Sevembrix, Sivinko, and Nepoxil, New Drugs for Severe Diseases, to Be Covered by Insurance from July

The new drug for chronic myeloid leukemia, 'Semblix,' the treatment for severe atopic dermatitis, 'Sibinco,' and the treatment for hyperphosphatemia improvement, 'Nepoxil,' will be covered by health insurance starting next month. It is expected to expand treatment opportunities for patients with these diseases and reduce their financial burden. Additionally, in the second half of this year, the benefit standard amount for assistive devices for people with severe disabilities will be increased.

The Ministry of Health and Welfare announced on the 29th that from July 1, three new drugs for chronic myeloid leukemia, severe atopic dermatitis, and hyperphosphatemia improvement in chronic kidney disease patients will be listed for reimbursement.

The newly reimbursed drug, 'Semblix Tablets' (Asciminib Hydrochloride) by Korea Novartis, is set to be reimbursed for adult patients in the chronic phase of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) who show resistance or intolerance to two or more tyrosine kinase inhibitors (TKIs). Until now, chronic myeloid leukemia patients bore an annual cost of about 56 million KRW out-of-pocket, but with this health insurance coverage, the annual medication cost per person will be reduced to 2.8 million KRW with a 5% co-payment.

Korea Pfizer's severe atopic dermatitis treatment 'Sibinco'
[Image source=Korea Pfizer]

The treatment for severe atopic dermatitis, 'Sibinco Tablets' (Abrocitinib) by Korea Pfizer, will also be covered. It will be reimbursed for adults with symptoms lasting more than three years and adolescents aged 12 to 17 who have not been adequately controlled despite receiving first-line treatment for more than four weeks and have shown no response or cannot use systemic immunosuppressants for more than three months due to side effects. Without coverage, adults paid 9.5 million KRW annually and adolescents 6.5 million KRW, but with coverage and a 10% co-payment, the cost will decrease to 950,000 KRW for adults and 650,000 KRW for adolescents.

The hyperphosphatemia improvement treatment commonly occurring in chronic renal failure patients, 'Nepoxil Capsules' (Ferric Citrate Hydrate) by Korea Kyowa Kirin, will also be listed. It is set to be reimbursed for end-stage renal disease patients undergoing hemodialysis whose serum phosphorus levels are 5.5 mg/dL or higher despite phosphorus-restricted diets before medication administration. Since the main ingredient contains iron, it also provides anemia prevention benefits for about 9,000 patients. With reimbursement, costs are expected to decrease from 770,000 KRW to 230,000 KRW annually.

Additionally, the reimbursement amounts for electric wheelchairs with enhanced pressure ulcer prevention functions for people with severe disabilities, as well as electric scooters, will be increased to reduce the economic burden on disabled individuals, and improvements in prescriptions for positive airway pressure devices and continuous glucose monitoring electrodes will enhance patient convenience. The reimbursement standard amounts will be raised to 2.36 million KRW for general electric wheelchairs, 3.8 million KRW for option-type wheelchairs, 1.92 million KRW for electric scooters, and 190,000 KRW for batteries for electric wheelchairs and scooters. Positive airway pressure devices will be allowed prescriptions for up to 12 months based on a physician's medical judgment, instead of the current uniform 3-month application. The increase in electric wheelchair reimbursement and other changes will be implemented in the second half of this year, and the improvements to the positive airway pressure device system will take effect from January next year.

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