"Switching of atopic dermatitis treatments not yet allowed"

Academics point out the limitations to patient condition-centered treatment options…"options must be provided"

Guidelines for atopic dermatitis treatment were revised in July for the first time in 9 years…more discussion on switching between agents

Expectancy↑as the response of HIRA changed after the basis for swithching therapy has been established

As new drug entries shift the market for atopic dermatitis, the public onion demands changes to reimbursement assessment, such as considering the comprehensive factors to use increased treatment options efficiently.

 

Opinions have been suggested to consider factors related to patient quality of life, such as improving itchiness, in addition to the Eczema Area and Severity Index (EASI)-75 achievement rate, which is a typical criterion for evaluating the effectiveness of atopic dermatitis treatment.

 

The view is that since switching between treatments is the major focus of the guidelines for atopic dermatitis treatment revised for the first time in 9 years and focus on switching between treatments, the Korean government must align with the global trend.

 

During Pfizer

Professor Ahn Ji Young, affiliated with the Department of Dermatology at the National Medical Center, and Professor Jang Yong Hyun, affiliated with the Department of Dermatology at Kyungpook National University, discussed the matter while sharing Korea's latest treatment trend of severe atopic dermatitis during the '2024 Pfizer Press University.' Regarding the necessity of switching between atopic dermatitis treatment, Ahn stressed the nature of the disease, which accompanies various factors.

 

Ahn explained, "The treatment of atopic dermatitis is difficult because of genetic and allergic factors and accompanying disease," and "Patients experience improved and worsened symptoms.

 

Therefore, the disease can progress to chronic disease, possibly leading to decreased patient quality of life and healthcare shopping." Ahn stresses the need to consider various factors for reimbursement assessment, such as itchiness, in addition to the previously defined EASI-75 score achievement.

 

Ahn emphasized, "EASI-75 is a familiar indicator because reimbursement coverage is provided when patients with moderate-to-severe atopic dermatitis reach the score during the treatment.

 

However, there are other important factors as well.

 

Subjective symptoms such as itchiness must also be considered when evaluating reimbursement." To reflect on the current situation, experts emphasize switching between medications.

 

Patient-optimized treatment options, depending on patient conditions, must become available.

 

Jang stressed, "Biological agents and JAK inhibitors are currently used to treat atopic dermatitis.

 

However, not all medications work for each patient," and "It is necessary to provide medication that suits patient's clinical outcomes, itchiness, and dermatological pathology.

 

If it doesn't work, another medication must be allowed."

(From left) Professor Ahn Ji Young, affiliated with the Department of Dermatology at the National Medical Center, and Professor Jang Yong Hyun, affiliated with the Department of Dermatology at Kyungpook National University.

Academics suggest that the basis for switching between treatments is currently sufficient.

 

While the approval criteria do not require the distinction between first-line treatment and second-line treatment, it has been suggested that a comprehensive factor such as the patient's condition must be considered when prescribing medications in clinical practices.

 

Jang stated, "Academics stress the need for prescribing optimized medication to patients with severe symptoms after considering the patient's condition," and "Another medication must be allowed to be used when a patient does not benefit from one treatment, showing insufficient response." According to the pharmaceutical industry, unlike the initial request for authorization of switching therapy, the government may be more willing to bring changes now.

 

For instance, the Health Insurance Review and Assessment Service (HIRA) has recently requested supplementary documents.

 

Therefore, switching therapy may be considered based on academic's suggestion for patients with insufficient response.

 

Jang said, "We were told there will be a meeting with the HIRA to discuss switching therapy."