Tecentriq attempts reimbursement after Keytruda fails

Applied for reimbursement expansion after expanding indication in April…expected to be put up for deliberation at the Cancer Drugs Benefit Appraisal Committee meeting

Roche's 1st-line reimbursement in lung cancer may be discussed together with MSD

‘Tecentriq’ is attempting what ‘Keytruda’ had failed.

 

Industry sources have said that Roche Korea had submitted an application for the reimbursement of its ‘Tecentriq (atezolizumab),’ as monotherapy in the first-line setting for non-small cell lung cancer (NSCLC) patients whose tumors have a programmed death ligand-1 (PD-L1) expression on at least 50% of tumor cells (TC), or tumor-infiltrating immune cells covering at least 10% of the tumor area.

 

The company received approval for this indication this April.

 

The agenda will be put up for deliberation by the Cancer Drugs Benefit Appraisal Committee of the Health Insurance Review & Assessment Service in July.

 

Accordingly, the possibility is rising for Tecentriq's reimbursement to be discussed together with MSD Korea’s PD-1 inhibitor ‘Keytruda,' which failed to be approved for the 8th time at the meeting held on the 26th last month, at the next Cancer Drugs Benefit Appraisal Committee meeting.

 

The authorities may induce competition among pharmaceutical companies to reduce fiscal spending, however, this would lead to a delay in reimbursement listing.

 

This irony often occurs in the process of listing expensive new drugs or expanding reimbursement in Korea.

 

As drugs are expensive, if pricing competition arises between pharmaceutical companies, the government can take advantage of the net function of the market.

 

Fiscal savings under the National Health Insurance system saved from such competition can create additional opportunities for coverage expansion.

 

However, the issue at hand is its timing.

 

It would be optimal if drugs of the same class are approved at a similar period so that they can apply for reimbursement listing at a similar timeframe, but this is not likely in reality.

 

In general, the period of each company's reimbursement listing application varies by 6 months to even over a year.

 

Of course, factors other than the physical 'application' date also do play a role in the reimbursement delay, but this difference is important because there are patients awaiting the approval.

 

Moreover, most of the drugs in issue are anticancer drugs.

 

Attention is on what the results would be for the 2 anticancer immunotherapies that walked very different journeys that are attempting the long-delayed reimbursement in first-line lung cancer.

 

The NSCLC reimbursement expansion for Keytruda had been discussed since September 2017, and it has already been nearly 4 years.

 

Among the many barriers, the biggest issue was the ‘pharmaceutical company taking the burden of the initial 3 cycles’ worth of administration cost’ requested by the government to companies with immunotherapy agents.

 

Roche, which owned the then-latecomer Tecentriq was the only company to accept the government’s proposal, and 2 types of PD-1 inhibitors – Keytruda and ‘Opdivo (nivolumab)’ were unable to accept the offer.