Although new drugs have improved treatment outcomes—such as raising the five-year relative survival rate for cancer patients from 54.2% to 73.7%—it has been pointed out that it takes an average of 22 months for anticancer drugs to be listed under the national health insurance system after they are approved.
On September 30, Rep. Kim Yoon of the Democratic Party of Korea, a member of the National Assembly’s Health and Welfare Committee, co-hosted a “Symposium on Strategies to Expand Access to New Drugs for Serious Diseases and Improve the Financial Efficiency of Health Insurance” in Seminar Room 3 of the National Assembly Members’ Office Building, in collaboration with the Korea Federation of Rare and Intractable Diseases, the Korean Federation of Patient Organizations, and the Korea Pharmaceutical Industry Association (KRPIA) in Seminar Room 3 of the National Assembly Members’ Office Building. The event was organized to discuss ways to move beyond viewing new drugs solely as a source of pharmaceutical cost burdens and instead approach them from the perspective of treatment outcomes and medium- to long-term reductions in social costs.
In his opening remarks, Rep. Kim stated, “As advancements in new drugs expand opportunities for patients, concerns about how to manage rising drug costs are also growing,” but added, “Since new drugs are a crucial means of improving treatment outcomes for severe diseases, reducing their use cannot be the solution.” He went on to emphasize, “We must improve access to proven treatments so that patients can use them when needed, while simultaneously reducing inefficient spending within existing drug costs to enhance the sustainability of the national health insurance system.”
Lee Beom-hee, a professor in the Department of Pediatrics at Asan Medical Center in Seoul, stated, “Among the approximately 7,000 types of rare diseases, only 5% have approved treatments.” He explained that even for existing treatments for rare genetic diseases, the domestic introduction process is complex, and for those covered by insurance, the reimbursement criteria are strict, placing a heavy burden on medical staff.
Kim Hee-jun, a professor in the Department of Hematology and Oncology at Chung-Ang University Hospital, noted, “On average, it takes about 22 months for an anticancer drug to be listed under national health insurance after receiving approval from the Ministry of Food and Drug Safety, and for recently listed drugs, this period has lengthened to 28 months,” “The fact that it takes nearly two years after approval means that a significant number of patients diagnosed with advanced cancer during that period will not have the opportunity to use these drugs under insurance coverage,” he pointed out.
Kwon Yong-jin, a professor at the Public Healthcare Center at Seoul National University Hospital, stated, “While health insurance drug costs increased by 5.7 trillion won from 2021 to 2024, the increase in drug costs for patients under special billing exemptions (1.9 trillion won) accounted for 33% of that total.” He noted, “Treatment outcomes have improved, as evidenced by the five-year relative survival rate for cancer rising from 54.2% to 73.7% and the number of people living with cancer reaching 2.73 million,” and “The market for off-patent drugs is shifting toward a price-competitive structure, and new drugs should be fairly reimbursed based on their efficacy,” he argued.
In the subsequent panel discussion, moderated by Professor Ra Seon-young of Severance Hospital, representatives from patient advocacy groups, the industry, the media, the National Health Insurance Service, the Health Insurance Review and Assessment Service, and the Ministry of Health and Welfare discussed directions for improvement, including the expansion of expedited listing, the use of conditional coverage and risk-sharing schemes, and the establishment of value-based evaluation criteria.
Baek Kyung-eun, President of KRPIA, stated, “Innovative new drugs can serve as a ‘social investment’ that not only increases patient survival rates but also reduces direct medical costs—such as hospitalization and surgical fees—as well as socioeconomic costs, including the burden of nursing and caregiving and long-term care expenditures,” “It is time to move beyond the framework that views new drugs merely as a factor increasing costs and shift toward a ‘value-based policy paradigm.’”
