Immuno-oncology drug 'Tiscentriq' coverage expanded to include hepatocellular carcinoma

Ministry of Health and Welfare Holds 10th Health Insurance Policy Deliberation Committee Meeting
Approximately 62.7 Million KRW Savings Possible on Medication Costs for Hepatocellular Carcinoma Patients
Dong-A ST Rebate Drug 'Price Reduction' to Take Effect on July 4

The 10th Health Insurance Policy Deliberation Committee.

[Asia Economy Reporter Kim Young-won] With the expansion of the health insurance coverage for the immuno-oncology drug 'Tislelizumab Injection (Tiscentriq)', patients with hepatocellular carcinoma will be able to save approximately 62.7 million KRW in medication costs starting this May.

On the 29th, the Ministry of Health and Welfare announced that it held a meeting of the Health Insurance Policy Deliberation Committee (HIPDC), the highest decision-making body for health insurance, and revised the drug reimbursement list and the reimbursement ceiling price table.

The HIPDC decided to expand the scope of health insurance coverage for Tiscentriq Injection to include "treatment of unresectable hepatocellular carcinoma patients who have not previously received systemic therapy in combination with Bevacizumab" and "monotherapy as first-line treatment for advanced non-small cell lung cancer patients without PD-L1 gene expression, EGFR, or ALK gene mutations."

Previously, health insurance coverage for Tiscentriq Injection was limited to second-line treatment for non-small cell lung cancer, urothelial carcinoma, and small cell lung cancer.

With this decision, the insurance coverage for hepatocellular carcinoma has been expanded, reducing the financial burden on patients. Without insurance coverage, the combined annual cost of Tiscentriq Injection and Avastin Injection for hepatocellular carcinoma is approximately 66 million KRW. With health insurance applied, the patient's annual medication cost burden is reduced to about 3.3 million KRW.

Additionally, the HIPDC decided to implement measures such as drug price reductions for Dong-A ST's drugs involved in rebate violations under the Pharmaceutical Affairs Act, in accordance with health insurance laws.

Previously, the Ministry of Health and Welfare imposed administrative sanctions including drug price reductions, reimbursement suspension, and fines for three cases of Dong-A ST's violations of the Pharmaceutical Affairs Act in September 2018 and March 2019. Subsequently, Dong-A ST filed for suspension of execution and administrative litigation to cancel the sanctions, and the Ministry prepared a re-sanction plan reflecting the court's ruling in favor of the plaintiff at the HIPDC meeting held that day.

According to the re-sanction plan, starting May 4, an average drug price reduction of 9.63% will be implemented for 122 items, including Glimel Tablets 1mg.

A Ministry of Health and Welfare official stated, "We will continue to respond firmly to illegal rebates through measures such as drug price reductions."

This content was produced with the assistance of AI translation services.