The Korean offshoot of Eli Lilly has set about to expand insurance benefits for its CDK4/6 inhibitor, Verzenio (abemaciclib).

Verzenio is a targeted agent used for HR+/HER2- (hormone receptor-positive/human epithelial cell growth factor receptor 2 negative) early breast cancer patients. It is the only drug of its kind, appearing in the treatment area for the first time in two decades.

Considering that the HR+/HER2- subtype accounts for the lion’s share of breast cancer and most Korean breast cancer patients are found in the early stage thanks to the national cancer screening project, one can guess Verzenio adjuvant therapy’s clinical value.

HR+/HER- breast cancer is known to show a better prognosis than other subtypes. Many of the early-stage patients are completely cured. Still, about 20 percent experienced relapse despite the existing postoperative adjuvant therapy.

Also, considering Korean breast cancer patients experience the onset of disease at far lower ages than their Western counterparts, the Verzenio adjuvant therapy is a way to prevent relapses and help them return to normalcy by saving social costs from recurrence.

However, it remains to be seen whether the Verzenio adjuvant therapy’s challenge to get insurance benefits will succeed. Korea’s health insurance system, which industry watchers say has only one purse, handles drug insurance applications according to a “priority list,” considering not only equity among diseases and cancer types but also social and financial needs according to the number of patients subject to be treated.

Looking at the insurance coverage for breast cancer, it will not be easy for the Verzenio adjuvant therapy to be included in this list.

Some breast cancer treatments, such as Enhertu (trastuzumab deruxetecan) and Piqray (alpelisib), are waiting to be tabled at a cancer review committee meeting. Both are used to treat progressive and metastatic cancer, targeting patients whose lives are at stake. Their primary purpose is not to prevent recurrence but to treat risky patients.

Enhertu, in particular, is like the “last bastion” for HER2+ metastatic breast cancer patients with poor prognoses, and there are significant social demands to provide insurance benefits for this drug. As a result, requests for Enhertu’s approval by the Ministry of Food and Drug Safety have been on the national petition website numerous times. More than 50,000 people have agreed to a petition for its insurance coverage four days after it was posted and was referred to the committee. Accordingly, market watchers said Enhertu’s tabling on the committee meeting would likely be advanced.

Therefore, they said that for Verzenio adjuvant therapy to succeed in its attempt to get insurance benefits, it must present a drastic financial sharing plan.

One promising point is the newly appointed CEO of Eli Lilly Korea, Christopher J. Stokes, a public policy analyst who strongly intends to improve patient access to treatments.

Stokes is reportedly collecting internal opinions to devise a plan to persuade the Korean government. According to insiders, the new CEO is not ruling out any possibilities, including proposing an unprecedented pilot program that can quickly provide Verzenio adjuvant therapy to patients while considering Korea’s insurance system.

This writer hopes that the new CEO of Lilly Korea, who has experienced public policies in various countries, will provide even a small clue to solving Korean breast cancer patients’ problems.

The yoke of health insurance finances has long been a factor limiting Korean patients’ access to treatment.

That explains why the industry pays additional attention to Lilly Korea’s attempt to get insurance benefits for the Verzenio adjuvant therapy.