Xtandi closes coinsurance gap with Erleada

clears up the issue of the different coinsurance rates held by the two prostate cancer drugs through the reimbursement review process

Completed drug price negotiations to change mHSPC indication’s selective reimbursement to full reimbursement

'Xtandi' has virtually overcome its difference in drug price with ‘Erleada.’ Dailpharm’s coverage found out that Astellas Pharma Korea recently reached a final agreement with the National Health Insurance Service to negotiate the drug price for its prostate cancer treatment drug Xtandi (enzalutamide) to convert its indication for metastatic hormone-sensitive prostate cancer (mHSPC) to full reimbursement.

 

The conversion will likely be made in November.

 

Through the negotiations, the company was finally able to close the out-of-pocket coinsurance difference between its Xtandi and Janssen Korea’s ‘Erleada (apalutamide).’ Controversy was raised over Xtandi’s coinsurance rate after Erleada’s reimbursement approval.

 

Xtandi’s reimbursement was extended in August last year through the selective reimbursement system.

 

Selective reimbursement allows companies to waive the economic feasibility evaluations and quickly extend the scope of reimbursement for a different indication of a listed drug, but with a differentiated coinsurance rate, when the expansion of coverage for a previously listed drug is deemed urgent.

 

Xtandi was first listed for metastatic castration-resistant prostate cancer (mCRPC) in 2014, and when the mHSPC indication became eligible for selective reimbursement, Astellas chose to receive reimbursement through the option.

 

But the situation differed for Erleada.

 

As a newly listed drug, selective reimbursement was not an option for Erleada, so it had no choice but to conduct a pharmacoeconomic evaluation and undergo the mandatory reimbursement procedures.

 

Of course, the time required for reimbursement between the two drugs also differed significantly.

 

However, the issue lay in the coinsurance disparity that arose from the patient's perspective.

 

The out-of-pocket rate for Xtandi is 30% with selective reimbursement, but only 5% for Erleada, which received essential reimbursement and special calculations, resulting in a disparity in drug prices between these two drugs that are the same class.

 

But this problem is soon to be resolved.

 

Xtandi's conversion to essential reimbursement can be seen as the result of quick action made by Astellas and the government to address the issue.

 

Considering how Erleada was listed in April, Xtandi's rate of conversion to essential reimbursement has been made quite rapidly.

 

Meanwhile, Xtandi’s reimbursement agenda passed the Cancer Disease Review Committee in June, the Drug Reimbursement Evaluation Committee reviewed its cost-effectiveness in July, and drug pricing negotiations began in August after the company accepted the conditions set by DREC.