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Expanding Insurance Coverage Standards for Keytruda: Focusing on Clinical Needs Rather Than Strategic Judgment

Consideration of clinical needs rather than strategic judgment…”Carcinomas with high unmet needs are given priority”

[의약뉴스] MSD Korea applied for a review to expand insurance coverage standards for 13 indications of the anti-PD-1 immune checkpoint inhibitor (immunotherapy) Keytruda (ingredient: pembrolizumab), drawing attention.

Rather than making a strategic decision to focus on specific indications in consideration of the market size or competitive situation, it is possible to expand coverage at once for indications with large unmet needs in the clinical field for patients suffering from the lack of a suitable treatment right away. It is the explanation of the company that it has been promoted.

▲ MSD Korea applied for a review to expand insurance coverage standards for 13 indications of Keytruda (ingredient: pembrolizumab), an anti-PD-1 immune checkpoint inhibitor (immuno-oncology drug), drawing attention.

According to the industry, MSD recently announced ▲early triple-negative breast cancer ▲metastatic or recurrent triple-negative breast cancer ▲metastatic or recurrent head and neck cancer ▲advanced or metastatic esophageal cancer ▲adjuvant therapy after surgery for renal cell cancer ▲non-muscle-invasive bladder cancer ▲ Persistent, recurrent or metastatic cervical cancer ▲Advanced endometrial cancer ▲MSI-H or dMMR Metastatic endometrial cancer ▲Inoperable or metastatic colorectal cancer with MSI-H or dMMR (KN-177) ▲MSI-H or dMMR It applied for a review to expand insurance coverage standards for Keytruda’s 13 indications, including metastatic small bowel cancer, MSI-H or dMMR metastatic ovarian cancer, and MSI-H or dMMR metastatic pancreatic cancer.

Keytruda is an immuno-anticancer drug that blocks the immune evasion mechanism of tumor cells and allows the patient’s immune system to attack the tumor cells. there is.

In this process, it has provided a breakthrough in cancer that was inaccessible with conventional anticancer therapies.

However, despite the steep increase in indications, it has been difficult to expand benefits. In the early days of its launch, it was listed on the health insurance benefit list faster than the market expected, reflecting medical demand for a new anticancer drug, but it has been difficult to expand benefits after the second treatment for non-small cell lung cancer.

It took four years to expand the first-line lung cancer treatment benefit because the indications are increasing so rapidly that the impact on health insurance finances is uncertain.

In a situation where the number of indications is still increasing rapidly, it seems that the company has now shifted its direction to applying for a one-time increase in benefits for cancer types in urgent need of new treatments, instead of approaching each indication sequentially.

An official from the management said, “(The 13 cancer types for which the reimbursement standard has been applied for) are aggressive enough to threaten the survival of patients, but there is no alternative drug or the latest treatment that is recognized for reimbursement, so there is a need to improve the accessibility of Keytruda.” “There was no case in which the need for reimbursement was required because it demonstrated clinical efficacy compared to existing drugs in the above multiple cancer types.”

“To meet this need, we applied for an expansion of the reimbursement standard for indications with high clinical demand for new treatments and a high need for reimbursement,” he said. “This is to increase treatment access for all patients who particularly need the treatment benefits of Keytruda.” explained.

As Keytruda is recommended as standard therapy in major domestic and international guidelines for all 13 indications for which coverage has been applied for, it is explained that if health insurance benefits are accepted, pain caused by cancer as well as social burden will be reduced.

The official said, “We hope that the day when all cancer patients can enjoy Keytruda treatment opportunities will be realized sooner through improved accessibility.” “We will make sincere progress by working closely with the health authorities and health care officials.”

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2023-06-27 15:54:12
#MSD #Application #Expansion #Benefits #Keytruda #Indications

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