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- 2026-04-11 21:14:15
- Policy
- NHI turns to deficit with a mere 2.6% coverage improvement
- by Lee, Jeong-Hwan Aug 26, 2022 05:35am
- With the new government preparing for complete reorganization and faceoff of the national health insurance coverage enhancement project ‘Moon Jae-In Care,' the ruling party criticized that Mooncare's implementation turned the current NHI balance into a deficit while raising the coverage rate by only a mere 2.6% points. Also, the party criticized that the National Health Insurance Service has planned incentives across all NHIS employees despite the 2.9% rise in health insurance premiums borne by the public and that the national subsidy rate of NHI general accounts does not meet the statutory standards. The ruling party requested disciplinary action against the National Health Insurance project managers under the Ministry of Health and Welfare and urged the NHIS to withdraw or return the incentives planned or paid to its employees. The People Power Party’s policy committee criticized as above while presenting the ‘Top 100 issue projects of the fiscal year 2021’ on the 25th. The People Power Party pointed out that the current NHI balance turned to a deficit from 2018 due to the government’s coverage enhancement policy while the coverage rate rose by only 2.6%p until 2020 compared to 2017. The NHI expenditures had increased from ₩4.7 trillion in 2017 to ₩5 trillion in 2018, then surged to ₩8.6 trillion in 2019, and the accumulated reserves of NHI finances that had reached ₩20.8 trillion in 2017 turned to a deficit in 2018 and continued on its decline. In particular, the People Power Party criticized that the previous government was unable to reach the 70% coverage rate it had aimed to achieve by 2022. The NHI coverage rate had increased from 62.7% to only 65.3% by 2020. In addition, the public’s national health insurance premium had increased by 2.9% on average every year except for 2017. Also, Moon administration’s national subsidy rate for NHI general accounts did not meet the statuary standards. The party also pointed to the Board of Audit and Inspection’s audit results of the NHI fiscal management status that showed that ₩250 billion’s worth of precious tax money had been wasted. The BAI had reported that the MOHW had excessively paid out loss compensations after implementing a loss compensation plan worth a total of ₩190.7 billion in anticipation of a decrease in medical treatment revenue arising from the reimbursement of 11 items including epigastric ultrasound and brain MRI. Due to the overpayment of loss compensations, a total of ₩90 billion had been paid out as loss compensation from 2018 to December 2021, ₩160.6 billion of which is suspected to be in violation of standards because a compliance check was not carried out due to NHIS's inadequate computerized system. Therefore, the People Power Party pressed for an improvement of the system, pointing out how the NHIS, which turned the NHI balance into a deficit and wasted the taxpayers' money due to negligent management and supervision, is planning a performance-based incentive for all its employees. Specifically, the NHIS had completed an internal review to pay out ₩29,084,898,000 in employee incentives. 17,010 employees will be receiving the incentives in September. The NHIS President will be receiving ₩59,298,000 and the Standing Auditor ₩38,232,000. The rate of incentive payment was set at 40.5% of the basic annual salary for the President and Executive Directors, 38.25% for the Standing Auditor, and 67.5% for its employees. In addition, the ruling party criticized that the NHIS had not prepared any measures despite the imminent depletion of NHI reserves that is expected by 2025, is negligent about the long-term financial prospect, and is obstructing the National Assembly’s long-term fiscal outlook. The party's remedial plan states, “We ask the government to discipline the health insurance project manager of the MOHW and the NHIS that infringed the National Assembly's right to review the NHI accounts. Also, the NHIS should immediately withdraw or return the incentives planned or paid to its employees. Also, a long-term fiscal forecast of over 40 years needs to be made to accurately disclose the reality of the increased burden that will be borne by the public in the future. In particular, the NHIS should cooperate and submit data for the National Assembly Budget Office's long-term fiscal forecast." “The NHIS President, who was appointed near the end of the last administration at the end of December 2021, had not even established a countermeasure for the deficit in health insurance that was made when Moon’s administration took office. The NHIS is holding a party amongst themselves after increasing public burden by raising the NHI premium rate in this economic crisis in the midst of COVID-19.”
- Company
- Zerbaxa on the verge of entering insurance benefits in 5 yrs
- by Eo, Yun-Ho Aug 26, 2022 05:35am
- The next-generation antibiotic Zerbaxa is finally registered as insurance benefits. It is the first time in five years that a domestic permit has been granted. According to related industries, MSD recently concluded a drug price negotiation with the NHIS for the antibiotic Zerbaxa. Due to the improvement of the system, it is possible to step on the PE track. The drug was approved in Korea in April 2017, but the prevailing view was that it was difficult to register under the system at the time. This is because it is not easy to prove cost effectiveness compared to the existing Old Drug, and it is difficult to prove clinical superiority due to the nature of the drug. Zerbaxa submitted an application for registration in the second half of 2018 and went through the procedure, but failed to pass the HIRA's committee in 2019. Zerbaxa has seen hope as the government has implemented an improvement plan to include essential drugs such as antibiotics in PE targets as a way to expand coverage. Zerbaxa passed the Drug Evaluation Committee in June this year and concluded the drug price negotiations, leaving only the passage of the Health Insurance Policy Review Committee until its listing. New Cephalosporin antibiotics Ceftolozane and Zerbaxa, a beta-lactamase inhibitor Tazobactam complex, which have an antipseudomonas aeruginosa effect, can be used in adult patients with complexity urinary tract infections and Metronidazole combination therapy. It is meaningful that it is the first alternative option at a time when the three major super bacteria in urgent need of securing treatments are Cabapenem-resistant fungi, Cabapenem-resistant Acinetobacter baumannii bacteria, Cabapenem-resistant and third-generation Cephalosporin-resistant intestinal bacteria.
- Company
- First patient dosed with Yuhan’s degenerative disc drug
- by Aug 26, 2022 05:35am
- Yuhan Corp (President/CEO: Wook-Je Cho) announced on the 25th that the first patient was dosed with its new degenerative disc drug, “YH14618(SB-01, Remedisc).” The clinical trial was led by the US pharmaceutical company Spine BioPharma on 400 degenerative disc patients at 30 clinical sites in the US. The Phase III trial was conducted to evaluate the improvement in persistent pain and other related disorders and the safety of YH14618 for 6 months after initial intradiscal injection. With a 12-month follow-up period, the results of the Phase III trial are expected to be secured by 2024. Yuhan Corp received the license for YH14618 from Ensol Biosciences in 2009 for domestic development. The company had licensed out the development rights and global commercialization rights (in countries other than Korea) for YH14618 to Spine BioPharma in 2018. With the first dosing of a patient complete for the Phase III trial, Yuhan Corp will receive a $2 million milestone payment (₩2.7 billion) as royalty from Spine BioPharma. YH14618 is a peptide drug that is injected into the spine to induce disc regeneration that is receiving expectations to satisfy the unmet need in the degenerative disc market where no cause or cure is yet available. An official from Yuhan Corp said, “This smooth start in the Phase III trial had been made possible through several years of close cooperation between Yuhan and Spine BioPharma. Spine Biopharma was able to receive approval to bypass the Phase II trial and initiate a Phase III trial from the US FDA based on the results of the clinical trial conducted by Yuhan Corp in Korea. We expect the speed of development to commercialization to accelerate after entry of the Phase III trial.”
- Policy
- Pts with osteopenia need screening tx
- by Kim, Jung-Ju Aug 26, 2022 05:35am
- The National Evidence-based Healthcare Collaborating Agency (Director Han Kwang-hyeop, NECA) analyzed the drug effect in osteopenia patients and developed a fracture risk prediction model and published the results of the study on the 25th. As aging rapidly progresses worldwide, the prevalence of osteopenia and osteoporosis is rapidly increasing. In particular, osteopenia is estimated to be about half of the current elderly population, and the social and economic burden of this is rapidly increasing as the frequency of hip fractures gradually increases. NECA conducted a study on the necessity of preventive treatment for fractures in osteopenia patients so that fracture risk factors can be analyzed and preemptively treated in osteopenia patients and announced the results. As a result of analyzing the data of a 66-year-old woman who underwent a life-changing medical examination of the NHIS, the number of osteopenia patients has continued to increase since 2007, and in 2019, osteopenia patients accounted for half of 66-year-old women. As a result of analyzing the incidence of fractures according to the bone density level, the incidence of fractures in the patients with osteopenia and osteoporosis was higher than in the group with normal bone density. As a result of identifying fracture risk factors and establishing a predictive model in 66-year-old female patients with osteopenia among life-changing health examiners from 2008 to 2009, falls, diabetes, cerebrovascular disease, asthma, and past fracture risk factors were included. As a result of reviewing domestic and foreign literature on osteoporosis fracture incidence, NECA confirmed that osteoporosis drug treatment groups had a statistically significantly lower risk of fracture than those without drug treatment in osteopenia patients and significantly increased bone density. Therefore, even if the bone density is not as low as that of osteoporosis, it is necessary to select and treat patients at high risk of fracture. According to expert opinion surveys from the Korean Society for Bone and Mineral Research and The Korean Endocrin Society, all respondents said they needed to selectively administer drugs to patients with osteopenia, and that they needed to expand insurance benefits to make actual prescriptions more active. Kim Jung-hee, an associate professor of endocrinology and metabolism at Seoul National University Hospital, said, "We confirmed that osteopenia patients have a higher risk of fracture than normal bone density groups, and active treatment should be considered for osteopenia patients with high risk of fracture." Professor Kim said, "We hope that the fracture prediction model developed in this study will be used as a useful indicator for evaluating the risk of fracture in patients with osteopenia." Yoon Ji-eun, an associate researcher at NECA, who is in charge of joint research, said, "We expect it to be used as an important basis for clinical treatment guidelines that determine whether to administer osteoporosis drugs to patients with osteoporosis in the future."
- Policy
- MET mutant anticancer drug Tepmetko challenges
- by Lee, Tak-Sun Aug 25, 2022 05:52am
- Following the MET mutant anti-cancer drug Tabrecta, which landed in Korea last year, Tepmetko is also undergoing a review. MET mutations occur only in about 3-4% of non-small cell lung cancer patients, but the prognosis is poor, so there is a desperate need for treatments that are covered by benefits. According to an industry on the 24th, the HIRA is considering establishing a new benefit standard for Tepmetko 225mg. Tepmetko 225mg is an anticancer drug approved in Korea by Merck in November last year and is used to treat patients with local progressive or metastatic non-small cell lung cancer with MET Exxon 14 skipping confirmed. When MET Exxon 14 deficiency occurs, the MET pathway, which plays a necessary role in cell signal, proliferation, and survival, is said to be excessively stimulated and cause cancer cell proliferation. On the same day, Tepmetko of Novartis Korea was also approved, allowing MET mutant anticancer drugs to be used for the first time in Korea. The two drugs had a mechanism to block the MET phosphorylation reaction by binding to the phosphorylase region of the receptor in the cell. The two drugs appear to be undergoing a benefit process afterwards. Tepmetko was on the agenda of the Deliberation Committee for Severe Cancer Diseases on the 10th, but failed to set a benefit standard. Currently, the two drugs can be used as non-reimbursedment, but it is difficult for patients to access them easily in that the price is around 10 million won. They want to apply prompt benefit to related patients and medical sites. However, it takes a long time to apply the benefit, such as setting anti-cancer drug benefit standards. Since Tepmetko failed to pass the cancer disease review committee, Tepmetko cannot guarantee to pass the first stage of the benefit process. In particular, in the case of MET Exxon 14 defects, the use environment is not easy because the companion diagnosis method has not yet been developed. Attention is focusing on whether Tabrecta and Tepmetko, which were approved on the same day, will be able to successfully register their benefits.
- Policy
- Entry of HER2-low breast cancer Tx imminent in Korea
- by Lee, Hye-Kyung Aug 25, 2022 05:52am
- Daiichi Sankyo Korea and AstraZeneca Korea’s human epidermal growth factor receptor 2 (HER2)-directed antibody-drug conjugate (ADC) “Enhertu Inj (trastuzumab deruxtecan)” is expected to be approved in Korea soon. This imminent entry of the first treatment for HER2-low breast cancer in Korea attracting much attention. According to industry sources on the 24th, the Ministry of Food and Drug Safety recently completed the safety and efficacy review for Enhertu. With the completion of the safety and efficacy review, the industry analysis is that the drug will be soon approved if no other variables arise. Enhertu, which has indications for breast and gastric cancer, was first approved for the treatment of recurrent metastatic HER-positive breast cancer in the US in 2019. Since then, Enhertu was additionally approved in the US for the treatment of locally advanced or metastatic HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma who have received prior standard treatment with “Herceptin(trastuzumab)” last year. In Korea, the drug has been under regulatory review after the MFDS granted Enhertu an Expedited Review Designation in June last year. If approved, patients who have difficulty using Herceptin or Perjeta due to low HER2 expression are expected to benefit from the marketing authorization of Enhertu in Korea. Although HER2 protein is generally expressed in breast cancer, it is also found in some other types of cancer. One out of five gastric cancer patients in the US is diagnosed with advanced HER2-positive gastric cancer. In October last year, the European Society for Medical Oncology Clinical Practice Guidelines were updated to recommend Enhertu for use as the preferred second-line therapy for patients with HER2 positive metastatic breast cancer following progression with a taxane and trastuzumab, based on the results of DESTINY-Breast03 trial. In July this year, the European Commission approved Enhertu as a monotherapy for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who have received one or more prior anti-HER2-based regimens.
- Policy
- 3rd gen ALK NSCLC drug Lorviqua to be listed on next month
- by Lee, Tak-Sun Aug 25, 2022 05:52am
- Pfizer ALK Inhibitory Non-Small Cell Lung Cancer Treatment Pfizer's third-generation non-small cell lung cancer treatment, Lorviqua, will be listed next month (September). As this drug can be used for non-small cell lung cancer that does not respond to ALK-positive first- and second-generation drugs, patients' treatment opportunities are expected to expand with registration. The HIRA announced on the 22nd that it will establish a new Lorviqua (second or more, chronic therapy) for non-small cell lung cancer in September while conducting an inquiry on the revision (draft) of the announcement according to drugs prescribed and administered to cancer patients. Detailed administration targets are progressive or metastatic patients who have been treated with ALK-positive and have been treated with primary ALK inhibitors such as Selectinib or Ceritinib or Brigatinib. However, patients who have received Crizotinib as a primary ALK inhibitor can also be used when disease progression is confirmed after administration of Alectinib, Ceritinib, or Brigatinib as a secondary ALK inhibitor. Xalkori is the first ALK inhibitor, and Alecensa, Zykadia, and Alunbrig are the second drugs. The HIRA said that as a result of reviewing textbooks, guidelines, and clinical papers, the therapy is mentioned as an ALK-positive non-small cell lung cancer treatment in the textbook. According to a single-group, phase 2 clinical trial (study 1001) of ALK-positive non-small cell lung cancer patients who previously received one non-Crizotinib TKI or two TKIs treatment, the reason for the establishment of the pay standard was reported as 39.6% for ORR, 6.6 months for mPFS, and 20.7 months for MOS. This is in accordance with the permission at the time of domestic approval in July last year. It also added that patients who started treatment with Brigatinib were included in the benefit list in consideration of guidelines and academic opinions. Lorviqua has been negotiating drug prices with the NHIS since it was recognized for its benefit adequacy at the HIRA Drug Reimbursment Evaluation Committee in April. Initially, it was expected to be registered this month, but it was completed to be registered next month through additional negotiations.
- Company
- LG Chem Life Science achieves new quarterly sales record
- by Kim, Jin-Gu Aug 25, 2022 05:52am
- LG Chem’s Life Science company, which is in charge of the company’s pharmaceutical business, has broken its quarterly sales record in the second quarter of this year. Its flagship products - the Zemiglo series and growth hormone - had shown strong sales performance in Korea and abroad, rising nearly 20% in one year. According to the Financial Supervisory Service on the 24th, LG Chem’s Life Science sector recorded ₩205.2 billion in sales in Q2 this year. This is a 17.8% increase from the ₩174.2 billion made in Q2 last year. The cumulative sales in 1H this year were ₩408 billion. If the company maintains the current growth rate, it may record sales of nearly ₩1 trillion by the end of the year. The company has continued stable growth despite the prolonged COVID-19 crisis. Compared to Q2 2019 (₩152.3 billion) before the COVID-19 crisis, this is a 34.8% increase made in three years. This strong growth is interpreted to be the result of the strong performance shown by the company’s flagship product, “Zemiglo” series, the growth hormone “Eutrophin,” and hyaluronic acid injection for arthritis, “Synovian inj.” According to LG Chem, combined sales of the DPP-4 inhibitor type diabetes treatment “Zemiglo (gemigliptin),” its metformin combo “Zemimet,” and rosuvastatin combo “Zemiro,” recorded ₩32.6 billion in Q2 this year. The series recorded a 3% external growth compared to the ₩31.5 billion in Q2 last year and maintained its lead among DPP-4 inhibitor class diabetes treatments in Korea. In the same period, its domestic market share increased from 21.1% to 22.5%. In the case of Eutropin, another flagship product, its market share increased by 1%p from 41.0% to 42.0% in the The flagship products performed well in both the domestic and overseas markets. LG Chem Life Science’s exports increased 17.3% from the same period last year from ₩65.3 billion to ₩76.5 billion in Q2 this year. Domestic market sales increased 18.1% from ₩109 billion to ₩128.7 billion during the same period. However, the operating profits of the Life Science company in Q2 decreased 16.6% from ₩29.1 billion to ₩24.2 billion. LG Chem explained that profitability had decreased somewhat due to the rise of R&D expenses in line with progress made in the company’s clinical trials. LG Chem is conducting various clinical trials in Korea and abroad. In Korea, the company received approval for the Phase III clinical trial protocol of its precocious puberty treatment candidate “GPP001” in June. When development is completed, it is expected to create further synergy with the company’s existing growth hormone Eutropin. The company had also completed a Phase 3 clinical trial of the Zemiglo+metformin+dapagliflozin combination. In June, the combination was approved under the name of Zemidapa. Dapagliflozin is an SGLT-2 inhibitor class diabetes treatment, and if development is completed, Zemidapa is expected to become the company’s fourth Zemiglo series drug. The company is also developing new drugs for hereditary obesity and gout abroad. Among them, the company applied for a Phase III clinical trial for its new gout drug candidate “tigulixostat” to the US Food and Drug Administration (FDA) on August 1st. Also, the company is participating in the development of the immuno-oncology drug ‘CUE-102’ with its partner, Cue Biopharma. LG Chem owns the exclusive right to develop and market CUE-102 in 11 Asian countries including Korea, China, and Japan. LG Chem explained, “We plan to further expand R&D investment to develop global new drugs. In particular, we will focus on oncology which has high growth potential, and diabetes and metabolic diseases where we own extensive R&D experience.”
- Policy
- Benefit for Sigmart 48mg will be newly established on Sept.
- by Kim, Jung-Ju Aug 25, 2022 05:52am
- Including Sigmart 48mg, JW Pharmaceutical's angina treatment, Nitroglycerin such as Nicorandil's drug, Elyson's Perlinganit 0.1% injection, which is used as a blood pressure control before and after surgery, and Verapamil HCl, Sanofi-Aventis Korea's Adenosine, are expected to be reimbursed next month. The benefits of Mycophenolate mofetil injections such as Roche's Cellcept, which is used to prevent rapid growth rejection of patients with kidney, heart, and liver transplants, and Ustekinumab injections such as Stella PFS 45mg, which treat psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis, will be expanded. The Ministry of Health and Welfare decided to push for a partial revision notice of details on the criteria and methods of applying medical care benefits" and recently made an administrative notice. First of all, as of the 1st of next month, four drugs related to angina will be included in the benefit. The target drugs are JW Pharmaceutical's Sigmart 48mg, Elyson Perlinganit 0.1% injection, ILSUNG Isoptin, and Sanofi-Aventis Korea Adenocor. Sigmart 48mg is considered to induce maximum congestion during intra-coronary pressure measurement when no-reflow occurs during PCI, and Perlinganit 0.1% injection is recognized for spasm relief, coronary angiography, and intervention in patients with dysplasia. ILSUNG Isoptin is provided to prevent vasoconstriction during carotid coronary angiography and intervention, and Adenocor is provided to induce maximum congestion during no-reflow during PCI and intra-coronary pressure measurement. Mycophenolate-based drugs such as Roche's Cellcept will be expanded to patients confirmed to be in the WHO classification stage of lupus nephritis. Ustekinumab injections, such as Janssen Korea's psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis treatment Stelara PFS 45mg, do not show an appropriate response to a universal therapeutic agent or are not resistant to mediocre ulcerative colitis patients.
- Policy
- All domestic restrictions on PVA cut are agreed
- by Lee, Tak-Sun Aug 24, 2022 05:56am
- 정해민 건보공단 약제관리실장이 23일 전문기자협의회와 브리핑을 하고 있다.Jeong Hae-min, head of the NHIS Pharmaceutical Management Office, is briefing with the Korea Special Press Association on the 23rd. In the PVA negotiations that reflect this year's revised guidelines, all domestic pharmaceutical companies agreed with the NHIS. Initially, negotiations with some domestic pharmaceutical companies were expected to be difficult due to opposition to the retroactive application of the revised guidelines, but they reached an agreement within the target deadline. The agreed items will be reviewed by the Health Insurance Policy Review Committee this week and announced on September 1. Jeong Hae-min, head of the NHIS Pharmaceutical Management Office, explained in a briefing with the Korea Special Press Association on the 23rd that 173 out of 175 items subject to negotiation were agreed. Type A negotiations are subject to an increase of more than 30% of the expected claims negotiated with the NHIS, and a product which cap has been adjusted by type price negotiations has increased by more than 60% or 10% from the previous year and increased by more than 5 billion won. This year's type C negotiations drew attention as the revised guidelines were reflected in April. The revised guidelines exclude less than 90% of the arithmetic average of the same main ingredient code and less than 2 billion won in annual claims from the negotiations. Previously, less than 100% of the arithmetic average and less than 1.5 billion won in annual claims were excluded. As a result, products from small and medium-sized pharmaceutical companies with an annual billing amount of less than 2 billion won will be excluded, but drugs with an arithmetic average of less than 90% will be included in the list, increasing the possibility of a drug price cut. In response, some pharmaceutical companies and the KPBMA have suggested that the guidelines should not be applied retroactively as of the previous year. However, regarding the retroactive application, the NHIS expressed its intention to reject it and began negotiations with individual pharmaceutical companies, saying that it shared it through meetings such as public-private consultative bodies. Jeong said, "We completed negotiations with individual pharmaceutical companies through sufficient consultation with pharmaceutical companies when negotiating with each company." As a result of the negotiations, an agreement was reached on 173 items in 52 product lines out of 175 items in 53 same product lines from 37 companies. Two items of one product line will be renegotiated, and the product is known to be two items of Xigduo XR of AstraZeneca Korea. Chief Jeong said, "The average cut rate of items that have been negotiated has decreased from last year, but the amount of fiscal savings has increased from last year." According to the revised guidelines, the average claim for drugs added due to the adjustment of the arithmetic average price was about 16.23 billion won, and the average claim for drugs excluded due to the upward revision of the claim was about 1.7 billion won. Director Jeong added, "As with the goal of revising the guidelines, we can see the reduction in administrative costs due to the exclusion of negotiations on drugs with small claims and the expansion of follow-up management of drugs with a large impact on insurance finances."
