Enhertu’s price falls to KRW 70 mil range with reimb

From the previous KRW 120 million range

Maximum list price set at KRW 1.4 million…cheaper than the non-reimbursed price of KRW 2.3 million

Actual price will drop further when RSA is applied... refund type and expenditure cap type RSA will be applied

The list price of the petitioned anti-cancer drug Enhertu was reportedly set at KRW 1.4 million per vial.

 

This is significantly cheaper than the non-reimbursed price of KRW 2.3 million.

 

In addition, the National Health Insurance Service (NHIS) will apply a risk-sharing agreement (RSA) system for the reimbursement of the drug, so the actual price of the drug is expected to be lower.

 

According to industry sources on the 21st, Enhertu’s price is going to be set at an upper limit of about KRW 1.4 million per vial.

 

The price had been reportedly applied to the drug when it passed HIRA’s Drug Reimbursement Evaluation Committee review in February.

 

In other words, the NHIS seems to have been negotiating around the price set by DREC.

 

This may explain why the negotiations began in late February and were completed in just a month.

 

Considering that an average weight patient requires 3 vials per treatment cycle (21 days), the drug’s non-reimbursed price is about KRW 7 million, and the listed reimbursed price is KRW 4.2 million.

 

In terms of annual treatment costs, the non-reimbursed price is about KRW 120 million and the list price is about KRW 71.4 million.

 

The actual price is likely to be lower with the application of the RSA system.

 

The expenditure cap type and refund type will be applied to Enhertu.

 

Enhertu’s reimbursement listing will be officially notified after being reported to the Health Insurance Policy Deliberation Committee's meeting scheduled for next week.

 

Enhertu is an antibody-drug conjugate (ADC) anticancer drug that is highly effective against HER2-positive breast cancer, which accounts for around half of all metastatic breast cancers.

 

It is also used for HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma.

 

In particular, the drug demonstrated a better effect over existing drugs in clinical trials.

 

Compared to chemotherapy, Enhertu reduced the risk of disease progression or death by 50%.

 

The overall survival (OS) was 23.4 months with Enhertu, 6.6 months longer than the 16.8 months of the control group.

 

The superior effect prompted the call for fast-track registration of Enhertu in the medical field.

 

The petition was signed by 50,000 people and reported to the National Assembly.