Calls grow for insurance coverage of Trodelvy, lifesaving drug for triple-negative breast cancer

Calls from patients are mounting for providing insurance coverage for the first antibody-drug conjugate (ADC) for triple-negative breast cancer, Trodelvy (sacituzumab govitecan).

“Uriduriguseulhana,” an organization of triple-negative breast cancer patients, issued a statement on Monday, lamenting the delay in the health insurance coverage of Trodelvy and urging the government to make a quick decision.

Triple-negative breast cancer is a subtype of breast cancer with a poor prognosis, predominantly affecting young women under the age of 40, with a high rate of recurrence and metastasis and a high unmet need for second-line therapies.

Trodelvy is the only new drug approved for the second-line treatment of triple-negative breast cancer. It was introduced in Korea in May 2023 but has not been covered by health insurance, putting high financial burdens on patients and their families.

“It is an unfortunate reality that the coverage of Trodelvy has been delayed only in Korea,” the patient group said. “In major countries, the rapid progression of the disease in young women has been reflected in policy decisions, leading to a faster coverage of Trodelvy.”

The organization emphasized that Trodelvy has also gained public support in Korea. It noted that about 105,000 people have signed a petition to reimburse the drug, and medical professionals also agree on expanding treatment options.

Trodelvy, which received a “reconsideration” decision from the Pharmaceutical Reimbursement Evaluation Committee of the Health Insurance Review and Assessment Service (HIRA) in August last year, will likely be reviewed again this year.

Gilead Korea has convinced its headquarters office to submit a proposal for additional financial sharing for Trodelvy, meeting the requirement for reconsideration.

“Providing health insurance coverage for Trodelvy is not just about a single treatment. It's about helping triple-negative breast cancer patients and their families spend the time they have left with their loved ones and dream of a better future,” the organization said. “We look forward to a quick and decisive decision from the government so that our voices are no longer drowned out.”

The group cited the case of its former representative, Lee Duri, who died last November after failing to receive help because her treatment was not covered.

Lee was diagnosed with stage 3 triple-negative breast cancer in 2019 and battled the disease for four years but missed out on treatment due to delays in reimbursement for innovative treatments. She passed away, leaving behind a six-year-old daughter.