The changes in sales right for Gavreto (pralsetinib), an RET (rearranged during transaction) inhibitor, may likely negatively influence the ongoing review for its insurance benefits, drawing the industry’s attention.

Roche recently discontinued its cooperation contract with Blueprint Medicines Corp., the developer of Gavreto. Accordingly, Roche Korea will be responsible for its sales only until the end of this year.

In late February, the two companies announced the end of the contract for Gavreto, saying Roche will return its global sales right to Blueprint Medicines except for the greater China region.

Such a contract change will take effect 12 months after the notification date of Feb. 22, 2023. According to it, Roche Korea will continue its domestic sales of Gavreto until the end of this year.

Blueprint said it would seek ways not to hurt patients’ treatment access in countries where Gavreto is being sold or developed within the period. However, which company will sell it in Korea following Roche Korea has yet to be known.

The problem is a review is underway in Korea regarding the provision of insurance benefits for Gavreto. In March of last year, Roche Korea won approval from the Ministry of Food and Drug Safety for Gavereto’s sales. It applied for reimbursement to the Health Insurance Review and Assessment Service (HIRA) in late 2022.

The company hoped the issue would be tabled on last month's cancer disease deliberation committee. Still, the screening procedure is being postponed longer than expected.

As Gavreto’s next sales agent becomes uncertain ahead of the review, some industry watchers express that Gavreto’s getting reimbursement this year may prove impossible.

Even if Gavreto passes the committee, they said it would be difficult for Roche Korea to go all out in ensuring negotiations with the insurance authorities.

Roche Korea is pushing hard to expand insurance benefits for its anti-PD-L1 immunotherapy, Tecentriq (atezolizumab), as the adjuvant therapy for early-phase lung cancer patients before this year passes.

Roche Korea’s move was stimulated by its intention to preempt the market, as the expansion of insurance benefits for rival products, Keytruda (pembrolizumab) for the same indication, becomes increasingly certain.

All this leads to the prediction that Roche Korea will unlikely be able to do its best to get reimbursement for Gavreto, the review of which will overlap with that of Tecentriq.

The industry insiders also pay attention to whether the situation facing Gavreto will influence the reimbursement deliberation of another rival RET inhibitor, Ely Lilly’s Retevmo (selpercatinib).

Retevmo crossed the threshold of the cancer disease deliberation committee last November and was tabled on the drug evaluation committee this month. However, the latter panel has decided to “rediscuss” the reimbursement of Retevmo.

All these situations increase watchers' interest in what effects Gavreto’s sales agent change will bring about on the domestic RET inhibitor market.