Korea Reviews Possible Insurance Reimbursement Eligibility For Some High-Priced Pharmaceuticals

The government of South Korea is beginning to offer insurance reimbursement for the use of several ultra high-priced drugs, a development that could be both lucrative for pharmaceutical companies and provide relief to Korean consumers.

Pharmaceutical treatments, under review by Korea’s Health Insurance Review and Assessment Service (HIRA) drug benefit evaluation committee, include Zolgensma, a gene therapy to treat spinal muscular atrophy. Produced by Novartis, the gene therapy costs more than $2 million for a single injection, but a one-time treatment can cure a patient entirely.

The Korean government already offers health insurance reimbursement for Kymriah CAR-T cell therapy for leukemia and lymphoma, also produced by Novartis. Kymriah costs more than $400,000 for a one-time treatment that can show significant therapeutic effects. Under current regulations, Novartis must refund a certain amount of money for patients who do not respond to the treatment within four years.

If the Korean HIRA review of Zolgensma is favorable, it will be eligible for the same therapeutic outcome-based reimbursement system as Kymriah.

Written by: Ames Gross – President and Founder, Pacific Bridge Medical (PBM)
Mr. Gross founded PBM in 1988 and has helped hundreds of medical companies with regulatory and business development issues in Asia. He is recognized nationally and internationally as a leader in the Asian medical markets. Mr. Gross has a BA degree, Phi Beta Kappa, from the University of Pennsylvania and an MBA from Columbia University.

Source used in the article: https://www.globallegalinsights.com/practice-areas/pricing-and-reimbursement-laws-and-regulations/korea