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- 2026-05-06 11:07:04
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- The Paradox of Shingrix
- by Moon, sung-ho Feb 14, 2023 05:48am
- Domestic companies such as GC Pharma are in trouble. Shingrix Expected to Change the Domestic Shingles Vaccine Market With Expensive Premium Vaccine. Analysts say that two months after its launch in Korea, it is rarely showing its strength in the hospital and clinic markets. In particular, at the clinical site, GlaxoSmithKline (GSK) seems to be in confusion as some say that its competitors are benefiting from its marketing policy to raise awareness of shingles with the launch of Shingrix. According to the pharmaceutical industry and the medical community on the 11th, GSK's Shingrix vaccine was released in December last year and is currently available in hospitals and clinics. Shingrix is a vaccine used to prevent shingles in adults over the age of 50 and immunocompromised people over the age of 18. In particular, given that the prevention rate is more than 90% in all age groups over the age of 50, the prevention rate was dominant and the release of Shingrix would shake the domestic shingles vaccine market. Perhaps that's why competition among domestic companies over copyrights for Shingrix sales and marketing was fierce. As a result, the main character who won the copyright through fierce competition is "GC Pharma," which is called a vaccine master, and "Gwangdong Pharmaceutical," which maintains a continuous cooperative relationship with GSK. In the case of GC Pharma, the most vaccinated internal medicine is focused on sales and marketing, while Guangdong Pharmaceutical is focusing on otolaryngology, orthopedics, and rehabilitation medicine. Two months after Shingrix's launch in the hospital and clinic markets, the prevailing opinion is that there are not many patients who want to be vaccinated at the clinical site. It is evaluated that the relatively "high price" of Singrix served as a hurdle. According to the Medical Times report, the single inoculation price of Singrix in hospitals and clinics is between 250,000 won and 300,000 won. Considering that it is two inoculations, the inoculation price is distributed between 500,000 won and 600,000 won. Moon Yeon-hee, executive director of GSK's vaccine business division, explained at the launch meeting, "The price of Shingrix was set by comprehensively considering its efficacy and socio-economic effects on complications after shingles." The clinical site suggested that such a price setting was not suitable in the recent economic crisis caused by three high-interest rates, high prices, and high exchange rates. "As soon as Shingrix was released, we brought 20 to the clinic, but there are no inoculators yet," said a Seoul physician who asked not to be identified. "We offered 500,000 won for two inoculations, but patients want 300,000 won, which is impossible for clinics." Kwak Kyung-geun, vice president of the Korean Internal Medicine Association (Seoul Internal Medicine), said, "Patients are interested in it, but there is too much resistance to the price. Moreover, it is difficult for patients to actively explain the vaccine effect to patients because they understand that the benefits of vaccination are entirely taken by clinics." He said, "In Gangnam, etc., Shingrix can be inoculated, but this is not large considering the total consumer population," adding, "The company should reflect the level of medical services and the economic level, but I think the company has taken too far." Park Geun-tae, chairman of the Korean Internal Medicine Association (Park Geun-tae Internal Medicine Clinic), also said, "I think patients are reluctant to take Shingrix because it is too expensive," adding, "Moreover, the burden of getting it twice compared to other competing vaccines is also working." Both clinical sites and pharmaceutical industries are paying attention to GSK's recent activities to raise awareness of shingles such as TV advertisements. It is a shingles campaign advertisement with no product name or company name on the front of the advertisement featuring actor Ma Dong-seok. The Pharmaceutical Affairs Act is also related, but unlike advertisements by existing pharmaceutical companies, the main focus is to inform patients of the risk of shingles by focusing on diseases. This, was expected to raise public awareness of the need for shingles management. GSK official said, "Shingles is a disease that occurs a lot in the age of 50 or older in Korea," and stressed, "This advertisement is designed to provide accurate information and raise awareness of shingles disease." TV advertisements to raise awareness of shingles are working, but they pointed out that they are not leading to Singrix vaccination. This is due to the high inoculation price of 500,000 won to 600,000 won. Kwak Kyung-geun, vice president of the Medical Association, said, "TV advertisements have increased the number of patients inquiring about shingles vaccine," adding, "We compare and explain the antibody production rate for each shingles vaccine, but in terms of price, Shingrix tends to be burdened." "There are patients who are hepatically vaccinated with Zostavax or Sky Zoster while inquiring about shingles vaccine through TV advertisements," he said. As a result, some in the pharmaceutical industry say that competitors MSD or SK Bioscience are actually taking advantage of the shingles advertisement. According to the Health Insurance Review and Assessment Service, the average inoculation prices of MSD Zostavax and SK Bioscience Sky Zoster are distributed from 140,000 won to up to 190,000 won in Gangnam-gu, Seoul. Among them, Zostavax price is 10,000 to 20,000 won more expensive on average than Sky Zoster, but the price alone is more than 300,000 won cheaper than Shingrix. As a result, it is suggested that it is establishing itself in the market as a vaccine with "cost-effectiveness." A doctor-turned-domestic executive, who asked not to be identified, said, "One man windows and another man reps have raised awareness of shingles due to advertising effects, but competitors seem to be working. He hinted that sales and marketing will not be easy because it is difficult to release vaccine supplies to distributors in a situation where the margin rate is not large. This is a difficult part for GC Pharma and Kwangdong Pharmaceutical, which won the copyright by presenting a relatively low margin rate along with GSK, the developer of Shingrix. As local governments have recently competitively carried out projects to support shingles vaccination, the need to supply supplies to Zostavax and Sky Zoster is rather increasing. The supply of Zostavax and Sky Zoster has been insufficient in the general hospital and clinic markets. The shingles vaccine market is not reorganized around Shingrix, but rather, competitive items have recently benefited from reflection. Some even say that it is regrettable that the volume is rather small at a time when competitors are benefiting from shingles advertisements. Kim Joo-han, medical director of the Korean Society of Otolaryngologists (Open St. Mary's Otolaryngology Clinic), said, "Shingrix does not have many inoculations, but as local governments run shingles vaccine projects, even Zostavax and Sky Zoster supplies are insufficient."
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- “5 of 10 TNF-αis prescribed last year were adalimumab”
- by Kim, Jin-Gu Feb 14, 2023 05:48am
- On the 13th, the healthcare big data analysis service Evidnet released the results of its analysis on the prescription data of 10 general hospitals nationwide last year. According to the results, ‘adalimumab (Humira)’ was the most frequently prescribed TNF- α inhibitor last year. Evidnet analyzed and announced 18,371 prescription data on TNF-α inhibitors from 10 general hospitals nationwide by indication and component last year. According to Evidnet, the most prescribed TNF-α inhibitor was adalimumab, which accounted for 50.7% of all prescriptions last year. Next was infliximab (Remicade) at 20.2%, followed by etanercept (Enbrel) at 15.1%, then golimumab (Simponi) at 14.0%. By indication, TNF-α inhibitors were most prescribed for ankylosing spondylitis, which accounted for 50.7% of all prescriptions, followed by rheumatoid arthritis (19.5%), Crohn's disease (13.0%), ulcerative colitis (5.7%), uveitis (5.3%), psoriasis (3.5%), then others (4.1%). by ingredient, etanercept (18.3%) and infliximab (16.4%) were prescribed the most for ankylosing spondylitis. In rheumatoid arthritis, adalimumab (46.0%), etanercept (30.2%), then golimumab (16.4%) were prescribed the most. On the other hand, for Crohn's disease, the most prescribed substances were infliximab (54.2%) and adalimumab (45.7%). For ulcerative colitis, the most prescribed were infliximab (47.5%), adalimumab (32.2%), and golimumab (20.3%).
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- Forxiga's patent war ended after eight years
- by Kim, Jin-Gu Feb 13, 2023 05:59am
- The Supreme Court sided with Generic in the dispute over Forxiga patents for SGLT-2 inhibitor-based diabetes treatment. Patent challengers will be able to release generics early after April 7. The Supreme Court's special second division ruled in the morning of the 2nd that AstraZeneca would dismiss the appeal in an appeal filed against 17 companies, including international drugs. Forxiga is protected by two substance patents. The first substance patent (10-0728085) expires on April 7, 2023, and the second substance patent (10-1021752) expires on January 8, 2024. In March 2015, 17 companies, including Kukje Pharmaceutical, filed a trial for invalidation of the second substance patent. In the first trial, generic companies won. In August 2019, the Patent Tribunal made a trial decision on the establishment of the claim. AstraZeneca objected. The patent court, which is the second trial, also sided with generic companies. The Patent Court ruled against the plaintiff in October 2020. The Supreme Court also sided with generics following the first and second trials. This effectively ended the eight-year patent dispute. The ruling will allow patent challengers to release Forxiga generics early after April 7, 2023, when the first substance patent expires. Generics have already overcome all the remaining patents. Generics won the first trial in August 2020 and even received generic for exclusivity. This means that SGLT-2 inhibitor-based generics will pour into the diabetes treatment market after April.
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- Daewoong Nabota has obtained an item license in Singapore
- by Kim, Jin-Gu Feb 13, 2023 05:59am
- Daewoong Pharmaceutical announced on the 9th that its botulinum toxin "Nabota" obtained an item license in Singapore on the 20th of last month. The acquisition of Singapore permits was the first of its kind among domestic botulinum drugs, and Nabota has increased the number of licensed countries worldwide to 62. Nabota 100 units are approved by the Singapore Health and Science Agency (HSA). Daewoong Pharmaceutical applied for an item license in September 2021. Daewoong Pharmaceutical plans to release Nabota in Singapore in the third quarter of this year. Hypens Pharma Pte Ltd is in charge of local distribution and sales. Hypens Pharma is a subsidiary of the SGX-listed Hypens Group. Compared to other Southeast Asian countries, Singapore has a smaller botulinum toxin market. However, as the beauty and medical industries are developed with high national income, it is considered a strategic point for expanding the regional market. For this reason, it is expected to gradually expand to neighboring countries and increase brand awareness. Park Sung-soo, vice president of Daewoong Pharmaceutical, said, "Singapore has a great influence on the Southeast Asian beauty and medical industry," adding, "Not only is it meaningful in that it is the first botulinum toxin brand in Korea to obtain Singapore approval, but it is expected to accelerate Nabota's market expansion in Asia." Nabota is a botulinum toxin preparation that Daewoong Pharmaceutical released in Korea in 2014. It is the only FDA-approved in Asia as well as in Korea. As of February 2023, 62 countries, including the United States and Europe, are providing excellent beauty and treatment options, and Singapore is also expanding its global business by obtaining permission.
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- Generic for Dukarb is coming soon
- by Kim, Jin-Gu Feb 13, 2023 05:58am
- According to the second trial decision of Dukarb on the 16th of this month, it is decided whether to release the core capacity at the same time. With Boryung Kanarb's generic set to be released next month, attention is focused on the second trial of the patent dispute, which is three days away. This is because the decision of the patent court determines whether to release the Dukarb generic core capacity at the same time. ◆Dukarb's generic will be released sequentially after registering next month's benefit According to the pharmaceutical industry on the 13th, the material patent of Boryung Kanarb expired as of the 1st of this month. In principle, a generic for Kanarb has become available. In addition, the remaining generics, except for the core capacity of Dukarb, which is protected by patents for composite compositions, will also be available. The drug that generics are paying attention to is Dukarb. Currently, 27 pharmaceutical companies have been licensed for 72 items of Dukarb generics with different capacities. No single-system Kanarb Generic has been licensed. They received permission for related products from December to January this year. He then applied for a salary registration with the HIRA. According to related regulations, Health insurance benefits will be announced two months after the date of application and will be applied as of the 1st of the following month. Since generic companies applied for salaries in December last year, it will be announced at the end of this month and the salaries will be applied from the 1st of next month. As a result, Dukarb generic is expected to be released sequentially after next month. Products from the four companies approved in December last year are expected to be released first on the 1st of next month, followed by products from the remaining 23 pharmaceutical companies on April 1. The pharmaceutical industry's attention is focused on the second trial of the Dukarb patent dispute, which is just three days away. This is because the ruling determines whether Dukarb's core capacity will be released simultaneously. Dukarb is protected by a patent that expires in 2031. However, the scope of this patent is limited to Dukarb 30/5 mg. Except for this capacity, the rest can be released after the 1st of next month regardless of the 2nd trial ruling. The key is the 30/5 mg product. If the patent court sides with Generic on the 16th of this month, Generic can release 27 items of Fimasartan and S-Amlodipine 30/2.5mg products simultaneously as other generics. In the case of S-Amlodipine, it is interpreted as half the dose of Amlodipine. The combination of Fimasartan and S-Amlodipine 30/2.5mg chosen by generics means that it is virtually the same drug as the original drug Dukarb's 30/5mg. If the court sides with Boryung in the second trial following the first trial, the timing of the release of the 30/2.5mg product by generics will be postponed. The product can be released only when generic companies win a reversal decision from the Supreme Court through an appeal or win a separate invalidation trial. If both methods fail, the capacity product may not be released until 2031, when the Dukarb patent expires. According to UBIST, a pharmaceutical market research firm, Dukarb's prescription last year was 46 billion won. Boryung explains that more than half of the performance comes from 30/5mg products, which are core doses.
- Company
- GC Pharma reinforces sales partnerships
- by Kim, Jin-Gu Feb 13, 2023 05:58am
- GC Pharma has been strengthening partnerships with pharmaceutical and biohealth companies in Korea and abroad by signing a series of copromotion agreements. After the company signed a copromotion agreement for GSK’s shingles vaccine ‘Shingrix’ at the end of last year, the company recently also signed an agreement to copromote Sanofi's anti-platelet agent ‘Plavix.' Also, earlier this year, the company expanded its sales agreement with BMS on selling the company’s hepatitis B treatment, ‘Baraclude.’ The industry interpreted this as the company’s move to diversify its business structure, focusing on blood derivative products and vaccines and securing a cash cow through external expansion. ◆Will copromote Shingrix and Plavis...expanded sales agreement for Baraclude According to industry sources on the 11th, GC Pharma has been jointly selling Sanofi’s anti-platelet agent Plavix (clopidogrel) from the first of this month. Under the copromotion agreement, GC Pharma is responsible for local sales, and Sanofi for sales at large hospitals. Plavix has been generating KRW 120 billion in the outpatient prescription market in Korea. According to the pharmaceutical market research institution UBIST, Plavix sold KW 117.6 billion last year, ranking fourth among all prescription drugs sold in Korea last year. (From the left) Shingrix, Plavix, Baraclude Also, the company had signed a copromotion agreement for GSK’s shingles vaccine Shingrix with GSK and Kwangdong Pharmaceutical and started joint sales of the drug in earnest in December last year. Shingrix has been gaining attention as a new premium vaccine in its area. It has shown a near 97% efficacy, twice higher than that of other existing shingles vaccines, and has demonstrated its long-term effect and safety. It had already raised KRW 2.26 trillion in sales in the global market in the first half of last year, which is near the KRW 2.70 billion that the vaccine had made in the previous year. Earlier this year, the company expanded its sales agreement for the hepatitis B treatment Baraclude with BMS. The company, which had previously jointly sold the product with BMS in the past, will exclusively distribute and sell the drug from this year. Therefore, the company will be selling the drug to all medical institutions including general hospitals in addition to local hospitals and clinics in Korea. Baraclude is a hepatitis B treatment that contains entecavir. The drug sold KRW 71 billion in prescriptions last year. Although its generic version has been released in the market after patent expiry, the original drug continues to exert an overwhelming influence in the market. Last year, it ranked second in sales in the market after Gilead Sciences Viread (KRW 89.5 billion). ◆Suceeds in joint sales of its self-developed Neulapeg·Shinbaro with domestic companies The company has also been strengthening partnerships with domestic pharmaceutical companies. GC Pharma has been adopting the strategy of jointly selling its self-developed drugs with domestic pharmaceutical companies. Neulapeg and Shinbaro are representative examples of such activity. Neulapeg is a treatment for Neutropenia that had been self-developed by GC Pharma. It is a biobetter product that is an upgraded version of the original drug, Kyowa Kirin’s Neulasta. It has improved purity and stability compared to existing treatments and reduced the drug’s half-life over existing drugs. GC Pharma has been jointly selling Neulapeg with Boryung Pharmacuetical until 2021, then with Jeil Pharmaceutical from last year. Its sales had surged during its partnership with Boryung Pharmacuetical. Its sales, which had been less than KRW 1 billion every quarter until 2018, surged to nearly KRW 6 billion in 2021 and exceeded that of the original version by Q4 2021. ◆ Strategies to fill the gap derived from non-sale of MSD vaccines + expanding business portfolio The domestic sales license transfer of the 3 MSD vaccines is pointed out as the background for GC Pharma’s recent moves. Until 2020, GC Pharma had been copromoting 3 of MSD’s vaccines: the shingles vaccine Zostavax, and cervical cancer (HPV) vaccines Gardasil 4 and Gardasil 9. Sales of the 3 vaccines reached KRW 106.1 billion in 2020. However, MSD changed its domestic copromotion partner for the three vaccines to HK inno.N in 2020. Since then, the company has been actively filling the gap that occured in its revenue by making new copromotion agreements. In the mid-to-long term, this is also in line with GC Pharma’s recent business structure diversification strategy. GC Pharma has recently been aggressively strengthening its prescription drug business. It plans to expand its business portfolio, focusing on existing blood derivative products and vaccines. Due to the heavily export-dependent nature of blood derivative products and vaccines, the disadvantage is that its sales are volatile depending on the overseas performance and period. This is why the company has established a mid-to-long strategy to expand its field to prescription drugs and secure a new cash cow.
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- Can Jakavi be reimbursed for GvHD within the year?
- by Eo, Yun-Ho Feb 13, 2023 05:58am
- Whether reimbursement of ‘Jakavi’ be extended to cover Graft versus Host Disease (GvHD) is gaining attention. Novartis Korea submitted an application to extend reimbursement of its Jakavi (ruxolitinib) to GvHD immediately after receiving approval for the indication in May 2022. However, 8 months have passed and no progress has been made at the Health Insurance Reimbursement and Assessment Service’s level. Therefore, whether the agenda will be deliberated during HIRA’s Drug Reimbursement Evaluation Standard Subcommittee meeting that is expected to be held within the week is gaining attention. When considering the remaining review process, it may be difficult to extend the drug’s reimbursement within the year if HIRA does not complete evaluations by the first half of this year. GvHD is a potentially serious complication that may occur after allogeneic stem cell transplantation (allo-SCT). The donor’s T cells (the graft) view the patient’s healthy cells (the host) as foreign and attack and damage them, affecting various organs including the skin, the gastrointestinal tract, the liver, and the lungs. As symptoms can appear throughout the body, GvHD poses another challenge to patients who have survived allogeneic hematopoietic stem cell transplantations by affecting the patient’s quality of life. Steroids are used as standard first-line therapy, but unmet needs exist as no standard therapy exists in the second-line for the 50% of patients that fail treatment in the first-line. In this area, Jakavi arose as an option that can be used to treat patients aged 12 years and older with acute or chronic GvHD who have an inadequate response to corticosteroids or other systemic therapies. Hee-Jae Kim, the Chief Chair of the Korean Society of Blood and Marrow Transplantation (Professor of Hematology at the Catholic University of Korea), said, “Jakavi demonstrated superior effect in treating acute and chronic GvHD patients in clinical studies and has shown similar outcomes in the field, opening up new possibilities for patients suffering from lack of an appropriate treatment option” He added, “Treatment access to Jakavi has been restricted in Korea due to its non-reimbursement. A considerable amount of time has passed since its approval, and Jakavi’s reimbursement should be applied as soon as possible so as not to further increase the burden of the patients that have already suffered enough, from hematopoietic stem cell transplantation to GvHD.” Meanwhile, Jakavi has demonstrated its efficacy in the Phase III REACH2 trial. Results showed that the overall response rate with Jakavi at Day 28 was 62%, which was higher than the 39% that was achieved with the best available therapy (61/155) Also, the durable overall response was found to be nearly twice higher in the Jakavi group at Day 56 at 40% (34/155), compared with the 22% (61/154) in the control group.
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- One step left to Dupixent’s reimb in pediatric patients
- by Eo, Yun-Ho Feb 10, 2023 05:53am
- The atopic dermatitis treatment ‘Dupixent’ has entered the last phase of extending its reimbursement coverage to children and adolescents. According to industry sources, Sanofi-Aventis Korea is conducting drug pricing negotiations for the low-dose formulation (200mg) of Dupixent (dupilumbab) with the National Health Insurance Service. The reimbursement agenda has made smooth progress after passing deliberation by the Drug Reimbursement Evaluation Committee of the Health Insurance Review and Assessment Service on the 12th of last month. When considering the set negotiation period, the results are expected to come out by March. Being an RSA (Risk Sharing Agreement) drug and the addition of the separate 200mg dose, the drug had to pass HIRA’s cost-effectiveness review process and complete drug pricing negotiations with the National Health Insurance Service to receive reimbursement. If the drug successfully completes drug pricing negotiations, Dupixent will finally be able to see results two years after applying for the reimbursement extension in April 2021. The journey had not been so easy for the drug. IT first took 7 months for expert opinion inquiries to begin on extending reimbursement of Dupixent to pediatric and adolescent patients, and the reimbursement standards for the indication were only set in May last year. Although the specific indications may differ, the difference in speed of progress is evident when compared to other JAK inhibitors that applied for reimbursement extensions in atopic dermatitis, such as Lilly Korea’s ‘Olumiant (baricitinib),’ Abbvie Korea’s ‘RInvoq (upadacitinib)’ etc. The price of JAK inhibitors is also relatively lower than that of Dupixent. The two drugs were both listed for reimbursement in May last year and Rinvoq is also attempting to extend its reimbursement to pediatric adolescent patients. Meanwhile, the 300mg dose of Dupxient is currently reimbursed for adult patients aged 18 years or older with chronic severe atopic dermatitis who have had the condition for over 3 years and satisfy all three of the following criteria: ▲ who are unable to control their symptoms after receiving topical treatment for over 4 weeks, and ▲ unable to use systemic immunotherapies due to side effects or saw no response (50% or more decrease in EASI, EASI 50) after receiving treatment with systemic immunotherapies, and ▲ had an EASI score of 23 or higher before administering Dupixent.
- Company
- Botulinum Xeomin can be stored at room temperature
- by Jung, Sae-Im Feb 10, 2023 05:52am
- Professor Heo Chang-hoon presenting at the Merz Xeomin press conference"Improving toxin quality and strengthening management change perceptions Merz's botulinum toxin Xeomin has been upgraded to room-temperature storage. It emphasized quality as the only room-temperature storage product with the highest purity among botulinum toxin drugs on the market in Korea. Merz held a press conference at the Grand InterContinental Seoul Parnas Hotel in Gangnam-gu, Seoul on the 9th to commemorate the Xeomin room temperature storage (1 to 25 degrees Celsius). Launched in 2011, Xeomin has recently changed its license for storage temperatures. Unlike other botulinum toxin preparations that require refrigeration at 2 to 8 degrees, Xeomin can be stored at 9 to 25 degrees Celsius. It is the only toxin product on the domestic market that is stored at room temperature. In order for biological agents such as botulinum toxin to be licensed for upper marriage storage, consistent effectiveness, and stability must be demonstrated at 1 to 25 degrees. As a result of the experiment, Xeomin confirmed that biological activity and human serum albumin content remained constant for 36 months under conditions of 25 degrees Celsius and 60% humidity. Director Park Je-young (Oracle Dermatology in Apgujeong), who served as the speaker of the meeting, said, "Xeomin has already been allowed to be stored at room temperature in the U.S. and Europe. This means that there is a low risk of decomposition and deterioration of products that may occur due to temperature changes during transportation or distribution," he explained. As a result, Xeomin is the only botulinum toxin preparation that removes complex proteins and can be stored at room temperature at the same time. It minimized the risk of developing resistance by leaving only neurotoxin, an active substance, and proved high stability by storing it at room temperature. Heo Chang-hoon, a dermatologist at Seoul National University Bundang Hospital, said, "Botulinum toxin is determined based on ▲ the purity of neurotoxin ▲ consistency of effect expression ▲ stability during distribution and storage." In particular, toxin preparations are often not consistently refrigerated in storage and movement, and Xeomin has achieved the desire of all medical staff and pharmaceutical companies to store them at room temperature, he added. Yoo Soo-yeon, CEO of Merz, said, "This permit can save the use of energy essential for refrigeration, which is in line with the ESG management pursued by Merz."
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- 80 billion won worth of Anticonvulsant Market
- by Nho, Byung Chul Feb 09, 2023 05:49am
- In the 80 billion Anticonvulsant market, Topiramate-based treatments form 30 billion units, leading the market. The epilepsy drug consists of about 10 components, including Topiramate, Lamotrigine, sodium Valproate, Oxcarbazepine, and Perampanel. According to the drug distribution performance data, as of last year, the performance of Lamotrigine, sodium valproate, Oxcarbazepine, and Perampanel drugs was 14.9 billion won, 10.4 billion won, 7.6 billion won, and 4.5 billion won, respectively. It is also notable that the rest of the formulations, excluding topiramate, show an annual growth rate of around 100 million won to 300 million won. About 10 products of Topiramate formulations have been released, forming the largest number of epilepsy drugs. Total sales in 2018, 2019, and 2020 were 23.2 billion won, 25.7 billion won, and 28.9 billion won, with the highest growth rate. The leading product of topiramate ingredients was the Janssen Topamax Sprinkle capsule, which generated about 10 billion won in sales last year. SK Chemicals Qudexy and Huons Ceti followed with 2.2 billion won and 2.1 billion won. GSK Lamicta, the No. 1 product of Lamotrigine ingredients, maintained its appearance of 11.9 billion won in 2021. It has the highest performance based on a single product of epilepsy drugs. Lamostal and Bukwang Lamotigine ranked second and third in the same ingredient, which recorded 800 million won 600 million won in performance. Myungin Camazepine and Novartis Tegretol Korea form an appearance of 2.9 billion won and 2.4 billion won. Perampanel-based product Eisai Korea Fycompa's 2021 performance is 4.5 billion won, while Handok Sentil is moving within 900-1 billion won for five years. According to academia, the prevalence of epilepsy is about 4 to 10 per 1,000 people, and it is known that 20 to 70 people per 100,000 people occur newly every year, especially in childhood (under 9) and old age (over 60). Genetic defects cannot be excluded as the cause of epilepsy, but it is a general classification criterion to classify it into structure, metabolism, and unknown cause. It is a case of seizures due to acquired diseases such as stroke, brain damage, and infection due to structural and metabolic causes, and can come from brain nerve cell stimulation due to hypoglycemia, uremia, withdrawal of alcohol, and sleep deprivation. Most likely causes include cerebrovascular disease, encephalitis, hippocampus sclerosis, cerebral palsy, brain tumors, vascular deformities, and degenerative diseases, but more than half of the causes are unknown. Looking at the guidelines for treatments of the Korean Epidemiology Association, epilepsy can be improved with drug treatment, and 60-70% of patients can control seizures with treatments. Since drug treatment should be maintained for a long period of at least two years, it is important to choose a drug that suits each patient's condition.
