Yoon Deok-hyun, Director of CAR-T Center at Asan Medical Center Seoul, "CAR-T Therapy Requires System Improvement for More Patients"

Kimria Insurance Coverage Burden Reduced
But Currently Only Prescribed and Administered at 'Big 5'
Hospitals Face Facility Acquisition Burden

"Treating All Patients in Seoul Is Inappropriate
Treatment Facility Standards Should Be Relaxed
to the Level of Hematopoietic Stem Cell Transplantation"

Yoon Deok-hyun, Director of the CAR-T Center at Asan Medical Center, Seoul (Professor of Oncology)

[Asia Economy Reporter Lee Gwan-joo] "Chimeric Antigen Receptor T-cell (CAR-T) therapy represents the culmination of modern medicine, combining advanced genetic engineering, immunology, and cell biology. Institutional improvements are essential to create an environment where more patients can access this medical service."

In April of this year, with the inclusion of Novartis's CAR-T cell therapy 'Kymriah,' known as the 'miracle anticancer drug,' in the national health insurance coverage, patient out-of-pocket costs were reduced from 400 million KRW to a maximum of 5.98 million KRW. Kymriah can cure relapsed or refractory B-cell acute lymphoblastic leukemia and diffuse large B-cell lymphoma at a near-complete level with just a single administration.

Currently, in South Korea, only large hospitals known as the 'Big 5' are authorized to prescribe and administer Kymriah. Professor Yoon Deok-hyun, head of the CAR-T Center at Seoul Asan Medical Center, which officially opened this month, likened the principle of CAR-T therapy to 'stealth' and 'radar.' Professor Yoon explained, "Cancer cells essentially have stealth capabilities that allow them to evade immune cell surveillance. CAR-T therapy artificially equips immune cells with powerful radar to detect cancer cells," adding, "After sufficiently increasing immune cells equipped with this advanced radar, they are re-administered to the patient to locate and effectively kill cancer cells."

The greatest advantage is its efficacy. Generally, about 90% of lymphoma cases improve with first-line chemotherapy, but 10% relapse or become resistant to chemotherapy, making treatment extremely difficult. Traditionally, hematopoietic stem cell transplantation was the only curative option in such cases. According to Professor Yoon, Kymriah is an innovative therapy that can cure 30-40% of these relapsed or refractory patients. He stated, "Out of 100 patients receiving Kymriah treatment, 60 experience tumor reduction, and among those 60, 40 achieve long-term survival close to a cure," calling it "a revolutionary, cutting-edge cell therapy that embodies the essence of modern medicine."

Although insurance coverage has reduced patient burdens, there is still a long way to go in prescribing and administering CAR-T therapies domestically. Professor Yoon emphasized the need for institutional reform first and foremost. Under current Korean standards, medical institutions must have facilities meeting Good Manufacturing Practice (GMP) levels to prescribe CAR-T therapies. Hospitals must invest hundreds of millions of KRW in facilities, and only a few hospitals in the country can afford such investments.

CAR-T therapy does not generate significant profits. In fact, the fees for processes such as cell collection do not even cover costs, resulting in hospitals incurring losses while allocating space and specialized personnel. This acts as a barrier for medical institutions to establish CAR-T treatment facilities. Professor Yoon pointed out, "In Japan, there are over 30 institutions treating with Kymriah, and this number is expected to expand to around 100 soon," adding, "Because CAR-T therapies can have late toxic side effects, patients are advised to stay near the treatment center for about a month. It is not desirable for all patients to be treated only in Seoul."

Specifically, Professor Yoon proposed relaxing CAR-T treatment facility standards to the level currently applied for hematopoietic stem cell transplantation, which many medical institutions perform. This would expand prescription opportunities while ensuring patient safety, thereby enhancing medical services for patients in blind spots. He emphasized, "The processes such as CAR-T cell collection performed by medical institutions are not very complex," and "Despite this, CAR-T therapy is subject to much stricter regulations than stem cell transplantation. Institutional reforms that provide both safety and patient accessibility are absolutely necessary."

The market outlook for CAR-T therapies is promising. Domestic companies are currently conducting clinical trials, and research on allogeneic cell-derived CAR-NK therapies is actively progressing beyond autologous CAR-T. Professor Yoon said, "Korea has many excellent researchers, and with industry-academia collaboration, we can develop internationally competitive CAR-T therapies," expressing hope that "the nation will take a strong interest and expand support."

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