UPDATE : Friday, August 7, 2020
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2 immuno-oncology therapies receive insurance coverage
  • By Kwak Sung-sun
  • Published 2017.08.21 15:03
  • Updated 2017.08.22 14:58
  • comments 0

Two cancer immunotherapies -- Keytruda Inj. (pembrolizumab) and Opdivo Inj. (nivolumab) — began to receive health insurance benefits on Monday.

The Ministry of Health and Welfare held the meeting of the health insurance policy deliberation committee Friday and decided to apply insurance coverage to the two drugs.

The panel set the prices of Keytruda 100㎎ and Opdivo 100㎎ at 2.8 million won ($2,461) and 1.3 million won, respectively, and that of Opdivo 20㎎, at 331,700 won.

Accordingly, patients’ financial burdens from treating non-small cell lung cancer will drastically decrease to 3.5-4.9 million won (assuming the patient weighs 60㎏ and pay 5 percent of total drug prices), from the previous 100 million won annually.

However, patients with various cancer, including gastric and breast cancer, who use these drugs more than approved amount, will have to move to hospitals with multidisciplinary teams and get the approval of the excessive use from the chief of Health Insurance Review & Assessment Service (HIRA)건강보험심사평가원.

Currently, the Ministry of Food and Drug Safety (MFDS)식품의약품안전처 has approved Keytruda and Opdivo to treat only melanoma and non-small cell lung cancer.

The multi-disciplinary team means a panel that consists of doctors specializing in the hemato-oncology division, the pediatrics division of blood tumor, the surgical division to operate cancer surgery, and the radiation oncology.

It is a process to secure minimal safety and effectiveness for the excessive use of these drugs.

“We will allow the continued use of these drugs by patients who have used the drugs without insurance coverage to prevent treatment stoppage,” said an official at the health-welfare ministry. “But they have to move to hospitals that have multidisciplinary teams by the end of this year and report the results to the chief of HIRA.”


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