Patients with Ultracet don't get benefit for anticancer drug

It is categorized as narcotics

It is a pain reliever commonly used in mild patients, which is contrary to purpose. Therefore, it is necessary to improve the standards

There have been cases that do not meet the intention of the original insurance benefit standard in the treatment of prostate cancer.

 

Targeted anticancer drug options such as 'Zytiga (Abiraterone acetate)' and 'Xtandi (Enzalutamide)' currently exist in adult resistant castration resistant prostate cancer (mCRPC).

 

Moreover, since last May, the coverage has been expanded through screening benefits (Copayment 30%) for both drugs.

 

It is said that the reimbursement is recognized if no narcotic analgesics are used, looking at the criteria for mCRPC treatment, such as Xtandi and Zytiga.

 

The point is not 'narcotics' but 'painless or mild'.

 

It is intended to administer anti-cancer drugs to patients who are not severe enough to be prescribed narcotic analgesics.

 

However, there are some medications used to manage pain in mild patients, such as Ultracet (AAP/Tramadol).

 

Ultracet is not classified as a narcotic analgesic by the MFDS, but Tramadol in Ultracet is classified as narcotic.

 

Ultracet is similar to the pain control effect of high-dose NSAIDs (non-steroidal anti-inflammatory drugs) in medical field, but has fewer side effects and is widely prescribed.

 

The mCRPC patient was excluded from the benefits of anticancer drugs because they were prescribed a commonly used drug.

 

Recently, there were cases of patients excluded from the benefits due to being prescribed Ultracet on the National Petition on Cheongwadae website.

 

The patient was diagnosed with end-stage prostate cancer and had surgery in June 2017 with bone metastasis.

 

Since then, his cancer has spread to the lungs, but his condition has improved as the oral anticancer drug is prescribed and the prostate specific antigen (PSA) level is maintained below 0.5.

 

However, because of Ultracet prescribed in the past, he were notified that it was no longer possible to get reimbursed, so he stopped taking the medicine.

 

Currently, his condition has worsened, with PSA levels increasing to 5.98.

 

Seok-Ho Kang, Public Relations Director of the KUOS, said "Ultracet is a widely prescribed pain reliever for patients with mild pain.

 

For those who cannot receive treatment due to unreasonable reimbursement standards, it is necessary to improve the standards that are more realistic and consistent with clinical evidence."