Refund RSA may be set higher than the lowest price

Reply to Rep. Kim Mi-ae's written question

Refund RSA may be set higher than the lowest price

The HIRA said that the cost-effectiveness evaluation criteria for omitted drugs that submit economic evaluation data are less than 80% of the lowest A7 adjustment price.

 

It also explained that the economical evaluation drug can be integrated into a risk-sharing system (RSA), which can set the indicator price higher than the lowest A7 price in case of refundable restrictions.

 

On the 2nd, The HIRA responded like this to a written inquiry from Rep.

 

Kim Mi-ae of the National Assembly.

 

Rep.

 

Kim Mi-ae pointed out that it is necessary to disclose the internal regulations of The HIRA on the criteria for lowering the level of cost-effectiveness evaluation of economic evaluation drugs.

 

Rep.

 

Kim also asked The NHIS' position on the basis of 80% of the lowest A7 price contradicts the NHIS' guidelines for drug price negotiations.

 

The NHIS explained that the actual price was deliberated to evaluate the cost effectiveness at about 80% of the lowest A7 adjustment price, considering the clarity of the criteria for "considering the lowest price" and whether to apply the risk-sharing system to excluded countries.

 

After this year's third Drug Reimbursement Evaluation Committee, it was added that it shared related information at an industry meeting on June 17 and a private consultative body on July 28.

 

Regarding the 80% standard of the A7 lowest price, The NHIS replied with the intention that it does not contradict the industrial complex negotiations, but that it means that prices can be lowered further when negotiated if necessary.

 

The NHIS said, "If the lowest A7 price risk-sharing contract is confirmed when determining the cost effectiveness of the economical evaluation drug, additional price cuts are needed due to uncertainty in the indicator price." It said, "Since October 8, 2021, the economic evaluation drug has also been integrated into a risk-sharing system," adding, "If the A7 lowest price is not subject to a risk-sharing contract, the A7 lowest price can be set higher."