K-CAB, Enteresto, Olumiant, Rinvoq signs PVA agreements

K-CAB’s refund rate was adjusted…Price of Entresto and Oluminat were cut

Price ceiling for Tremfya and Alprolix was adjusted through PVA

HK.InnoN

The domestic P-CAB-based gastroesophageal reflux disease treatment 'K-CAB Tab (tegoprazan, HK Inno.N) and heart failure treatment 'Entresto Film Coated Tab (sacubitril-valsartan-sodium salt complex) the oral JAK inhibitors Olumiant Tab (baricitinib, Lilly), and Rinvoq ER Tab (Upadacitinib hemihydrate, AbbVie) have agreed on a price-volume agreement (PVA) upon negotiations with the National Health Insurance Service.

 

As a result, the refund rate for K-CAB was adjusted, while the price of Entresto and Olumiant will be reduced next month.

 

According to industry sources on the 27th, 3 products recently agreed to a ‘PVA B type’ negotiations with the NHIS to adjust reimbursement and the price ceiling amounts.

 

Since 2021, K-CAB has been reimbursed under a refund-type PVA agreement with the NHIS.

 

Under the agreement, the pharmaceutical company refunds the NHIS for the increase in usage amount instead of reducing the upper limit amount.

 

The new agreement is likely to have adjusted the refund amount for K-CAB.

 

Since the reimbursement agreement, K-CAB has undergone 2 PVA negotiations with the NHIS and the company refunded an amount to make up for its increased usage.

 

By adjusting the refund rate, it has maintained its price ceiling of KRW 1,300 per tablet since its listing in 2019.

 

The price of the heart failure drug Entresto will be reduced to KRW 1,599 per tablet from KRW 1,683 per tablet for 3 products through the PVA.

 

Entresto’s sales had been KRW 59.4 billion in 2023 according to IQVIA, up 29% YoY.

 

Lilly's Olumiant was also unable to escape PVA negotiations due to increased usage this year.

 

Olumiant also generated KRW 17.9 billion in sales last year, up 16% YoY.

 

The deal will lower the price of the 4mg tablet from KRW 20,635 to KRW 20,172 and the 2mg tablet from KRW 13,757 to KRW 13,448.

 

Another JAK inhibitor, Rinvoq XR tablets, will also see its price ceiling reduced through PVA type B negotiations.

 

The price of the 15mg product will go from KRW 19,831 to KRW 18,740, and the 30mg product will go from KRW 31,628 to KRW 29,850.

 

Rinvoq XR tablets generated KRW 20.7 billion in sales last year, up 81% YoY, according to IQVIA.

 

Type B negotiations will be conducted when the insurance price ceiling has been adjusted through Type A negotiations, or 4 years have passed since the ceiling amount has been adjusted by negotiation without Type A negotiations and the claims of the same product group have increased by 60% or more than 10% from the previous year's claims more than four years after the date of first listing or the date the ceiling amount was adjusted by negotiation, and the increased amount exceeds KRW 5 billion.

 

Two other products, including Janssen's autoimmune disease treatment Tremfya prefilled syringe Inj (guselkumab), will also receive a price cut through PVA Type B negotiations.

 

This is the second year the price reductions were made in a row.

 

For the second year in a row, the insurance price ceiling for Tremfya Prefilled Syringe and Tremfya One-Press Auto-Injector will be adjusted from KRW 1.5493 million to KRW 1.524511 million.

 

Five products of Sanofi's hemophilia B treatment Alprolix will also have their insurance price ceiling reduced from KRW 1,081 to KRW 1,088 through PVA type B negotiations.

 

The price adjustments will be made effective January 1, 2025.