New blood cancer drugs reach Korea but insurance delays hinder survival rates: expert

Game-changing new drugs have been developed and introduced to Korea for treating blood cancers, including multiple myeloma. Still, an expert pointed out the nation’s gap in survival rates with advanced countries has not narrowed much.

Noting that the reason for this is not the level of treatment by Korean medical professionals but the delay in health insurance coverage, the expert called for improving the treatment environment.

On Wednesday, Professor Yoon Dok-hyun of the Department of Oncology at Asan Medical Center gave a presentation on the problems and ways to improve the treatment environment, focusing on blood cancer, at a debate on “How to Improve the Treatment Environment for Patients with Blood Diseases in Korea” hosted by Rep. Lee Ju-young of the Reform Party and co-organized by the Korean Society of Hematology and the Korean Doctors’ Weekly.

“Multiple myeloma used to be a disease that caused patients to die in just two to three years. However, with the development of remarkable treatments, the survival period is gradually increasing,” Professor Yoon said. ”However, the gap between the survival rate of multiple myeloma in Korea and that of the U.S. and Germany is not narrowing. This is not because doctors here are not good enough but because we don't have access to the right treatment for patients.”

According to Professor Yoon, Darzalex, a fourth-line treatment for multiple myeloma, was covered by health insurance in April 2019 for patients who failed first, second, and third-line treatments. After that, it was used in foreign countries as a third or second-line treatment, not a fourth-line treatment. Recently, it has been reported to reduce the chance of death of patients by nearly half when used in combination with conventional treatments as a first-line treatment. However, Korea has yet to expand coverage.

“There are even cases where some foreign companies have decided not to introduce their new drugs to the Korean domestic market,” Yoon said. “I am concerned that the opportunity for new drugs to be introduced may be lost altogether.”

The meeting also discussed the unclear reimbursement standards for expensive new drugs.

Using Kymriah as an example, Professor Yoon said, “A lymphoma patient I recently treated could only be treated with Kymriah. However, due to the current reimbursement criteria, this patient can only be considered for Kymriah after she has tried conventional therapies and has seen her disease worsen.”

Yoon continued, “For diffuse large B-cell lymphoma, Kymriah's reimbursement criteria define adults with ‘relapsed or refractory disease after two or more systemic therapies,” but patients who have been treated according to this criteria are being cut off at the point of care because they do not qualify as refractory in the traditional sense. Repeated reimbursement delays and unclear reimbursement criteria for expensive drugs can reduce access to care for Korean patients and limit optimal treatment.”

“More precise reimbursement standards and a specialized review system are needed to ensure the timely introduction of innovative blood cancer treatments to Korean patients,” Professor Yoon emphasized. “I hope that the opinions of blood cancer specialists can be actively reflected in this process.”