Court halts Faslodex price cut, giving AstraZeneca Korea time to prepare transition to successor drug

AstraZeneca's breast cancer treatment Faslodex (fulvestrant) has been granted a one-month reprieve from a planned price reduction in Korea. 

The Ministry of Health and Welfare had planned to implement the price cut on Aug. 1, but a court issued a stay of execution, meaning the previous price will remain in effect until Aug. 31. The reduction, approximately 20 percent, reflects mounting pressure to adjust prices for original drugs like Faslodex, especially amid the increasing availability of generics.

In 2023, the ministry issued an administrative notice indicating that the maximum price of Faslodex would be reduced by about 20 percent starting Aug. 1, 2025. However, on Wednesday, the court granted a stay of enforcement in response to an administrative lawsuit filed by AstraZeneca Korea, temporarily suspending the reduction. As a result, the existing drug price will remain unchanged through August, and the future price will depend on the outcome of the main trial.

This decision provides AstraZeneca Korea some time to reconsider its pricing strategy. However, the one-month reprieve is not merely a grace period -- it could also serve as a “buffer zone” for strategic shifts.

Price cuts linked to generic competition

The planned price cut stems from the entry of generic versions of Faslodex. Following the drug’s patent expiration several years ago, Korean pharmaceutical companies began developing and launching generics, which were subsequently listed for reimbursement.

Typically, the entry of generics leads to a roughly 30 percent price cut for the original drug. Faslodex already experienced such a reduction after generics launched, and a further cut was scheduled this time. Notably, the generics themselves also underwent price cuts, eventually resulting in price parity between the original and the generics.

AstraZeneca Korea opposed this outcome and pursued legal action, successfully securing a temporary injunction. However, the price cut could still take effect depending on the court’s final ruling.

Echoes of AstraZeneca’s approach with Forxiga

AstraZeneca Korea’s handling of the Faslodex price cut is reminiscent of its previous strategy with Forxiga (dapagliflozin), a diabetes treatment. After generics of Forxiga flooded the market, the government moved to reduce its price by nearly 50 percent. AstraZeneca Korea strongly objected and filed a lawsuit. While the court granted a temporary injunction, the company ultimately withdrew its Korean approval and exited the market.

That decision was largely influenced by China’s announcement that it would reference Korean drug prices when setting its own. AstraZeneca Korea feared that a steep price drop in Korea could affect prices globally, including in China.

As a result, Forxiga exited Korea but continues to perform well worldwide. According to AstraZeneca’s 2023 results, Forxiga is now the company’s top-selling product, generating billions in revenue.

Preparing for a transition to camizestrant

Regardless of the price battle over Faslodex, AstraZeneca is already preparing its next move. The company is developing camizestrant, an oral selective estrogen receptor degrader (SERD), which it aims to launch in Korea by next year. Camizestrant is seen as the next-generation breast cancer treatment that will likely replace Faslodex.

Unlike injectable Faslodex, camizestrant offers the convenience of oral administration and improved efficacy. With a shift in endocrine therapy patterns expected, industry experts anticipate that camizestrant will naturally succeed Faslodex.

AstraZeneca Korea views the Faslodex price cut not simply as a pricing issue but as a “soft landing” strategy aligned with the upcoming transition. While the company could take a drastic step like it did with Forxiga and withdraw Faslodex from the Korean market, it appears more focused on maintaining trust with local healthcare professionals and patients as it navigates the transition to camizestrant.

Thus, the court’s stay of execution serves not only as a legal win but also as valuable time to manage the shift smoothly. While the price reduction may still be implemented depending on the final ruling, attention is now on how AstraZeneca Korea will maneuver strategically in the coming months.