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- 2026-05-20 13:12:08
- Company
- Zolgensma & Kymriah will be entered the Korean market
- by Eo, Yun-Ho May 08, 2020 06:34am
- Two very expensive new drugs by Novartis enter the Korean market. According to a related industry, Novartis Korea submitted an application for the approval of a treatment for Spinal Muscular Atrophy (SMA), Zolgensma (Onasemnogene abeparvovec) & CAR-T (Chimeric Antigen Receptor T cells) cell gene therapy, Kymriah (Tisagenlecleucel) earlier this year. The two drugs are expected to be approved in Korea in the second half of the year as soon as they have obtained approval in Japan following the United States. Zolgensma is an SMA treatment such as Biogen's Spinraza (Nusinersen), which has attracted attention as an expensive drug, but it was also priced very expensive. Currently, it costs about ₩2.5 billion per dose. The United States has approved the world's highest price for $2.1 million as a single treatment. For reference, Spinraza's domestic insurance upper limit is ₩92,359,131 per bottle. However, Spinraza is administered six times in the first year and three times each year from the following year, whereas Zolgensma is administered only once. Zolgensma is a gene therapy product designed to produce SMN proteins that do not function properly in patients with spinal muscular atrophy in specialized motor neurons that can regulate muscle contraction. The indications for the first CAR-T drug Kymriah are 'recurrent or refractory B-cell Venous Lymphoma in patients under the age of 25' and 'relapsed or refractory diffuse large B-cell lymphoma after two or more adult systemic treatments'. In Korea, it was already designated as an orphan drug in March last year. Novartis prepared a document based on ELIANA data, a global phase II clinical trial, and submitted a New Drug Application (NDA) in Korea. Kymriah was first commercialized in the United States in the world in August 2017, and approved in Europe in 2018. However, CAR-T is also very expensive. Although this drug is approved for domestic market with a cost of about ₩500 million per dose, it is judged that it will be difficult to be placed in the reimbursement list. For reference, Kymriah is administered once. Meanwhile, Novartis is also preparing to commercialize the macular degeneration treatment drug Beovu (Brolucizumab) in Korea. Beovu has proved its effectiveness through the HARRIER trial that directly compares to Eylea (Aflibercept).
- Policy
- Felodipine indication to get limited to stable angina
- by Lee, Tak-Sun May 08, 2020 06:34am
- Original felodipine ‘Munobal’ by Handok Felodipine, used on patients with hypertension and angina, is facing an indication adjustment to only treat stable angina when used for angina. Korea Ministry of Food and Drug Safety (MFDS) is planning to finalize the order to change the medicine’s indication on May 22. A calcium channel blocker (CCB), felodipine has a brand-name drug like Munobal tablet (Handok), approved in 1990. After reviewing safety and efficacy data submitted for the oral felodipine’s license renewal, MFDS announced it has decided to alter the drug’s indication. The final order would be made on May 22 as the ministry has previously issued the preannouncement. Initially labeled as hypertension and angina treatment, the drug would be indicated to treat hypertension and stable angina. CCBs have been used to treat angina as it relaxes the blood vessels in coronary artery. Amlodipine, benidipine, efonidipine, felodipine and nifedipine are some popular CCBs. Generally used amlodipine is indicated to treat stable angina and variant angina. Angina can be categorized into three types—stable angina caused by chronic constriction with arteriosclerosis; variant angina caused by atherosclerotic plaque rupture; and variant angina caused by coronary vessel spasm-based blood flow dysfunction. Currently, nifedipine (brand name: Adalat (Bayer)) is limited to treat stable angina and soon felodipine would become the same. Total 33 felodipine items licensed by 31 companies would be subject to the indication change. Considered as an original felodipine drug, Munobal by Handok has made 1.6 billion won last year from outpatient prescription, according to UBIST.
- Company
- Jeil got a domestic exclusive promotion for Amitiza
- by Lee, Seok-Jun May 08, 2020 06:34am
- Jeil distributes FDA-approved constipation drugs in Korea. Jeil announced on the 6th that it has signed an exclusive promotional contract (distribution, marketing, and sales rights) in Korea with Amitiza soft capsule (Lubiprostone), a chronic constipation treatment for Takeda. Amitiza received FDA approval in 2006. In Korea, the approval process was completed in May last year. It is a type II chlorine ion channel local accelerator in small intestinal lining cells, and it has indications for the treatment of narcotic analgesic (opioid)-induced constipation △in adult patients with chronic non-cancerous pain, and △in adults patients with chronic idiopathic constipation. Amitiza is expected to be released this year. As of 2018, global sales amounted to ₩680 billion.
- InterView
- I tried to make the KOEDC 'Social butterfly '
- by Lee, Jeong-Hwan May 08, 2020 06:34am
- The KOEDC (President Young-mi Yoon)“The KOEDC (Korea Orphan & Essential Drug Center) is the place where the government and the public need attention more than any other institution. I wanted to increase the utilization of the public by spreading the awareness to the society that it is a place to supply medicines that are essential for the treatment of incurable patients and that the social supply of essential medicines does not stop. I hope that the government's support for the center's operating budget will increase significantly, and that the capacity to contribute to society will increase rapidly.” 'Inssa (Insider, Social butterfly)', which stands for social and organizational mainstream and friendly person, is a word that seems somewhat distant from the KOEDC. This is because the KOEDC is dedicated to rare and incurable disease drugs that have a relatively small number of patients or have relatively low social awareness and are less likely to receive social attention. In a way, the KOEDC seems to have no choice but to support the supply and treatment of remedies for incurable patients who are prone to alienation in society, taking on a task close to Assa (Outsider, not social). However, President Young-mi Yoon (51, Dongduk University of Pharmacy), who has led the KOECD for the past two years, made efforts to imprint rare disease and the existence of the center by making the center from outsider to insider and beyond to a social bufferfly. Director Yoon's term for the center ended on the 22nd of last month, but the appointment of the next president has not been completed, and the term has been temporarily extended without a new leader being decided. If the next president is decided, she will be officially retired. Specifically, Director Yoon is in many ways, including nurturing rare proceeds that have been solidified through 20 years of practice, advancing delivery of orphan drugs through regional centers and base pharmacy projects, and improvement of purchasing treatment hemp oil, led the improvement of the system by communicating with the National Assembly. This is the background of last year's national audit that raised the center's profits and improved the efficiency of budget support for the MFDS. Director Yoon suggested that the center's operation would be normalized based on the increase in the budget-to-government support rate for the newly appointed director's main job. The detailed work is the president's intrinsic competency and authority, but she believes that the lack of budget should not continue to do what the center has to do for the society and patients. "Unfortunately, in the past two years, we haven't completed the budget support problem for normal operation of the center, the expenditure of money, and the delivery of courier services," she said. In the end, it resulted in the issue of budget support from the MFDS and remained as the next president's homework. ” "In order to solve the safety issues of biological products that require temperature-controlled shipping and courier delivery with illegality, it is a consignment delivery pilot project, and at the same time, we have worked hard to establish a safe supply process for orphan drugs as a regional base center and base pharmacy. "The system is not complete, but I think this is the way the future center should go," she said. When asked what led the center to focus on, President Yoon responded, "I wanted to improve the utilization of the center by greatly increasing the interest of the people and society in the center." The intention is to make the KOEDC that is unfamiliar to the general public a social butterfly . "To inform the existence of the KOEDC, we needed to innovate in the center's hardware and software as a whole," said Yoon. "We moved the office to the city hall to build facilities such as pharmacies and drug warehouses in the center. This is why we created a process that minimizes supply and demand inconvenience. " Director Yun suggested that the center should plan to enhance the accessibility and safety of orphan drugs. In particular, it is said that it is the path for the country and patients to minimize the probability that the center will fall into the supply of orphan drugs even in extreme situations by closely analyzing the current situation in which the domestic supply of orphan drugs in the world is struggling due to the COVID-19 crisis. "There are more than 20,000 orphan drugs that the center supplies per year. The importance and social needs of orphan drugs are getting bigger every day," she said. Nevertheless, the center still needs to be improved in terms of facilities, management, accounting and operating systems. "It is the KOEDC that can reveal the willingness of the nation to somehow care for the underprivileged," she said. "We need to constantly monitor which pharmaceutical companies around the world are developing, producing and distributing what kind of pharmaceutical companies in the world and check the distribution line in real time so that we can have the bargaining power to supply domestic patients' drugs," said the Center. It is time to further advance the system to increase social utilization, "she suggested. “I took the job as a general manager and worked every day, at least once a week, hoping that the KOEDC would be known in the media,” said she. The center faces the challenge of formulating a budget for the MFDS for normal operation. We ask for your continued interest and support to ensure that the Center plays a role in the national health defense frontier.
- Opinion
- Time to stop the delay in drug patent conflict
- by May 08, 2020 06:33am
- Professor Kim Kwan Shik The world bombarded with COVID-19 related news has been disheartening. Even the new coined term ‘Corona Blue’ was trending. But on the lighter side, I came across some good news for myself, who mainly lectures and researches on patent law depicted in news articles. It was from a global pharmaceutical company, AbbVie announcing it would give up on the global patent rights to Kaletra, a potential COVID-19 treatment. In other words, anyone can make a copycat version (generic) of Kaletra. Anyone with a slightest interest in the industry would understand that giving up on a patent right means a tremendous commitment. Considering pharmaceutical companies are spending astronomical expense to protect and extend the pharmaceutical patent right as much as possible, the news actually sounded a little ironic. Global and Korean pharmaceutical companies use various tactics to prolong the market exclusivity period protected by the patent rights. One of the most popular strategies is ‘patent term extension.’ A patent’s term is valid until 20 years after the patent issue date, but in some cases it could be extended up to five years. As for pharmaceutical patent, a drug with listed patent cannot be commercialized immediately as it has to receive marketing approval from Ministry of Food and Drug Safety (MFDS) reviewed based on efficacy and safety data collected from clinical trial. Taking account of the time spent on the administrative procedure, the term can be extended up to five years. Many of Korean pharmaceutical companies tend to manufacture generics that copy original products with expired patent and sell them in inexpensive pricing. And by doing so, conflicts arise frequently due to the possibility of infringing patent rights. A famous case reported recently was on a drug sharing same effect with a patented original drug, but was using an incrementally modified substance uniquely approved by MFDS. The conflict fired up as the original drug company claimed the modified drug maker has infringed its patent right with extended term. In the end, the pharmaceutical industry was disconcerted by a staggering decision of the Supreme Court overruling the lower-instance Court’s conclusion that the patent was not infringed. Another pharmaceutical company has requested negative confirmation of the original’s patent scope to the Intellectual Property Trial and Appeal Board claiming that an item sold with effect and benefit, initially not acknowledged for the original’s patent that based the term extension, is not infringing the extended patent right of the original. However, the legal conflict has been on hold due to the COVID-19 pandemic. The order of strict social distancing has slowed down the court proceedings. Probably the pharmaceutical company pursuing the Court’s decision would be deeply frustrated as it needs to complete all procedures before the product launch. Recently lost in a series of term-extension related patent trials, pharmaceutical companies should not be hindered by the ‘delay in proceedings,’ when they have finally found an alternative strategy. This specific case and its follow-up trials would play a crucial role in the Korean pharmaceutical industry, as it could harmoniously arbitrate the conflict among pharmaceutical sovereignty, financial health of National Health Insurance, patients and stakeholders of the Korean pharmaceutical industry. Sources say the damage taken by pharmaceutical company from the pandemic is resulting in stagnating economic growth. The patent law was found to protect and promote invention and to contribute in industry advancement. The Intellectual Property Trial and Appeal Board and the Court should promptly make a reasonable decision, in accordance with the original objective of the patent law, for the pharmaceutical companies continuing to take challenges amid the difficult times to propel the flourishing industry in Korea.
- Company
- Pharmaceutical companies ended telecommuting
- by Kim, Jin-Gu May 07, 2020 06:02am
- The 45-day “social distance campaign” ended. The government has announced that instead of ending social distance on the 5th, it will start “distancing in daily life” from the 6th. According to the government guidelines revision, pharmaceutical companies are also returning to normal business one after another. Most pharmaceutical companies ended telecommuting on the 6th. Pharmaceutical companies that are still working from home are expected to return to normal business starting next week. Existing guidelines such as wearing a mask or checking fever are still applied. Meetings and events are also encouraged to refrain. From the 6th, the government changed the COVID-19 response guidelines to keep distancing in daily life instead of social distance. (Data: the KCDC) ◆Chong Kun Dang, telecommuting ends in a month, major domestic companies return to normal business Among domestic companies, Chong Kun Dang began telecommuting from sales offices in Daegu, Gyeongbuk at the end of February, and all employees worked telecommuting at the end of March. Telecommuting, which has continued for more than a month, has ended entirely on the 6th. It is said that the salesperson entered normal work from Monday (April 27) last week, and from 6th immediately after the holiday was over. Other pharmaceutical companies are in a similar situation. in the case of HK inno. N and Kolmar Korea, the field work of the salesperson will resume from next week. So far, salespeople have seen live education or web seminars through office work instead of on-site visits. GC Pharma and Ildong Pharmaceutical have also resumed their sales activities in a limited manner since mid-March. However, it is also flexible for employees raising young children. If you are an employee who has entered normal work, but in the case of employees whose children have not started school yet, the flexible work schedule allows them to adjust their time to work. Most foreign pharmaceutical companies that have actively responded to the COVID-19 crisis than domestic companies have either ended or will end their telecommuting. Amgen Korea, which started work at home for the first time in Korea, will start work next week. Pfizer Pharmaceuticals of Korea and Abbvie Korea are also expected to commence normal work next week. Novartis Korea has been working normally since last week, and Roche Korea has started on the 6th. ◆Distancing in daily life campaign is still ongoing However, all of them are acting cautiously to prevent any possible infections, including 'distancing in daily life' according to government guidelines. Checking the fever in the lobby of Hanmi This includes running a thermal camera at the doorway and wearing a mask indoors. In some places, after long telecommuting, ventilation and quarantine of the entire building were carried out. As before, meetings and business trips should be avoided as much as possible. It is same for in-house events. Ildong Pharmaceutical held the 79th anniversary of its foundation on the 6th and attended the event with minimal attendance. Some pharmaceutical companies have a system in place to automatically switch employees to telecommuting if they go to the area where the confirmed person is located or if there are confirmed patients or people with symptoms. An official from a domestic company said that they returned to normal business, but they was more concerned with daily life prevention according to government guidelines and was carefully resuming normal business with thorough prevention. ◆Expectations that may improve in May At one time, some hospitals advised to refrain from visiting salespeople A domestic salesperson A, who is responsible for pharmacies in Gyeonggi-do, said that pharmacists are brighter than before, it seems that the number of patients who visited pharmacies has increased again since the end of last month's disaster aid was paid. He added that the situation was very bad in March and April, but he expects the situation to improve after May. A domestic salesperson B, who is responsible for clinics in Seoul, said that the mood was very bad for about two months after facing the damage caused by the COVID-19 incident directly, however, it has been improved since the end of last month. He said that more and more places were allowed to return to salespeople, and he said they were encouraging each other, mentioning the end of the COVID-19 outbreak.
- Company
- Reimbursement talks on first CMV prophylaxis soon to begin
- by Eo, Yun-Ho May 07, 2020 06:01am
- The reimbursement approval talk is about to get started for Prevymis, a medicine to prevent cytomegalovirus (CMV) infection in stem cell transplant recipient. Korean pharmaceutical industry sources reported MSD’s Prevymis (letemovir) that was passed by Economic Evaluation Subcommittee last month would be deliberated by Health Insurance Review and Assessment Service (HIRA) Drug Reimbursement Evaluation Committee (DREC) on May 7. Reactivation of CMV in patients, who have undergone a stem cell transplant, could cause diseases like pneumonia, hepatitis, myocarditis, gastroenteritis and encephalitis. Despite a low level of CMV viral load in blood, it could increase the risk of mortality. A study found that in early hospitalization stage of CMV-positive patients who had stem cell transplant, the risk in overall mortality could be 3.5 times higher than in non-infected patients, whereas the mortality rate in patients with CMV viremia have 2.6 times greater risk of overall mortality than patients with no viremia up to 60 days after the transplant. However, the current CMV treatment in allogenic hematopoietic stem cell transplantation (HSCT) recipients mostly relies on pre-emptive therapy, which injects antiviral medication when the viral load exceeds a certain level. In 2018, Korean Ministry of Food and Drug Safety (MFDS) has approved of Prevymis to be used to help prevent CMV infection and disease in adults who have received an allogenic HSCT. The treatment has both injection and tablet formulation options and it can be administered once-daily from the day of or within 28 days of HSCT for up to 100 days after the transplant The U.S. Food and Drug Administration (FDA) has approved the use of Prevymis in 2017 and also designated it as a Breakthrough Therapy, Priority Review Drug and Fast Track Drug. President Yoon Sung-soo of Korean Society of Hematology (Department of Internal Medicine at Seoul National University School of Medicine) explained, “The limitation of the existing pre-emptive therapy is clear as it initiates treatment only when the CMV viral load reaches the threshold level. The medical demand on Prevymis is surging as it is a crucial treatment option for the survival of high-risk patients.” Clinical studies have confirmed Prevymis hindering the reactivation of CMV and lowering the risk of mortality. The studies reported no observation of adverse reactions like myelosuppression or renal toxicity. In the 2019 guidelines published by the National Comprehensive Cancer Network (NCCN) and European Conference on Infections on Leukemia (ECIL), Prevymis has been recommended as a prophylaxis in CMV-seropositive allogeneic HSCT recipient.
- Company
- Temptation to reduce the cost of DMF
- by Kim, Jin-Gu May 07, 2020 06:01am
- About 7 out of 10 DMF that pharmaceutical companies have registered for use are from India and China. Compared to 10 years ago, the share of DMF in India and China is also increasing significantly. It is an analysis that pharmaceutical companies have increased demand for inexpensive Indian·Chinese drug products to cut costs. According to the MFDS on the 4th, the number of DMF last year was 601. Excluding 71 cases in Korea, 530 cases were registered overseas. By country, India had the largest number of DMFs. The total number was 254, accounting for 42.3% of the total. China was followed by 153 cases (25.5%). The share of the rest of the countries was less than 5%. India and China combined account for 67.7% of the total. 7 out of 10 DMF were made in India or China. Top 10 countries for DMF in 2019. Of the total 601 cases, 407 cases were from India and China (67.7%) (Source: the MFDS) Cumulative number of DMF in 2009-2019. Of the 5,523 cases, India·China accounted for 61.5% (the MFDS)From 2009 to 2019, a total of 5,523 DMF were registered for 11 years (including re-registration). Of these, Korea had 875 cases (15.8%) In the cumulative DMF, India was the largest with 2,066 cases (37.4%). China was followed by 1,329 cases (24.1%). Excluding Korea, 227 cases in Italy (4.1%), 183 cases in Spain (3.3%), and 84 cases in Germany (1.5%) were followed. Looking at the changes for the past 10 years since 2009, the proportion of registration of DMF from India·China is increasing. In 2009, only 17.9% of Indian·Chinese ingredients were registered. Then, it increased to 39.4% in 2010, and has remained in the mid to late 60% since 2011. Compared to 2012, when DMF notification system was changed to a registration system, the share of DMF in India and China increased by 9.8% p from 57.9% to 67.7%. On the contrary, the proportion of Korean DMF is generally small. It decreased from 47.4% in 2009 to 11.8% last year, down to a quarter level in 10 years. The share of DMFs in India·China over the past 10 years (Source; the MFDS) It is analyzed that the biggest reason for the increase in the share of DMF registration in India and China is the low price. It is known that Indian and Chinese ingredients are about 20 to 30% cheaper than domestic ones. As pharmaceutical companies are looking for inexpensive DMF to cut costs, registration of drug products from India and China seems to have increased. There are also some institutional reasons. In 2011, the MFDS changed the regulations to register as a DMF if salts or hydrates are different even if the same active ingredient is used. As a result, the number of DMF registrations exploded. In the process, registration of DMF from India and China has also increased significantly. At that time, 377 cases were made in India and 194 cases in China in one year.
- Policy
- People with hepatitis C tx shouldn't take birth control pill
- by Lee, Tak-Sun May 07, 2020 06:01am
- Patients receiving hepatitis C DAA (direct-acting antiviral drugs) will not be able to take the contraceptive containing Ethinylestradiol. This is because the MFDS is pursuing an order to change the permit to add the DAA administration group as a contraindication to patients taking contraceptives based on EMA’s information. Previously, only Viekirax (Ombitasvir/Paritaprevir/Ritonavir), the treatments for hepatitis C, was contraindicated. The MFDS announced that it will instruct the change on the 12th of May through the preliminary notice period until May 11th for the changes in the permits. Since Ethinylestradiol is one of the female hormones Estrogen, it regulates the menstrual cycle, so it is mostly contained in pre-contraceptives. It is also contained in domestic market leading items such as Mercilon (Alvogen Korea), Myvlar (Dong-A Pharm), and Yaz (Bayer Korea), and 26 items of 14 companies are instructed to change the permit including these items. It has significantly higher levels of ALT in females using Ethinylestradiol-containing agents in clinical trials of Ombitasvir/Paritaprevir/Ritonavir that are at least 5 times higher than normal peak (ULN). Only Ombitasvir/Paritaprevir/Ritonavir, the treatments for hepatitis C, was contraindicated when taking pre-contraceptives. On the other hand, it was added that ALT elevation was observed when the combination of hepatitis C antiviral agent containing Glecaprevir/ Pibrentasvir (Maviret) and oral contraceptives containing Ethinylestradiol was added. Accordingly, the target of contraindications was expanded to patients with direct hepatitis C direct-acting antiviral (DAA). The DAA-based hepatitis C treatments released in Korea are 8 items including Viekirax, Maviret, Exviera, Sovaldi, Harvoni, Zepatier, Daklinza, and Sunvepra. The MFDS said that after the comprehensive review of the current status of domestic and foreign permits and submitted opinions regarding the safety information of the European Medicines Agency (EMA) containing Ethinylestradiol, an opinion inquiry was conducted. On the 12th, it was announced that the final permit change order will be announced.
- Company
- Cancer Committee lets down both Keytruda and Tagrisso
- by Eo, Yun-Ho May 07, 2020 06:01am
- Apparently, neither one of Keytruda and Tagrisso won the Cancer Deliberation Committee’s nod. According to the pharmaceutical industry sources on May 1, Health Insurance Review and Assessment Service (HIRA) Cancer Deliberation Committee convened a meeting after postponing it twice due to COVID-19, and decided to ‘defer’ the reimbursement decision on MSD’s Keytruda (pembrolizumab) and ‘unapproved’ AstraZeneca’s Tagrisso (osimertinib). Basically, the reimbursement expansion on immunotherapy Keytruda and targeted therapy Tagrisso would unlikely to happen any time soon in Korea. The Cancer Deliberation Committee reviewed granting reimbursement on Keytruda’s five indications, including as a first-line treatment (monotherapy and combination therapy) for non-small cell lung cancer (NSCLC), monotherapy for second or later-line treatment in bladder cancer, and monotherapy for third or later-line treatment in or refractory classical Hodgkin lymphoma. In March 2017, Keytruda monotherapy has been approved as a first-line treatment in patients with NSCLC. And the MSD Korea has submitted an application for reimbursement approval on the monotherapy indication to be used as a first-line treatment in September 2017, and continued the talk with the government for over two years. Regardless of the effort, the talks fell through in September last year. Considering the health authority’s decision, MSD showed its commitment by submitting unasked-for economic evaluation data on the first-line treatment in NSCLC to seek for the reimbursement expansion. But the Cancer Deliberation Committee rather demanded additional data on reducing the cost and deferred the decision. As for Tagrisso, the result was even grimmer. AstraZeneca Korea has submitted a reimbursement expansion application for the first-line indication of its osimertinib treating epidermal growth factor receptor (EGFR)-mutated NSCLC. Although the company has expressed its assertive intention to reduce the financial burden as proposed by the government, the committee members (oncologists) raised the issues on the treatment’s clinical efficacy and insisted on not approving the reimbursement. The anticancer treatment has been deferred by the committee once already in last October. The committee’s decision then was due to the Asian subset analysis result of the FLAURA Phase 3 trial in Tagrisso, specifically confirming the overall survival (OS) value. The study found the median OS with osimertinib was 38.6 months, 6.8 months longer than first generation EGFR-TKIs, Iressa (gefitinib) and Tarceva (erlotinib). However, hazard ratio (HR) in the Asian subset analysis recorded a value of 0.995. Compared to the standard value of ‘1,’ the value difference of 0.005 meant no significance. Regarding the study result, some academics have questioned the efficacy of Tagrisso as a first-line therapy in Asian race. Meanwhile, others have raised concern over the committee applying double standard as first and second generation EGFR-TKIs, Iressa, Tarceva and Giotrif (afatinib), have been listed for reimbursement as first-line therapies without concrete evidence on the OS. Some also argued the solution is in drug pricing adjustment. Based on the speculations, AstraZeneca also persuaded its headquarters and expressed its intention to adjust the pricing, but the deliberation result was a let-down.
