Korean physicians call for faster reimbursement of innovative drugs to improve patient access in KRPIA survey

Korea’s health professionals are voicing growing concern over delayed reimbursement for innovative drugs, calling for faster listing on the national health insurance scheme to improve patient access and treatment outcomes.

The Korea Research-based Pharma Industry Association (KRPIA) said that a new survey of 100 clinical experts in Korea found overwhelming support for reforming the country’s reimbursement timeline. The survey, conducted by global research firm Ipsos in January, gathered responses from physicians across various specialties on the state of drug accessibility in Korea.

All respondents agreed that the current interval between regulatory approval by the Ministry of Food and Drug Safety (MFDS) and the drug’s inclusion in the National Health Insurance Service (NHIS) benefit list is too long, with 74 percent describing it as excessively long.

When asked what they considered a reasonable timeframe, 81 percent said it should take no longer than 10 months, and 41 percent suggested it should be completed within six months.

However, the current reality in Korea paints a different picture. As of 2022, it took an average of 608 days, or about 20 months, for innovative drugs to be reimbursed after receiving regulatory approval.

This duration is nearly twice the timeframe considered appropriate by Korean physicians and significantly longer than in peer countries such as Germany (281 days), Japan (301 days), and France (311 days).

Doctors also emphasized the clinical consequences of such delays, with 83 percent of respondents saying that they believed that patient outcomes would meaningfully improve if drugs already widely used abroad were made reimbursable in Korea.

Also, 85 percent said relaxing reimbursement criteria for already listed drugs would enable broader and earlier use, resulting in better patient care.

The survey highlighted that 95 percent of respondents supported introducing a fast-track reimbursement process analogous to the MFDS’s GIFT (Global Innovative Products on Fast Track) program, which shortens the review period for breakthrough drugs by up to 75 percent.

Physicians argued that the Ministry of Health and Welfare should adopt similar measures to ensure quicker coverage decisions.

Concerns also extended to Korea’s international competitiveness in drug access, with 94 percent of the physicians surveyed agreeing that Korea lags behind global peers in terms of access to new treatments.

Meanwhile, 97 percent warned that multinational pharmaceutical companies may opt out of launching innovative drugs in Korea -- so-called Korea-passing -- due to opaque regulations and uncompetitive pricing.

Physicians also noted Korea’s low spending on new drugs. While only 13.5 percent of the national pharmaceutical expenditure is allocated to innovative medicines, the average across OECD countries is 33.9 percent.

Regarding this matter, 76 percent of respondents cited this gap as worrisome, and 88 percent called for Korea to improve drug accessibility to match top-tier OECD standards.

The survey also highlighted the importance of clinical input in policy decisions, with 88 percent of respondents stressing that frontline medical professionals should have a greater say in reimbursement evaluations, and 80 percent believed that physicians should participate in defining the patient populations eligible for reimbursed therapies.

“Medical professionals working directly with patients feel the burden of delayed drug access more than anyone,” KRPIA said. “They strongly support quicker and broader reimbursement to improve patient care.”

The organization added that it hopes the findings contribute to more patient-centered policy planning.

To address the issue, KRPIA has been advocating for a streamlined administrative process, faster review timelines, and a ‘list-first, evaluate-later’ approach that mirrors advanced healthcare systems. The association is continuing its dialogue with government agencies and industry stakeholders as policy discussions evolve.