Starting November 1st, several new medications will be listed in the reimbursement system without undergoing the typical maximum price negotiations. This is due to the pharmaceutical companies accepting prices below the negotiation exemption threshold, leaving only the projected claim amounts for first-year reimbursement to be negotiated.

According to the Ministry of Health and Welfare (MOHW), drugs such as Santen Korea’s glaucoma treatment Rhopressa Eye Drops 0.02%, Kyowa Kirin Korea’s secondary hyperparathyroidism treatment Orkedia, and Onconic Therapeutics' Ja Q Bo have been approved for reimbursement.

A key aspect of these approvals is that all the drugs bypassed the usual maximum price negotiation process. Typically, if the price is set below the weighted average price of comparable treatments, companies may forgo price negotiations. In these cases, companies accepted 90-100% of the weighted average price, qualifying them for the exemption. However, the projected claim amount for the first year remains negotiated.

Rhopressa Eye Drops

The maximum price for Rhopressa Eye Drops has been set at $7.62, with patients expected to pay around $33.26 after a 30% copayment. The drug, which bypassed negotiations by accepting a price below the weighted average, showed comparable efficacy to existing treatments for patients with intraocular pressure below 26 mmHg, according to medical societies. For patients who experience side effects or resistance to long-term glaucoma medications, Rhopressa may serve as a safe and effective alternative.

Orkedia

Orkedia, used to treat secondary hyperparathyroidism in dialysis patients with chronic kidney disease, will have a maximum price of $1.43 for the 1mg dose and $2.15 for the 2mg dose. The patient burden is expected to be around $393.11. Medical societies have highlighted its cost-effectiveness compared to current treatments, such as cinacalcet, particularly in reducing gastrointestinal side effects like nausea and vomiting. This could improve dosage adherence and long-term compliance for patients.

Ja Q Bo and Related Gastroesophageal Reflux Treatments

For the gastroesophageal reflux disease treatments Ja Q Bo, Q Zetas, and On-CAB, the listed price will be $0.69. These medications bypassed price negotiations by offering a price below 90% of the weighted average price of comparable treatments, meeting the negotiation exemption criteria. Experts note their advantages over proton pump inhibitors (PPIs), including faster onset, sustained gastric acid suppression, and convenience of dosing regardless of meals. Patients will pay approximately $11.34 with a 30% copayment.