The Ministry of Health and Welfare said it would grant health insurance benefits to three medications consecutively from next month. The three are Huons’ Zopista (ingredient: eszopiclone), Takeda Pharmaceuticals Korea’s Zejula (niraparib), and Fresenius Medical Care Korea’s Velphoro (sucroferric oxyhydroxide).
The ministry’s Health Insurance Policy Deliberative Committee agreed Wednesday on revising the list of reimbursed drugs and the maximum reimbursement rates.
Zopista is a psychotropic drug used for treating insomnia. The panel set the maximum reimbursement at 108 won (93 cents) per tablet of Zopista 1mg, 162 won for 2mg, and 203 won for 3mg. The payment is valid from Nov. 1.
Zopista’s reimbursed price was set less than 90 percent of the weighted average price of Zolpidem, an alternative drug. The company skipped the drug pricing negotiation with the National Health Insurance Service, and the price was finalized at the meeting of the health and welfare ministry’s review board.
Zejula will get the benefit as second-line maintenance therapy for “patients with BRSA mutation-positive, platinum-sensitive, recurrent, high-grade serous ovarian cancer.” The maximum reimbursed price is 76,400 won per capsule from Dec. 1.
Zejula is an alternative to Lynparza (capsule), which has the same pharmacological mechanism. A related academic society has presented an opinion to the government that the treatment needed insurance benefits to improve patient convenience and offer various treatment options.
The government decided to put Zejula under a risk-sharing agreement where the drugmaker shares a percentage of an excess charge if the actual cost exceeds the expected total after the health insurance benefit.
Melphoro is a hyperphosphatemia drug used to control phosphorus in serum in dialysis patients with chronic kidney disease. The government set the upper limit of the reimbursement at 1,697 won per tablet. The payment will start on next Jan. 1 when the company can supply the drug.
The government made the reimbursement decision on Velphoro based on academic opinions that the drug can help maintain serum phosphorus levels in the normal range by increasing the patient's drug compliance with fewer pills, compared to Sevelamer.