The Ministry of Health and Welfare (Minister: Cho Gyu-hong) has announced that starting from December 1, measures such as an increase in insurance drug prices and the application of coverage for treatments for serious diseases will be implemented to support the stable supply of essential medicines and enhance the coverage of treatments for serious diseases. This decision follows deliberations by the Health Insurance Policy Deliberation Committee.
As part of these measures, the prices of pediatric asthma drugs (2 companies, 2 items), particularly inhalers containing micronized budesonide like Pulmican, will be increased due to recent high demand post-COVID-19.
Additionally, six items, including essential antibiotics, facing production challenges due to a surge in raw material costs, will be newly designated as exit prevention drugs. This designation allows an increase in the upper limit to conserve costs, and the costs of six items already designated as exit prevention drugs will also be adjusted accordingly.
This initiative aims to support the stable supply of a total of 63 items from January to November 2023 through drug price increases for 26 items and cost conservation for 37 exit prevention drugs.
Looking ahead, the Ministry of Health and Welfare plans to closely analyze changes in supply, usage, and market inventory for drugs with unstable supply and demand over the past 3 to 5 years. If necessary, drug prices will be adjusted promptly, in proportion to additional production, to minimize inconvenience to patients.
Support for the Stable Supply of Essential Medicines
The insurance drug prices for inhalers containing micronized budesonide, primarily used for bronchial asthma and acute laryngotracheobronchitis in infants and children, will be increased from December 1. These drugs, including Pulmican, have faced supply challenges due to a surge in demand after COVID-19. Recognizing the essential nature of these drugs, especially for infants and children under 4 years of age with no alternative medications, steps have been taken to ensure a smooth supply with appropriate drug price compensation. Considering the substantial increase in monthly average usage post-COVID-19 (2.1 million units per month compared to 1.2 million units per month before COVID-19), the condition is set to supply at least 26 million units over the next 13 months (from November '23 to November '24).
Pulmican Nebulization Suspension (Micronized Budesonide) - Geonil Pharmaceutical Co., Ltd.
Pulmicotrespu Nebulization Suspension (Budesonide (Micronized)) - Astra Zeneca Korea Co., Ltd.
To address recent production and supply challenges due to a surge in raw material costs, six items, including essential antibiotics, have been newly designated as exit prevention drugs as of December 1. This designation allows an increase in the upper limit to conserve costs. Additionally, the upper limit price for six existing exit prevention drugs will also be raised.
Fruit Manju (2mL) - JW Joongwae Pharmaceutical Co., Ltd.
Taco Room (7.5㎠/1 Sheet) - Korean Red Cross
Taco Room (23.04㎠ (Pre-rolled)/1 Sheet) - Korean Red Cross
Taco Room (23.04㎠/1 Sheet) - Korean Red Cross
Taco Room (45.6㎠/1 Sheet) - Korean Red Cross
Boryeong Nafcillin Sodium Injection 1g (Nafcillin Sodium) - Boryeong Co., Ltd.
Dexahy Tablet 4mg (Dexamethasone) - Daewoong Pharmaceutical Co., Ltd.
Euromitexan Injection (Mesna) - Bukwang Pharmaceutical Co., Ltd.
Jeil Glucose Injection (4g/20mL) - Jeil Pharmaceutical Co., Ltd.
Cheil Pharmaceutical Potassium Chloride Injection (3g/20mL) - Jeil Pharmaceutical Co., Ltd.
Jeil Pharmaceutical Sodium Chloride Injection (2.34g/20mL) - Jeil Pharmaceutical Co., Ltd.
Cheil Sterilized Water for Injection (20mL/Ampoule (PE)) - Jeil Pharmaceutical Co., Ltd.
This time, newly designated exit prevention drugs include antibiotics and trace element preparations, and the upper limit amount for steroid preparations and basic infusion preparations has been adjusted.
The Ministry of Health and Welfare has increased drug prices for 26 items (average 29%) from January to November 2023 and maintained the cost of 37 exit prevention drugs (average 24%), thus providing support for a total of 63 items deemed essential for health security. Looking forward, the ministry plans to closely analyze changes in supply, usage, and market inventory for drugs with unstable supply and demand over the past 3 to 5 years, promptly adjusting drug prices if necessary to minimize inconvenience to patients.
Strengthening Coverage of Treatments for Severe Diseases
Starting from December 1, 2023, two new drugs, one for the treatment of patients with advanced or metastatic endometrial cancer (Dostalimab) and another for the treatment of neuromyelitis optica (Satralizumab), will be included in insurance coverage. This inclusion aims to increase access to treatment for severe patients and alleviate their economic burden.
The target for endometrial cancer treatment includes patients with recurrent or progressive endometrial cancer during or after platinum-based chemotherapy, satisfying specific genetic testing conditions.
Gemperlyju (Dostalimab) - GlaxoSmithKline Korea Co., Ltd.
Enspring Prefilled Syringe (Satralizumab) - F. Hoffmann-La Roche Ltd.
Upper Limit Amount: KRW 7,723,456
This move is expected to reduce the recurrence of symptoms with fatal impacts on daily life, such as blurred vision and lower limb paralysis, providing patients with a better quality of life.
Patients who used to bear an annual cost of around KRW 50 million for endometrial cancer treatment will now save up to KRW 25.1 million* with the application of health insurance. (*Considering a 5% self-payment)
For the neuromyelitis optica treatment, patients who used to bear an annual cost of approximately KRW 116 million will now save up to KRW 11.59 million* with the application of health insurance. (*Considering a 10% self-payment or a maximum of KRW 10.14 million with the self-payment ceiling)
Thus, from January to November 2023, a total of 63 new drugs have been included in health insurance coverage or expanded their coverage, reinforcing the guarantee of treatments for severe diseases. Notably, 11 high-cost drugs* have been newly included or had their coverage expanded, allowing more citizens to benefit from health insurance.