No. of refunded RSA drugs become 23 with addition of Onivyde

Agreement term terminated for 5 RSA drugs

NHIS presents list of drugs eligible for refund for the 100% copayment cost borne by patient

‘Naglazyme’ and other drugs whose RSA will be terminated may still receive refunds for drugs administered within their term

With the new addition of Servier Korea's pancreatic cancer treatment 'Onivyde (irinotecan liposome)' that was approved for reimbursement, a total of 23 drugs are now being covered under the Risk-sharing Agreement (RSA) scheme.

 

Patients who take RSA drugs need to bear the full cost of the drug, then request refunds to the applicable pharmaceutical company.

 

Recently, the National Health Insurance Service (NHIS) provided information on drugs eligible for the refund and the contact information of relevant reimbursement officials in each company for patients who paid a 100/100 copayment for the use of RSA drugs.

 

23 drugs are currently maintaining the RSA contract.

 

5 drugs whose RSAs were terminated - 'Pirespa tab,' 'Revlimid cap.,' 'Xalkori cap.,' 'Soliris inj.,' and 'Naglazyme inj.,' - may also apply for refunds if the patients received the drugs within the RSA term.

 

NHIS monitors the RSA claims data regularly and notifies the pharmaceutical companies of the RSA refund amount and the financial expense each company has incurred according to their RSA scheme.

 

Refunds of the additional cost borne by patients who paid 100/100 copayment for their drugs are directly conducted by the pharmaceutical companies or their agencies.

 

In 10 of the 23 companies, the patients may directly contact the company to receive the refund, however, for the other 13 drugs including 'Erbitux,' patients need to ask an agency or academic society for reimbursement.

 

The NHIS receives a monthly notice on the details of refunds from pharmaceutical companies and sends a notice to patients who did not receive refunds after comparing the refund details with the 100/100 copayment claims records.

 

Meanwhile, when a medical care institution such as a hospital or pharmacy prescribes or dispenses an RSA drug with 100/100 copayment by the patient, the doctor or pharmacist responsible should file a claim under Section code U (Health insurance 100/100) according to the 'Method on claiming medical care benefit expenses, and form and tips for filling out review claims and statements.' ▶RSA drugs eligible for a refund for the f00/100 patient copayment cost Erbitux Inj., Xtandi Soft Cap., Stivarga Tab., Pomalyst Cap., Opdivo Inj., Keytruda Inj., Ibrance Cap., Kyprolis Inj., Cyramza Inj., Darzalex Inj., Spinraza Inj., Perjeta Inj., Dupixent Prefilled Inj., Imfinzi Inj., Strensiq Inj., Verzenio Tab., Bavencio Inj., Kisqali Tab., Benlysta Injection, Ninlaro Cap., Hemlibra S.C Inj., Defitelio Inj., Onivyde Inj.