Discussions are advancing on expanding insurance coverage for switching JAK inhibitors in rheumatoid arthritis treatment. This has raised questions about whether similar expansions will be made for atopic dermatitis treatments.

Industry sources report that coverage for switching treatments in both rheumatoid arthritis and atopic dermatitis has been previously denied due to insufficient clinical evidence. However, medical societies, including the Korean Rheumatology Association and the Korean Atopic Dermatitis Association, have persistently shared their clinical data and experiences with the government. In response, the Health Insurance Review and Assessment Service (HIRA) reassessed the coverage policy and shared a positive outlook with the Ministry of Health and Welfare (MOHW).

As a result, it is expected that insurance coverage will soon be expanded to include switching between JAK inhibitors for rheumatoid arthritis. Currently, four JAK inhibitor drugs—Olumiant (Lilly Korea), Rinvoq (AbbVie Korea), Jyseleca (Eisai Korea), and Xeljanz (Pfizer Korea)—are available in Korea. Expanded coverage would likely increase their prescription rates.

In parallel, efforts are underway to extend coverage for atopic dermatitis treatments, including switches between JAK inhibitors and between JAK inhibitors and biologics. Currently available options for atopic dermatitis include two JAK inhibitors—Rinvoq and Olumiant—and two biologics, Dupixent (Sanofi) and Adtralza (LEO Pharma). Ongoing discussions continue on the best approach for coverage expansion.

To qualify for switching treatments, patients with atopic dermatitis must undergo an initial three-month therapy and meet a threshold Eczema Area and Severity Index (EASI) score of 23 or higher. Currently, patients with severe atopic dermatitis cannot switch treatments immediately, even if they experience side effects or lack of efficacy.

In response to increasing calls from patients and medical experts for expanded coverage, the government sought input from medical societies in July. Despite this progress, financial considerations remain a key factor, and the government has not yet made a final decision. A consultation meeting between HIRA and medical societies took place on September 4th, and the results are now under review for further consideration of the coverage expansion.