In Korea, Eli Lilly and Novo Nordisk are pushing for national health insurance coverage for their diabetes drugs Mounjaro and Ozempic, which have demonstrated benefits in blood sugar control and weight loss.

Korea Biomedical Review has learned on Friday that Lilly Korea is applying for health insurance coverage for Mounjaro (tirzepatide) for the indication of diabetes. The company is in discussions with the Health Insurance Review and Assessment Service (HIRA), and the agenda is currently under review by a subcommittee before being submitted to the Pharmaceutical Reimbursement Evaluation Committee (PREC).

Tirzepatide is a dual GIP/GLP-1 receptor agonist. In other countries, it has been approved under the brand names Zepbound for obesity and Mounjaro for diabetes. However, in Korea, it was approved under the single brand name Mounjaro for both indications.

A Lilly Korea official said, “Since we applied for reimbursement as a new drug, there is a deadline for negotiating reimbursement, but it is difficult to predict exactly when reimbursement can be approved as the schedule may be delayed due to data supplementation.”

“We will do our best for diabetes patients in Korea,” she added.

Novo Nordisk Korea also plans to reapply for Ozempic (semaglutide) for the diabetes indication later this year. Ozempic is a semaglutide-based GLP-1 receptor agonist, similar in composition to the obesity drug Wegovy, but with a different indication.

Its application for Ozempic reimbursement is noteworthy. Previously, Novo Nordisk Korea applied for insurance coverage after receiving domestic approval for Ozempic in April 2022. The application passed the PREC review by HIRA in May 2023, but the company later withdrew during the drug price negotiation process.

'Diabetes patients should benefit from reasonable drug prices'

At a press conference held Wednesday, the Korean Diabetes Association (KDA) emphasized the need for diabetes drugs to enter the reimbursement system and highlighted the association’s related efforts.

“Diabetes patients face various complex issues,” said KDA Chairman Cha Bong-soo, professor of endocrinology at Severance Hospital. “Compared to existing GLP-1 drugs, newer medications have been proven to safely control blood sugar and address the root cause -- obesity.”

He added, “For patients, a monthly drug cost of about 500,000 won ($348) is a heavy burden. To resolve this, academic societies and pharmaceutical companies are working together to promote reimbursement.”

KDA’s Scientific Affairs Director Kim Sin-gon, professor of endocrinology at Korea University Anam Hospital, also commented, “Ozempic needs to be included in the reimbursement system to be used for diabetes patients. Even Wegovy is a good treatment for obese patients with cardiovascular disease, but those who face economic hardship cannot access it.”

Lee Byung-won, Director of the KDA’s Clinical Practice Guideline Committee and a professor of endocrinology at Severance Hospital, noted that semaglutide and tirzepatide were listed by their ingredient names—not just by drug class—for the first time in the newly disclosed 2025 Diabetes Treatment Guidelines.

“This reflects KDA’s emphasis on the importance of these agents,” he said.

“In terms of efficacy, we placed these two agents at the top of the treatment algorithm because they belong to a different class from traditional GLP-1 drugs,” Lee explained. “While existing GLP-1 drugs can lower HbA1c levels to 6.5, these two drugs can lower it to 5.7.”

He continued, “If semaglutide and tirzepatide are only listed as a class in the guidelines, they will be considered clinically similar to traditional GLP-1 drugs, making it harder for pharmaceutical companies to negotiate reimbursement. That’s why we had extensive discussions at the KDA and took the bold step of naming them by ingredient.”

In response to concerns that diabetes drugs with the same ingredients as obesity drugs could be misused for weight loss if covered by insurance, the KDA emphasized safeguards could be put in place.

“You just need to create enough safeguards,” said Kim. “If the innovative drug doesn’t lower blood sugar or reduce weight, then reimbursement should no longer be provided. We can also consider tiered out-of-pocket payments based on a patient’s financial capacity.”

At issue is whether the government will approve reimbursement for high-priced diabetes drugs, especially given the chronic nature of the disease.

“As we pursue our social responsibility, we look forward to the day when Korean patients—especially those in need—can access innovative treatments without financial hardship,” Kim added.