The reimbursement of Jaqbo Tablet (zastaprazan citrate), a P-CAB formulation developed by Onconic Therapeutics, a subsidiary of Jeil Pharmaceutical, has become visible, facilitating its commercial launch.

The introduction of a new P-CAB drug will also likely accelerate the expansion of P-CAB drugs’ share in the peptic ulcer market, industry insiders said.

The Health Insurance Review and Assessment Service held the ninth Pharmaceutical Reimbursement Evaluation Committee (PREC) and released its results last Thursday.

The committee deliberated on three P-CAB drugs—Onconic Therapeutics' Jaqbo Tablet, Jeil Pharmaceutical's Qzetas Tablet, and Jeil Health Science's ON-CAB Tablet—and determined that they are “appropriate for reimbursement if they accept below the evaluated amount.”

Qzetas Tablet and ON-CAB Tablet are twin drugs made at the same manufacturing facility as Jaqbo Tablet, but they have different product names.

Last month, Jeil Pharmaceutical began preparing for Jaqbo’s launch, conducting a “Jaqbo POA” (Plan of Action) event to share the drug’s sales strategy with over 400 sales and marketing representatives.

Pharma industry insiders expected the launch of Jaqbo to accelerate further the growth of P-CAB formulations in the domestic peptic ulcer market. Jaqbo is the third P-CAB product to enter the market, following HK inno.N’s K-CAB in 2019 and Daewoong Pharmaceutical's Fexuclue in 2022.

P-CAB drugs have the characteristics of rapid and stable suppression of gastric acid secretion by improving the slow onset of action of PPI (proton pump inhibitor) drugs, a disadvantage of existing GERD drugs. Unlike PPIs that must be activated by stomach acid, P-CAB drugs have the advantage of self-activation so that they can be taken regardless of meals. They are not easily degraded even when exposed to stomach acid, have a long duration of action, and are effective in suppressing stomach acid secretion at night.

According to pharmaceutical market research firm UBIST, the market share of P-CAB formulations was about 3.8 percent in 2019, when they first appeared in the peptic ulcer market. Since then, the share has steadily increased, reaching 8.1 percent in 2020 and 10.4 percent in 2021. Since Fexuclue was launched in 2022, the growth has accelerated further, accounting for about 12.5 percent in 2022 and 16.7 percent in 2023.

In the first half of 2024, the overall market size for peptic ulcer drugs is expected to reach 655.5 billion won ($488.8 million). Among them, the market size of P-CAB drugs was 127.1 billion won, accounting for 19.4 percent of the total market. Considering that P-CAB preparations have only been in the peptic ulcer market for four years, the market share of P-CAB preparations is expected to expand even faster.

“PPIs still have a larger share than P-CABs in the peptic ulcer market (prescriptions for PPIs were expected to reach 695.1 billion in 2023 or 54.8 percent of the total peptic ulcer market),” said a representative from a pharmaceutical company that sells P-CABs. “There are more than 200 PPIs, while P-CABs are only K-CAB, Fexuclue, and Jaqbo.”

The business official continued, “Our priority is to increase the share of P-CABs in the overall peptic ulcer market. We do not see other P-CABs as competitors, but rather as partners in shifting the paradigm of the peptic ulcer market from PPIs to P-CABs and expanding the market share of P-CABs together.”