KRW 250 bil market shakes from reimb reevaluations

Some indications of 3 substances including loxoprofen removed from the reimbursement list as a result of this year’s reimbursement reevaluations

Prescriptions of loxoprofen and epinastine rise after the pandemic…market expected to contract with reduced reimbursement

The KRW 100 billion limaprost alfadex market hit hard by the government’s reimbursement reduction measure.

The pharmaceutical industry has expressed great disappointment regarding the results of the government’s drug reimbursement reevaluations.

 

The reimbursement scope of three ingredients - loxoprofen, limaprost alpha dex, and epinastine hydrochloride - will be reduced.

 

This is a loss worth KRW 250 billion in the prescription market.

 

The losses felt by pharmaceutical companies are expected to be even greater due to the reimbursement reductions made for products that have seen a surge in their respective prescription markets due to the COVID-19 pandemic and endemic.

 

This year's reimbursement reevaluations resulted in the indication reduction of 3 substances including loxoprofen...

 

KRW 250 billion market impact According to industry sources on the 28th, the Ministry of Health and Welfare recently held a Health Insurance policy review committee and announced the results of this year's salary reassessment.

 

Reimbursement for the 2 substances, rebamipide, and levosulpiride, which demonstrated their clinical utility, was decided to be maintained as is.

 

Three substances including loxoprofen sodium, limaprost alpha dex, and epinastine hydrochloride, will have their coverage reduced.

 

Evaluation of 2 substances, oxiracetam, and acetyl-L-carnitine hydrochloride, whose reimbursement has already been discontinued and efficacy/effect indications removed due to lack of evidence of efficacy during MFDS clinical reevaluations, were excluded from reimbursement reevaluations.

 

Pharmaceutical companies are now facing the reality of prescription market losses due to reimbursement reductions made on three drugs - loxoprofen, rimaprost alpadex, and epinastine - in addition to the two drugs that have been removed from the market due to failed clinical reassessments.

 

The list includes a number of products that have seen a surge in prescription volume in the wake of the recent COVID-19 pandemic and epidemic.

 

According to the market research institution UBIST, the total outpatient prescription market size of the three benefit reductions - loxoprofen, rimaprost alpadex, and epinastine - was KRW 251.4 billion last year.

 

This is a large market worth 250 billion won a year, a market where a decline in prescriptions is expected with the reimbursement reduction.

 

Loxoprofen’s reimb as a pain and reliever indication deleted from specifications…lights can serve as a loss of a KRW 100 million. Loxoprofen has been reimbursed in three areas: ▲as analgesia for chronic rheumatoid arthritis, osteoarthritis (degenerative arthritis), low back pain, periarthritis of the shoulder, and cervical spondylosis; ▲ analgesia for postoperative, post-traumatic, and post-extraction pain, ▲ and as antipyretic analgesia for acute upper respiratory tract infections.

 

Of these, the ‘antipyretic analgesia for acute upper respiratory tract infection' indication will be removed as after the government found its reimbursement justification inadequate.

 

For pharmaceutical companies, the removal of one indication for loxoprofen will result in lost prescriptions.

 

Last year, the outpatient prescription market for loxoprofen was estimated at 103.5 billion won.

 

Given the rapid growth of loxoprofen’s reimbursement-deleted indication during the COVID-19 pandemic, the losses felt by the pharmaceutical companies are expected to be even greater.

 

Prescriptions for loxoprofen increased by 6.6% from KRW 78.3 billion in 2018 to KRW 83.5 billion in 2019, but then declined to KRW 74.9 billion and KRW 72.4 billion in 2020 and 2021, respectively.

 

However, the prescription market for loxoprofen surged 43.0% year-on-year to KRW 103.5 billion last year.

 

Since late 2021, the demand for loxoprofen has increased dramatically when the number of COVID-19 cases increased by hundreds of thousands per day.

 

Loxoprofen continued to show growth in sales this year.

 

the growth trend has continued.

 

In the third quarter, prescriptions for loxoprofen totaled KRW 26.9 billion, up 52.4% from two years ago.

 

Cumulative prescriptions in the third quarter of this year showed that the amount totaled KRW 82.9 billion, up 57.5% in 2 years from the KRW 52.6 billion it had raised in December 2021.

 

of 2021.

 

The recent increase in prescriptions for loxoprofen is likely due to the increase in cold and flu patients since the end of the COVID-19 pandemic.

 

KRW 150 bil market may contract due to reduced reimbursement of limaprost alpha dex and epinastine limaprost alpha dex is used to ▲improve ischemic symptoms such as ulcers, arthralgia, and coldness caused by occlusive thromboangiitis, and to ▲improve self-symptoms and walking ability caused by acquired lumbar spinal stenosis.

 

Dong-A ST’s Dong-A Opalmon is the original drug.

 

limaprost alpha dex’s reimbursement for one of the two of its indications, ‘Improvement of ischemic symptoms such as ulcers, arterial pain, and coldness caused by occlusive thromboangiitis’ will be excluded from reimbursement.

 

Prescription sales of limaprost alpha dex had recorded over KRW 25.6 billion in Q3.

 

This is a 12.9% three-year increase from the KRW 22.7 billion in Q3 2020.

 

While growth in the prescription market for limaprost may not have been significant, the removal of one of the two indications is likely to contract the prescription market.

 

Last year, prescriptions for limaprost alpha dex amounted to KRW 98.9 billion.

 

Among the reimbursement-cut drugs, epinastine has also recorded high growth recently.

 

Epinastine is indicated for ▲ bronchial asthma ▲ allergic rhinitis ▲ urticaria, eczema-dermatitis, itchy skin, itchy rash, moderate psoriasis with itching ▲ prevention and relief of itching in allergic conjunctivitis.

 

This indication, "Prevention and relief of itching in allergic conjunctivitis," is applicable only to epinastine ophthalmic solutions.

 

Epinastine’s outpatient prescription sales in Q3 were KRW 15.1 billion.

 

This is a 12.5% increase from the same period last year and a 27.9% increase from KRW 11.8 billion in Q3 2021.

 

The increase in prescriptions for epinastine can be attributed to its increased use for bronchial asthma since the COVID-19 outbreak.

 

With the removal of epinastine’s bronchial asthma indication reimbursement, prescription sales are expected to decline.