Insurance price ceiling reeval negotiations to end on Aug 18

Public notice of the results to be issued on September 1

MOHW orders 12,800 items to undergo negotiations...drugs were classified into 3 types for negotiations

The pricing negotiations for items subject to revaluations of their insurance price ceiling in Korea are taking place from the 4th to the 18th of this month.

 

The negotiations are expected to be completed within the deadline as the National Health Insurance Service has been discussing the measures with pharmaceutical companies in advance.

 

Therefore, the adjusted drug price will be announced on the 1st of next month after the results of the negotiations are reported to the Health Insurance Policy Deliberation Committee at the end of this month.

 

According to the NHIS on the 8th, the Ministry of Health and Welfare issued a negotiation order on a total of 12,800 items by 206 companies that received insurance price ceiling reevaluations.

 

Although 16,000 items were known to have received reevaluations, items that had already completed negotiations and were adjusted accordingly were excluded from the negotiations.

 

The Generic Drug Division of the Pharmaceutical Benefits Department of NHIS plans to divide the companies subject to negotiation into 3 types and complete the negotiations by the 18th.

 

HIRA had received data from pharmaceutical companies until last February and conducted a re-evaluation on the price ceiling of subject drugs.

 

The first results were released in May after the results were reviewed by the Drug Reimbursement Evaluation Committee.

 

After the results of the first evaluation were released, companies filed objections on 1,300 items, and the review results of the objections were finally deliberated by DREC on the 3rd.

 

Afterward, HIRA transferred the results of the re-evaluation to NHIS.

 

The NHIS had held discussions in advance with pharmaceutical companies before the main negotiations since last April and agreed on most of the terms of the negotiations.

 

An NHIS corporation explained, "The pharmaceutical companies cooperated well with the NHIS during the preliminary discussion period and there seems to be no problem in completing the negotiations as scheduled." The reevaluation of the insurance price ceiling has been in progress to maintain or lower the upper limit set for insured drugs depending on whether or not the listed drugs meet the criteria for bioequivalence tests and DMF listing.

 

Drugs that satisfy both requirements – DMF and self-bioequivalence tests – can maintain their price as is, and the price of those that only meet one of the requirements is adjusted to 85%, and those that meet none are adjusted to 72.25% of the previous price.

 

Meanwhile, the 5,000 drugs subject to the second round of reevaluations by NHIS also submitted their data last month, and their review is expected to begin soon.