Objectives: Korean government has been making efforts to improve the access of orphan drugs or cancer drugs to patients since it is difficult for these drugs to be reimbursed due to its high price or lack of clinical evidence. We aim to investigate the current status of reimbursement and reviewed related schemes in Korea. Methods: Appraisal results for orphan or cancer drugs during 7 years (2007~2013) were included and recommendation rate, final listing rate and order of entry among 8 countries were analyzed. Results: Total 331 were recommended to be reimbursed in overall 467 appraisal results (71%), whereas 74 was recommended to be reimbursed among 121 results for orphan or cancer drugs (61%), indicating that it was less likely to be recommended for those drugs. Fifty eight orphan or cancer drugs (48%) were finally listed through NHIC negotiation process. For cancer drugs, recommendation and listing rate seem to increase from 47% to 64% and 32% to 48% (2008~2010 vs 2011~2013), respectively. Those drugs have been reimbursed in the 4.86th place among 8 countries including Korea on the average. Besides, 15 drugs considered as rule of rescue in those drugs have been listed for reimbursement. Conclusions: We identified that orphan or cancer drugs has been more accessible to patients as time goes. As the benefit enhancement plan for four major diseases (2013) and the Risk Sharing scheme (2013) have been implemented, it is expected for the coverage for those drugs in Korean National Health Insurance to be widened through these schemes.
Kim, Y., Na, Y., Yim, E., Kim, J., & You, M. Y. (2014). Current Status of Reimbursement Decisions for Orphan Drugs or Cancer Drugs and Implementation for Access Schemes in Korea. Value in Health, 17(7), A654. https://doi.org/10.1016/j.jval.2014.08.2383