Health authorities are currently reviewing the potential expansion of insurance coverage for switching atopic dermatitis treatments, drawing significant attention to the possible outcomes. This review specifically concerns switching between JAK inhibitors and between JAK inhibitors and biologics, excluding the interchange between different biologics.

According to industry sources on July 18th, the Ministry of Health and Welfare (MOHW) and the Health Insurance Review and Assessment Service (HIRA) are considering this expansion and have requested opinions from relevant academic societies.

Currently, JAK inhibitors such as AbbVie's Rinvoq, Lilly's Olumiant, and Pfizer's Xeljanz, as well as biologics like Sanofi's Dupixent and Leo Pharma's Adtralza, are covered for the treatment of atopic dermatitis. In the JAK inhibitor category, Pfizer's Xeljanz, which had long been the leader, has seen a decline due to safety concerns, while Rinvoq is rapidly gaining traction. Among biologics, Dupixent has been leading, with Adtralza entering the insurance coverage list last month, intensifying the competition for prescriptions.

There has been a continuous demand from patients and healthcare professionals for the possibility of switching atopic dermatitis treatments. However, the government has not permitted insurance coverage for switching treatments, citing a "lack of evidence."

As a result, patients with severe atopic dermatitis face difficulties in immediately switching treatments when they experience side effects or lack of efficacy with biologics or JAK inhibitors. To qualify for insurance coverage, patients must use a first-line treatment for three months and meet the EASI (Eczema Area and Severity Index) score of 23 or higher. Patients with atopic dermatitis express dissatisfaction with these insurance criteria, as they feel compelled to discontinue treatment and potentially worsen their condition to access new therapies.

In a press conference held last May regarding the coverage of Adtralza, Professor Ji-young Ahn from the Department of Dermatology at the National Medical Center highlighted that the most common response from healthcare professionals regarding unmet needs was the "inability to switch treatments," followed by "strict and complex coverage criteria."

In response to these demands, the government is now reviewing the expansion of insurance coverage for switching between JAK inhibitors and biologics and has requested opinions from relevant academic societies.

The review includes the following aspects:

ⓐCurrent treatment methods for atopic dermatitis, administered medications, and relevant evidence.

ⓑOpinions on switching medications and their specific grounds (medical validity, necessity in clinical practice, and actual clinical conditions).

ⓒComparative tables of atopic dermatitis medications and opinions on their cost-effectiveness.

ⓓ Criteria and methods that can typically be used in clinical practice to select patients who need treatment switching.

ⓔ The anticipated financial impact of such changes.

Given the continuous demands from patients and experts, there is significant interest in whether this opportunity will lead to the expansion of insurance coverage for treatment switching in atopic dermatitis.