MSD on final stretch with Keytruda coverage expansion

Now back to government, the Cancer Deliberation Committee could include it in the upcoming session

MSD “Thoroughly reflected recommendation made in last session to receive reimbursement”

MSD Korea made the last move for the Keytruda coverage expansion.

 

Now it is back to the government’s turn to make the decision.

 

Related industry sources confirmed, MSD has submitted the final financial expense sharing plan to Health Insurance Review and Assessment Service (HIRA) after revising the detailed strategies regarding the reimbursement expansion of immunotherapy Keytruda (pembrolizumab) in treating patients with non-small cell lung cancer (NSCLC) as a first-line therapy.

 

Accordingly, the Cancer Deliberation Committee would be able to revisit the matter on Oct.

 

14 at earliest.

 

The next session would be Keytruda’s eighth Cancer Deliberation Committee review.

 

If the upcoming session does not include Keytruda in the agenda, the reimbursement expansion talks would be delayed by more than a month.

 

The Cancer Deliberation Committee deferred Keytruda’s reimbursement expansion once again on Aug.

 

26, claiming the expense sharing plan was insufficient.

 

HIRA then relayed the financial plan discussed among the committee to MSD in early September and demanded a revised version.

 

The health insurance authority actually took the version positively as it was flexible on the conflicted clause of ‘the pharmaceutical company to pay for the initial three-cycle administration cost.’ As the MSD’s global headquarters was unconvinced of the clause, the company certainly seemed like it won a wiggle room in expanding the coverage.

 

However, the government proposed MSD to resubmit a financial plan including a new clause equivalent to the initial clause.

 

The company immediately started revising the plan, and sent in the latest version right before the Chuseok holiday.

 

It seems like the company has a similar clause that could replace the clause of ‘initial three-cycle administration cost payment.’ If the Cancer Committee refuses the new financial plan, Keytruda’s attempt to expand coverage would be technically over.

 

MSD official noted regarding the issue that “The company has presented a new version of Keytruda expense sharing plan to receive reimbursement as a first-line therapy treating NSCLC, prior to the eighth Cancer Deliberation Committee session.

 

The revised version has thoroughly reflected the recommendations made by the committee in August, and increased the company’s part of the expense sharing as a final stretch.”