, the head of the Pharmaceutical Management Support Team can be a 5th Grade official. The team is supposed to be in charge of encouraging pharmaceutical companies to manufacture and provide administrative support to stabilize the supply of medical products to respond to public crises, but instead of a Director with a Grade 4 clearance or higher, a Grade 5 Deputy Director would be in charge. Although they can manage, it would have been nice to have a Deputy Director take charge of the team and make viable promises to pharmaceutical companies. In addition, the Pharmaceutical Management Support Team will have a set term and will end on January 31, 2027. After the term, the team’s tasks will be reassigned to the Pharmaceutical Policy Division. However, when looking at the roles taken by the Pharmaceutical Management Support Team, the team seems to be an indispensable department that has a close relationship with medical institutions, pharmacies, and pharmaceutical companies. The MFDS’s decision to reorganize its structure to manage the unstable supply and demand of drugs is laudable, but thoughts are required on whether a 3-year temporary team with a team leader at the level of a 5th-grade official will be able to function as intended.
Company
Rare drug Ultomiris posts KRW 40 billion in sales in 3 yrs
by
Nho, Byung Chul
Mar 06, 2024 06:03am
Becoming a KRW 40 billion blockbuster in just 3 years since its launch, the growth potential of AstraZeneca’s Ultomiris Inj (ravulizumab) is gaining industry-wide attention. The biological orphan drug Ultomiris Inj. is considered to be the successor to Soliris Inj. (eculizumab) with significant improvements in dosing convenience. The drug was approved in June 2021 at a reimbursed price of KRW 5,598,942 for the 30 ml vial and is indicated for paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome. By Q3 2021, 2022, 2023, Ultomiris has generated sales of KRW 19.5 billion, KRW 43.1 billion, and KRW 37.8 billion, respectively. Ultomiris is administered every 8 weeks as a maintenance dose (through intravenous infusion 2 weeks after administering a loading dose based on body weight). In contrast, Soliris is dosed with weekly intravenous infusions for the first 4 weeks, followed by a 5th dose 7 days after the fourth dose, and then every 2 weeks thereafter. While Ultomiris is a follow-on to Soliris, it is notable that Soliris still maintains sales as a blockbuster drug that posts sales in the KRW 10 billion range, by securing indications such as systemic myasthenia gravis and neuromyelitis optica spectrum disorder. Soliris had generated KRW 43.8 billion to KRW 43.9 billion in sales in 2019-2020 before the launch of Ultomiris. Since then, it has maintained sales of KRW 31 billion, KRW 10.1 billion, and KRW 6.4 billion through Q3 in 2021, 2022, and 2023, respectively. In addition, Soliris has undergone two drug price cuts from KRW 6,138,844 in February 2017 and is currently priced at KRW 5,132,364 per 30ml vial. PNH is a life-threatening rare blood disease characterized by the destruction of red blood cells by the complement component that is part of the immune system. Without treatment, 4 out of 10 patients die within 5 years after diagnosis. In Korea, around 200 patients suffer from PNH. Until Ultomiris’s launch in Korea in 2012, Soliris was the only treatment for PNH and was shown to improve the 5-year survival rate by 95.5%. Meanwhile, Ultomiris’s efficacy was demonstrated through 2 prospective studies (Study 301 and Study 302) that were conducted on PNH patients. In both studies, Ultomiris demonstrated non-inferiority compared to Soliris in the primary efficacy endpoints of avoidance of the need for transfusions, LDH normalization, and LDH change rate, as well as in the secondary endpoints of LDH change rate, change in the quality of life (FACIT-Fatigue), breakthrough hemolysis, and proportion of patients with stabilized hemoglobin. In addition, a preference assessment study that was conducted as an extension study in patients with paroxysmal nocturnal hemoglobinuria who were previously treated with both Soliris and Ultomiris showed that 93% of patients preferred Ultomiris.
Company
Reimb for Verzenio in early breast cancer undergoes review
by
Eo, Yun-Ho
Mar 06, 2024 06:03am
Verzenio, the first CDK4/6 inhibitor to apply for insurance reimbursement in early breast cancer, is taking the second step to extend its reimbursement coverage. According to a report, the agenda of reimbursing Lilly Korea’s Verzenio (abemaciclib) will be presented to the Health Insurance Review and Assessment Service's Cancer Disease Deliberation Committee today (March 6). Therefore, the industry’s attention is on whether Verzenio will succeed in its second reimbursement attempt. The company had difficulty reaching the CDDC stage during its first attempt for reimbursement in early breast cancer. After a long 6-month wait after submitting the application, the case reached the CDDC deliberation stage in May last year, but no standards were set. The company resubmitted the reimbursement application 5 months later to HIRA in October. The same month, a petition was posted on the Cheong Wa Dae National Petition Board, “Petition requesting reimbursement for the targeted therapy Verzenio in early breast cancer.” Also, the application was backed by additional clinical evidence.: 5-year monarchE data that was presented at the 2023 European Society for Medical Oncology (ESMO) Congress. This was a follow-up study to the 4-year data presented at the Annual San Antonio Breast Cancer Symposium Annual and Lancet Oncology in December 2022. Results showed that the gap between the Verzenio arm and the control arm (endocrine therapy alone) in the primary clinical endpoints of invasive disease-free survival (IDFS) and distant recurrence-free survival (DRFS) widened further in year 5 compared to year 4. At year 5, the primary endpoint, the difference in invasive disease-free survival (IDFS), was approximately 8% between the two arms. This suggests that even after completing treatment with Verzenio for a limited period of time, 2 years after the surgery, the treatment benefit continued to year 5. Other than the letrozole generic that is used as endocrine therapy, it is the only new drug available for HR+/HER2- type early breast cancer. The drug’s indication was expanded on November 18th, 2022 as an adjuvant treatment for adult patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-), node-positive, early breast cancer (EBC) at high risk of recurrence in combination with endocrine therapy. More specifically, the drug is indicated for a very limited range of patients with ▲ patients with 4 or more positive axillary lymph nodes, ▲ 1-3 positive axillary lymph nodes, and tumor size of 5 cm or larger, or ▲histological grade 3 disease. Keun Seok Lee, Professor of the Center for Breast Cancer at the National Cancer Center, said, “The Verzenio and endocrine therapy combination is recommended with a high level of evidence in major national and international practice guidelines as adjuvant therapy for patients at high risk of recurrence. With various clinical studies and major academic society reviews confirming its clinical utility, we need to enable rapid access to the treatment through prompt reimbursement to improve the survival of patients at high risk of recurrence.”
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