Drug Evaluated as ‘Necessary for Reimbursement’ by Pharmaceutical Committee30-Day Negotiation Period Upon Ministry’s Directive

주식 : AstraZeneca has announced its decision to withdraw its diabetes treatment, ‘Farxiga,' from the Korean market due to challenges with drug pricing reduction. However, the saga continues as negotiations intensify. Amidst a surge in claim amounts compared to the previous year, Farxiga faces scrutiny under 'Volume-Value Agreement (PVA)' negotiations, with a looming deadline set for June 30th, sparking speculation about potential price reductions.

investing : Industry sources reveal that during the April 4th meeting of the Health Insurance Review and Assessment Service's Pharmaceutical Benefit Evaluation Committee, Farxiga, an SGLT-2 inhibitor for diabetes, was deemed eligible for reimbursement. However, failure in PVA negotiations could lead to further regulatory actions, such as exclusion from coverage or mandated renegotiation for a year, based on committee recommendations. Pharmaceutical companies may be required to reimburse the National Health Insurance Corporation for expenses incurred during negotiation delays.

In the event of successful renegotiation, adjustments to the upper limit amount will be reported to the Ministry of Health and Welfare (MOHW) and deliberated upon by the Health Insurance Policy Deliberation Committee. Failure to reach an agreement may result in exclusion from national health insurance coverage.