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- 2025-12-26 09:24:31
- Policy
- If the MFDS followed the EMA instead of the FDA for Belviq
- by Lee, Tak-Sun Feb 19, 2020 06:33am
- Appetite suppressant At the time of approving Belviq, banned by the MFDS on the 14th, it would be regrettable that it had not been approved in accordance with the European EMA's decision. The European EMA disagreed with the approval due to side effects from animal testing, and the developer voluntarily withdrew the application. The US FDA, on the other hand, approved it in June 2012, subject to post-marketing studies on cardiovascular risk. Belviq was licensed in Korea through Ildong, an importer, in February 2015. In April of last year, Belviq XR was approved. Belviq was designated for re-examination at the time of domestic approval and was ordered for post-marketing investigation for six years from February 2015 to February 2021. Developed by the US Arena Pharmaceuticals, Eisai owns all rights in the United States, and Arena owns all rights in Europe and Asia. In 2012, Ildong gained copyright through a contract with Arena. The MFDS issued an order to suspend sales and recall in Korea on the 15th, referring to the US FDA's withdrawal order for Lorcaserin. U.S. distributor Eisai is reportedly withdrawing from the United States. As a result, Ildong Pharmaceutical, a domestic seller, is expected to exit the market by returning the permit. All items on the market will be recovered. Belviq's problem is the risk of developing cancer. The U.S. FDA reviewed CAMELLIA-TIMI 61, a clinical trial conducted by Eisai, and concluded that the longer the treatment period, the greater the incidence of cancer compared to the placebo group. In the past five years, over 12,000 patients with high cardiovascular risk were overweight or obese, and 520 cases of primary cancer were diagnosed in 462 patients (7.7%) in the Lorcaserin group and 470 cases, 423 patients (7.1%) in the placebo group. In particular, the incidence of some types of cancer, such as pancreatic cancer, colorectal cancer, and lung cancer, was higher in the Lorcaserin-administered group than in the placebo-administered group. In fact, Belviq's issue was whether it was safe in cardiovascular disease. This is because the obese drug Sibutramine has been withdrawn from the market due to side effects of 'cardiovascular disease'. Eisai also conducted a post-marketing investigation with an emphasis on cardiovascular safety. As a result of the 'CAMELLIA-TIMI 61' clinical trial, the annual incidence of cardiovascular events (MACE) was 2.0% in the Belviq group (Lorcaserin 10mg, twice daily), and 2.1% in the placebo group. The risk of adverse effects on the cardiovascular system was negligible. But because of the unexpected side effects of developing cancer, Belviq eventually got stuck. Earlier, the European EMA rejected Belvik's approval in an animal trial in late January 2013 for side effects such as tumor induction, heart valve disorders and mental illness. Although it was not related to the human test, it was the conclusion that the results of animal experiments were actively reviewed. On January 16, the FDA announced that it would review the issue of cancer, and the MFDS announced that it would distribute safety letters to review domestic and international permits and usage. In the meantime, information on cancer incidence increased in animal experiments is reflected in the permit, and the association with humans is unknown. However, the fact that the incidence of cancer has increased in animal experiments is not included in the Belviq permit, which was granted in February 2015, but in the Belviq XR, which was granted last year. This is why the MFDS has been actively aware of the issue at the time of its approval. If the agency had listened to the European EMA decision and not the US FDA, the risky drug would not have been used in the patient. Belviq was launched in Korea in the first quarter of 2015 and recorded sales of ₩13.6 billion in IQVIA, ₩15 billion in 2016, ₩12.2 billion in 2017, and ₩9.8 billion in 2018. While selling more than ₩50 billion, no measures were taken in Korea.
- Policy
- MOHW to require reimbursement negotiation for generic
- by Kim, Jung-Ju Feb 19, 2020 06:32am
- Even generic drugs, reimbursed pricing decided according to set formula, would have to negotiate with the insurer about the insurance benefit. The government is aiming to establish legal basis to prevent companies evading pricing reduction by listing the same drug as another, and also to require post-management. Basically, the revision is constructing legal foundation for further drug pricing system revision. Korea’s Ministry of Health and Welfare (MOHW) posted a draft of revised ‘Regulation on National Health Insurance Reimbursement Standard’ on Ministry of Government Legislation’s board. The draft has been more specified than the version unveiled at Health Insurance Policy Deliberation Committee’s (HIPDC) subcommittee meeting in last December, as a part of this year’s drug pricing system revision plan. MOHW would improve generic drug pricing system by mandating negotiation track for generics, currently exempted from pricing negotiation before reimbursement listing, to fine-tune contract terms, and by preventing companies to wiggling out of pricing reduction penalty. Also the revision would stipulate the government to authorize maximum reimbursed price as well. The draft focuses on four following issues; improving reimbursement decision-making principle with detailed pharmaceutical reimbursement deciding principles and prioritization system; stipulating rejection on reimbursement applicant evading drug pricing reduction penalty; unifying pharmaceutical reimbursement application procedure; and establishing government-authorized track and revising related procedure. First, the government plans to set detailed reimbursement deciding principles and implement pharmaceutical reimbursement prioritization system. With the changes, the government would be able to decide on listing items considering sustainability of limited National Health Insurance resources. At the same time, the changes in detailed principle and prioritization system would be stipulated on the regulation. Another new regulation would stipulate the government regulator rejecting pharmaceutical companies avoiding drug pricing reduction. When the change is finalized, the government regulator could legally shut off a company penalized to reduce drug pricing for providing illegal rebate but trying to evade it by applying for reimbursement as another item under company’s subsidiary. The pharmaceutical reimbursement listing procedure would be unified as well. All drugs that passed reimbursement feasibility review would have to complete negotiation within 60 days and decide on an outcome. This would legally require a generic item, or non-negotiated drug automatically priced by set formula, to negotiate with National Health Insurance Service (NHIS). NHIS not only negotiates reimbursed price of a new drug, but also handles contract regarding supplier’s responsibility, patient protection (accessibility) and financial stability. And the insurer would be able to include generic in their scope as well. A pre-negotiation with the president of NHIS could be conducted, for the manufacturer to flawlessly process the actual negotiation procedure. Also a new track would be available for pricing negotiation-exempted drug to expedite the negotiation procedure. Reporting to the Minister of Health and Welfare would follow after Drug Reimbursement Evaluation Committee (DREC) deliberation, and the result would be notified to the president of NHIS. The streamlined procedure seems to be the government’s solution to the new DREC changing the reimbursement listing procedure and requiring face-to-face briefing for DREC that slowed down the expedited non-negotiated track. The revision would touch up the government-authorized pricing calculation and listing procedure as well. The changes would apply for when reimbursement standard needs adjustment based on a change in label, overseas label and reimbursement status, and clinical evidence. This would also legally stipulate the listed drug reevaluation, the government is lately pushing on. In detail, the government could order a negotiation between NHIS and applicant company when it is needed for stable supply. But when the government authorizes the negotiation, the reimbursement decision would have to be made after it to properly reflect the amended listing procedure. Considering the drug pricing system revising plan the government has, the above changes would be specified and finalized before the second half of the year.
- Policy
- NSCLC targeted therapy Vizimpro approved in Korea
- by Lee, Tak-Sun Feb 18, 2020 06:35am
- Pfizer Pharmaceutical Korea’s non-small cell lung cancer (NSCLC) targeted therapy Vizimpro has been approved to market in Korea. The treatment is a second-generation targeted therapy like Boehringer Ingelheim’s Giotrif. On Feb. 14, Ministry of Food and Drug Safety (MFDS) has approved Pfizer Pharmaceutical Korea’s three Vizimpro tablets (dacomitinib) in 15 mg, 30 mg, and 45 mg doses. The treatment has been indicated as a first-line therapy for locally advanced or metastatic NSCLC patients with epidermal growth factor receptor (EGFR) gene deletion in exon 19 or exon 21 L858R substitution mutations. AstraZeneca’s Tagrisso also shares the same indication. Apparently, EGFR is overexpressed in more than 70 percent of NSCLC patients, which affects proliferation of cancer cells and metastasis. EGFR tyrosine kinase inhibitor (TKI) targeted therapy generally defines all treatments with mechanism of using a molecule to block EGFR in cells. The EGFR TKI even has third-generation targeted therapy that overcame the initial tolerance in earlier drugs. AstraZeneca’s Iressa (gefitinib), Roche’s Tarceva (erlotinib) are first-generations, Boehringer Ingelheim’s Giotrif (afatinib) is a second-generation. And AstraZeneca’s Tagrisso (osimertinib) is a third-generation. Lazertinib, currently in development by Yuhan, is also a third-generation EGFR TKI treatment. Newly approved Pfizer’s Vizimpro is in the same class of second-generation EGFR TKI as Giotrif. However, it would also compete straight against Tagrisso as well, because they share the same indication. But Tagrisso’s reimbursement has not been cleared for first-line treatment. In a transnational clinical study with 452 patients, Vizimpro demonstrated statistically meaningful improvement in progression-free survival, compared to that of gefitinib. Sub-analyzing Asian-region patient group treated with the second-generation targeted therapy, the median progression-free survival was recorded at 16.5 months, whereas the first-generation gefitinib group was at 9.3 months. The pharmaceutical industry predicts the follow-on EGFR TKI treatment Vizimpro would set lower pricing than predecessors to ease into the market. The targeted therapy has won the U.S. Food and Drug Administration’s approval in September 2018.
- Policy
- Avastin additional coverage approved for colorectal cancer
- by Lee, Hye-Kyung Feb 18, 2020 06:35am
- Combination therapy of Avastin (bevacizumab) plus irinotecan plus low-dose capecitabine (mCAPIRI)’ treating metastatic colorectal cancer would receive insurance benefit from Mar. 1. Moreover, indications to treat patients with stage IIB or later mycosis fungoides, primary cutaneous anaplastic large cell lymphoma (pcALCL), or Sézary disease have been added to Adcetri’ (brentuximab). The drug’s current reimbursement is limited to second-line or later treatment for relapse or refractory CP30 positive anaplastic large cell lymphoma. Health Insurance Review and Assessment Service (HIRA) is collecting public opinion on the said changes made. Without any issue, they would come in effect from Mar. 1. HIRA has reviewed expanding coverage of Avastin to also cover for an ‘irinotecan plus mCAPIRI plus bevacizumab combination therapy.’ Initially, the drug was approved to treat metastatic colorectal cancer as a combination therapy with fluoro pyrimidine class chemotherapy. According to a literature review on textbook, guideline and clinical trial studies, the combination therapy has not been mentioned on either text or National Comprehensive Cancer Network (NCCN) guideline. But a 2018 guideline by European Society of Medical Oncology (ESMO) has mentioned it to have ‘study in progress,’ and a Phase 3 clinical trial comparing noninferiority of 'FOLFIRI plus bevacizumab’ and FOLFIRI has confirmed noninferiority with median overall survival of 16.8 months and 15.4 months. The combination therapy has been granted for reimbursement as a second-line treatment. HIRA explained, “The reimbursement on the drug has been granted for treating metastatic colorectal cancer as it could enhance convenience of outpatient treatment better than the already reimbursed therapy, and it could also provide more option of treatment to patients.” Additionally indicated to treat patients with CD30 positive cutaneous T cell lymphoma, who has been treated with one or more systemic treatment, Adcetris is recommended as category 2A by NCCN guideline for treating mycosis fungoides, primary cutaneous anaplastic large cell lymphoma (pcALCL), or Sézary disease. In Phase 3 ALCANZA study, the patient group with stage IIB or later mycosis fungoides and primary cutaneous anaplastic large cell lymphoma (pcALCL) demonstrated overall reaction rate (ORR) of 70.8 percent, and specifically 62.5 percent of the group had reaction over four months. And 18.8 percent of the group experienced complete response. HIRA official said, “The reimbursement on the treatment was approved considering the specific indication lacks other alternative treatment option.”
- Policy
- The MFDS collects 900 Metformins & tests for carcinogens
- by Lee, Tak-Sun Feb 17, 2020 06:26am
- The MFDS is conducting extensive testing of carcinogens in the drug 'Metformin', which is used as the primary treatment for type II diabetes. It is known that as many as 900 items to be inspected. As the US FDA announced the results of the survey yesterday, the MFDS is expected to speed up the survey in order to advance the publication date. According to the Ministry of Food and Drug Safety on the 4th, after conducting a raw material system survey with Metformin manufacturers in last December, the raw materials stored by the companies are collected and tested for impurities. On the 15th of last month, NDMA (N-nitrosodimethylamine) test method for carcinogens using GC-MS / MS has been announced, The MFDS is said to have identified the raw materials to be investigated based on systematic investigations. Nevertheless, it is explained that the survey period is getting longer because there are about 900 items. Currently, there are 640 finished products containing Metformin. The MFDS has been investing a lot of people recently to address COVID-19 infection issues. In particular, 30 people were dispatched to investigate the excessive profits of masks, and related departments are checking daily supply and demand, making it difficult to take the plunge on the Metformin survey. However, some research has been conducted, and results from other countries are coming up one after another. The investigation into NDMA, which is a carcinogen for Metformin, began on Dec 4 when Singapore health authorities recovered three Metformin products. At the time, Singapore health officials said more than 96 ng of NDMA were detected per day in Metformin products. The MFDS confirmed that the ingredients of the same manufacturer of the product recovered by the authorities of Singapore were introduced in Korea, and carried out a full-fledged investigation. Afterwards, a systematic investigation was conducted to ask domestic manufacturers to submit data on the source of production items. Meanwhile, the US FDA reported on the 4th that a sub-standard NDMA was detected in six lots of two of the 10 products. However, it is safe to use because it has a small amount of 10 to 20 nanograms per tablet. To date, no country has issued a prohibition on sales or a recovery order because no NDMA above the baseline has been detected in Metformin products except Singapore. Therefore, the prospect that Korea will have no problem is coming out cautiously. Major domestic manufacturers and sellers are also reporting that NDMA has not been detected through their own research. The domestic market for Metformin preparations is about ₩400 billion, which is widely used in both single and combination drugs. Single drugs include Diabex of Daewoong Pharmaceutical, Glucophage of Merck. If NDMA is detected above the threshold and sales bans or recovery measures are taken, a huge impact is expected, and the pharmaceuticals are unable to let go of tensions.
- Policy
- The TF agrees on COVID-19 treatment, 2 tabs of Kaletra BID
- by Kim, Jung-Ju Feb 17, 2020 06:25am
- Although the development of 'COVID-19' treatment has not been completed, the principle has been established that the treatment can be considered by administering two tablets of Abbvie’s Kaletra twice a day. Chloroquine, an antimalarial drug, is also considered, but not domestically distributed. Instead, Hydroxychloroquine, which is used as a drug for autoimmune diseases, may be considered. The National Medical Center held the 6th video conference with the COVID-19 Central Clinical TF, which consists of medical staff and experts in the COVID-19 confirmed patients care hospital nationwide, and agreed on the treatment principles on the 12th. According to the TF, there are currently no treatments for COVID-19 that have proven effective in humans. Therefore, the agreement is the most important clinical decision of the attending physician for the decision of antiviral treatment, the selection of treatment, and the duration of treatment. However, the summary of the agreement is based on the scientific literature published and the experience of TF team members, and is an important reference for treatment. According to the agreement of the TF, if the symptoms of young and healthy patients without the underlying disease are relatively mild, they can be observed without antiviral treatment. In particular, if more than 10 days after onset and symptoms are relatively mild, anti-viral therapy may be less likely. Conversely, antiviral therapy should be considered in patients with old or underlying disease and in patients with relatively severe COVID-19. If the patients are treated with antiviral treatment, it may be theoretically helpful to start dosing as soon as possible. Administration of Kaletra as an antiviral therapy may be considered. The TF can consider two tablets of Kaletra once a day (LPV/ r 400mg/100mg po bid) or Chloroquine 500mg po qd, but Chloroquine is not distributed in Korea, so Hydroxychloroquine 400mg po qd could be considered. It is the TF's judgment that there is no evidence that the combination of Kaletra and Chloroquine (or hydroxychloroquine) is superior to monotherapy. Combination of these drugs can cause serious arrhythmias and drug interactions with increased QT interval (electrocardiogram QRS wave time). Therefore, this combination therapy should be administered carefully in very limited cases. Antiviral treatment, on the other hand, may seem appropriate for 7 to 10 days, but may be shortened or extended depending on the patient's progress at the clinical site. The TF said that Ribavirin, hepatitis C treatment and Interferon, a substance that inhibits viral infection and proliferation in the human body, are not recommended as they have severe side effects, and the use of Ribavirin or Interferon are considered in limited circumstances where Kaletra or Chloroquine(or Hydroxychloroquine) is ineffective or difficult to administer.
- Policy
- “Genetic testing not required for reimbursed Soliris use"
- by Lee, Hye-Kyung Feb 17, 2020 06:25am
- Health Insurance Review and Assessment Service (HIRA) has disseminated a press release to explain a news article raising issues on preliminary review on atypical hemolytic uremic syndrome (aHUS) treatment Soliris injection (eculizumab). Apparently, a news article has reported the government deferring and rejecting preliminary approval on Soliris has caused 12 deaths out of 59 patients, and criticized patients are losing their golden time as the government is demanding genetic testing, not a part of the usual procedure, despite the drug qualifies 18 other reimbursement standards. Before using an expensive drug like Soliris, costing 6.04 million won per vial, a healthcare institute using the drug has to apply for HIRA’s preliminary review applied, and it can administer the approved drug to patient within 60 days. HIRA refuted, “In case of emergency, Soliris can be administered as soon as the preliminary review application is submitted. The news report on patients dying due to delayed or rejected approval is not true.” Reimbursement standard on Soliris stipulates qualification standard of administration subject (standard of disease determination, standard of active thrombotic microangiophathy, standard of renal damage) and also administration exemption (same type of malignant tumor, transplantation, thrombotic microangiophathy caused by infection due to autoimmune disease) HIRA’s press release explained, “The standards have been set based on foreign country guidelines, related academic societies’ consultation, and foreign country reimbursement listing standards. Korea's reimbursement listing is on par with other countries’ standards, such as Canada and Australia. HIRA requires healthcare institute to submit genetic testing results, when submitting a monitoring report after two months into the treatment.” In other words, HIRA says the administering standard of Soliris’ reimbursement does not stipulate genetic test, but it is required for the monitoring report. HIRA stated, “The news article claiming HIRA demanding genetic testing, regardless of qualifying other standards, is false. HIRA would continue to do its best to provide coverage on safe medical service and treatments saving patient’s life.”
- Policy
- Nocdurna to receive reimbursement from next month
- by Kim, Jung-Ju Feb 17, 2020 06:25am
- Nocdurna sublingual tablet identification photo (Source: Korea Pharmaceutical Information Center) Ferring Korea’s Nocdurna sublingual tablet (desmopressin acetate) is to get listed for reimbursement next month. On Feb. 12, Ministry of Health and Welfare (MOHW) issued an administrative notice on amending ‘Pharmaceutical Reimbursement Listing Standard and Method,’ and plans to collect public opinions until Feb. 20. Ministry of Food and Drug Safety (MFDS) has indicated the drug to treat nocturia due to idiopathic nocturnal polyuria. As other drugs with desmopressin acetate have different content, only a part of Nocdurna’s indication would be reimbursed. Desmopressin acetate has received reimbursement for treating patients aged over five with primary nocturnal enuresis and adult patient with any nocturia symptoms related to nocturnal polyuria. According to the government’s approval details, Nocdurna’s indication to treat primary nocturnal enuresis in patients aged over five would not receive reimbursement. The listing would be limited to treating adult patient with nocturia due to idiopathic nocturnal polyuria. The approved contents of Nocdurna are 25 μg and 50 μg. After reviewing collected public opinions until Feb. 20, MOHW would revise the reimbursement standard as of Mar. 1. Desmopressin acetate is available in Korea as Ferring Korea’s Minirin tablet, Hanmi Pharmaceutical’s Demoresin POWD, Nex Pharm Korea’s Newlitan tablet, Pharmbio Korea’s Denirin granule and Dongkoo Bio Pharm’s Demorin fine gradule.
- Policy
- Opposition buys time with Covid-19 delaying HIPDC meeting
- by Lee, Jeong-Hwan Feb 14, 2020 06:35am
- Due to the Covid-19 outbreak, the pilot program for providing reimbursement on Korean herbal medicine would inevitably be delayed. Initially, the government was planning to particularly discuss of coverage on herbal medicine at a Health Insurance Policy Deliberation Committee’s (HIPDC) subcommittee meeting, right as Korean Herbal Medicine Reimbursement Consultative Committee unveils the pilot program plan. But all schedules have been halted, because of the state emergency. Some of healthcare and pharmaceutical professional organizations, who have been opposing against the pilot program, seem to be busy preparing statement and related resources regarding safety issues of the herbal medicine reimbursement system. According to healthcare and pharmaceutical groups on Feb. 13, Ministry of Health and Welfare (MOHW) has not finalized the schedule for the HIPDC subcommittee meeting on Korean herbal medicine reimbursement, originally scheduled on Feb. 6. Pharmaceutical industry explains the meeting has been indefinitely postponed until Covid-19 outbreak is contained and the country feels safe again. The industry source also added, individual issues like coverage on herbal medicine would be set aside for now, as MOHW has urged healthcare and pharmaceutical groups, such as Korean Medical Association, Korean Pharmaceutical Association, Association of Korean Medicine, and Korean Nurses Association, to focus on promptly responding to the state emergency and infectious disease prevention task. However, related organizations are showing anxiousness with the indefinitely postponed talks on the agenda, as the issue is strongly conflicted between medical, pharmaceutical and Korean medicine industries. Postponed HIPDC deliberation would mean delayed procedures of reimbursement feasibility evaluation and related industry negotiation, which would eventually push down the whole timeframe of the pilot program. In fact, MOHW is currently unable to pin down when the subcommittee meeting could be convened. MOHW insider hinted, “Discussion between Korean Herbal Medicine Reimbursement Consultative Committee and other related organizations is essential to the pilot program. While the government and the country’s interest and response capacity are all locked on Covid-19, related schedule would be unlikely to get fixed, yet. This would affect the entire schedule of the pilot program.” Now, the medical, pharmaceutical and Korean herbal medicine industries on the opposing side have earned some time to prepare data pointing out prospective issues and risks of reimbursement on herbal medicine. The urgency the organizations felt, when preparing for opposing statement until the initial HIPDC and subcommittee meeting schedules, seems to be somewhat relieved. Korean Medical Association and Korean Pharmaceutical Association have actually warned of the organizations cooperating to disapprove of the Korean herbal medicine reimbursement. Association of Korean Medicine also has been reprehending MOHW’s pilot program planning by constantly issuing an opposing statement. A member of the Korean Herbal Medicine Reimbursement Consultative Committee disapproving of coverage on the herbal medicine claimed, “As I have been on the side to stop the pilot program, the delay in schedule is a good news. By vastly researching more about the safety issues of Korean herbal medicine, we should strategize resistance against the plan with those on the same side from the consultative committee and HIPDC.” The member added, “All capacity of healthcare and pharmaceutical organizations is on containing Covid-19 at the moment. When it is in the fairly controlled state and MOHW notifies the HIPDC meeting schedule, the industry organizations’ conflict would surface.”
- Policy
- It is time to support quarantine with the 'COVID-19'
- by Lee, Jeong-Hwan Feb 14, 2020 06:35am
- The Democratic Party's COVID-19 Countermeasures Committee urged an agreement on the opposition party on the composition of parliament. With the intention that the national disaster should not be controversial due to naming conflicts such as Wuhan pneumonia, it is a suggestion that the government should support joint efforts on the prevention site by creating a joint special led by the Health and Welfare Committee by establishing a joint specialty centering on the new corona name 'COVID-19' finalized by the WHO. On the 12th, the Democratic Party's COVID-19 Countermeasures Committee (Chairman Sang-hee Kim) began hearing opinions on the site of defense at the Democratic Party's representative office in the National Assembly. On this day, Kyung Rim Shin, the chairman of the Korean nurses association, Senior Vice Chairman No-bong Park, the Korean health and Medical Workers’ Union, Senior Vice Chairman No-Bong Park of the National Health Care Industry, Senior Vice Chairman Mi-Kyung Kwon of the Federation of Korea Medical industry Trade Union(KMITU), Chairman Mok Huh, National public health center’s director council and Chairman Jung-Hyun Cho of the Korean Public Health Council. If the last meeting was to collect voices of macroscopic defense sites from the heads of doctors' associations and hospital associations, this time, The intention is to look into more detailed microprotective situations. Chairman Sang-hee Kim stressed the need for COVID-19 in the parliament. The WHO named the new corona official name as COVID-19 and the Ministry of Health and Welfare followed the domestic name as Corona-19, suggesting that the background for the rapid creation of undisputed privileges was provided. Chairman Kim said, "The WHO has set the official name of the new corona as COVID-19. So far, unnecessary controversy over the congressional narrative over the National Assembly Corona has been continued, this is deplorable. It would be reasonable to focus on welfare. The name is subsidiary and it is productive to support the defense by creating a parliamentary commission. It would be reasonable to focus on the welfare committee " Chairman Kim said, "The government is currently taking measures to deal with the serious stages of the prime minister. The patient is discharged, but there is no situation to be relieved yet, and we will try to provide enough budget to small businesses". Kyung Rim Shin, the chairman of the Korean nurses association asked the medical staff such as nurses who are involved in the quarantine service not to suffer social stigma. In particular, she mentioned the necessity of expanding nursing personnel in addition to disaster emergency. It is important to be prepared to avoid the hassle of increasing the number of nurses in a hurry due to Corona-19. Chairman Shin said, "It is very hard to work as a nurse once in a confirmed patient's quarantine. Two protective nurses have to go in every two hours, and the job itself is difficult and there is a fear that the nurse will spread the word to the family. A mother nurse is socially stigmatized and has trouble in her daily life". Chairman Shin said, “It is a big problem because they face and care for patients directly. Psychological treatment, physical support, and social follow-up measures are necessary, and it is also a way to have a regular nursing staff. It is difficult to recruit emergency personnel due to infectious diseases outbreak". Mok Hur, chairman of the National Health Center Directors' Council, said that even in the event of a national disaster, there is no support for public health centers, making night work a daily routine. Huh said, "There is no support for the public health centers for infectious diseases. We are actually fighting the situation with barehanded, and the reality is that even if we do not evade responsibility of the public health center in a national disaster. we have never left work since the last 20 days". "Health centers are directly affiliated with local governments and professional organizations, and people with a high level of administrative experience must be deployed, they move up like general auxiliary agencies, and they are upset, and we have asked the MOHW and the KCDC several times regarding the workforce but no change".
