New listing and coverage expansion drugs are already over 400 billion KRW within 1Q 2024

Since the beginning of this year, it has been revealed that the annual expenditure for newly added or expanded drugs on the health insurance drug list has already surpassed 400 billion KRW within just four months. This amount far exceeds the annual expenditure of 381.4 billion KRW for drugs that were newly added or expanded in usage over the course of last year. The significant increase in expenditure is largely attributed to the inclusion of Tagrisso and Leclaza and the introduction of Enhertu into the health insurance coverage.

According to the Ministry of Health and Welfare on the 31st, a total of 18 drugs, either newly added or with expanded usage coverage, were included in the health insurance drug list from January to April this year. Among these, seven were included in January, four in February, two in March, and five in April. Among them, 14 were newly added, and the remaining four had expanded usage coverage.

The increase in annual expenditure due to new listing or expanded coverage is led by Enherzoo, a breast and gastric cancer treatment drug by Daiichi Sankyo, newly introduced on April 1st, with an expenditure of 134.7 billion KRW. This is followed by AstraZeneca's lung cancer treatment drug Tagrisso (expanded coverage) with 92 billion KRW, Yuhan Corporation's lung cancer treatment drug Leclaza (expanded coverage) with 88.1 billion KRW , AstraZeneca's neurofibromatosis treatment drug Koselugo capsule with 37.59 billion KRW , Daewoong Pharmaceutical's cytomegalovirus treatment drug Livtencity tablet with 15.3 billion KRW, and Bayer's diabetes and chronic kidney disease treatment drug Kerendia tablet with 9.95 billion KRW .

Furthermore, Pfizer's multi-drug resistant bacterial antibiotic Zavicefta injection with 8.95 billion KRW , Astellas Pharma's acute myeloid leukemia treatment drug Xospata tablet (expanded coverage) with 8.38 billion KRW , AstraZeneca's neuromyelitis optica treatment drug Soliris injection (expanded coverage) with 7.21 billion KRW , and Novartis's genetic retinal dystrophy treatment drug Luxturna injection with 5.86 billion KRW , followed the list.

Additionally, BMJ's ulcerative colitis treatment drug Zeposia capsule with 4.04 billion KRW , Ono Pharmaceutical's rectal and colon cancer treatment drug Braftovi capsule with 3.93 billion KRW , Pfizer's chronic myeloid leukemia treatment drug Bosulif tablet and Kolon Pharma's asthma and COPD treatment drug Trimbow inhaler with 3.5 billion KRW each, Kyowa Kirin's sarcoidosis and granulomatosis syndrome treatment drug Poteligeo injection with 3.37 billion KRW , Daewoong Pharmaceutical's psoriasis treatment drug Sotiktu tablet with 2.99 billion KRW , and Daiichi Sankyo's acquired hemophilia treatment drug Obizur injection and GlaxoSmithKline's asthma and COPD treatment drug Trelegy 200 Ellipta inhaler with 2.4 billion KRW each had relatively smaller expenditure.

While the number of newly added or expanded drugs is considerable at 18, it is worth noting that three drugs, Tagrisso, Leclaza, and Enhertu, account for about 73% of the increased expenditure. Particularly, it is anticipated that Tagrisso and Leclaza, with annual expenditures estimated to increase to 204.6 billion KRW and 137.7 billion KRW , respectively, will significantly contribute to the overall increased expenditure.

With the addition of Enhertu, three drugs among the newly added or expanded drugs until April this year are expected to join the "1 trillion KRW club" in terms of claims. Notably, the appearance of these blockbuster drugs, which have grown rapidly into mega-blockbusters through expanded coverage in recent years, is a noteworthy trend.

As a result of the impact of these drugs, it is expected that the number of drugs in the "1 trillion KRW club" for claims will increase to about 10 by next year, and there may be fluctuations in the ranking of top claims. In particular, it is expected that Keytruda, with estimated claims of 250 billion KRW in 2023, will continue to maintain its position as the top-rank for the time being. Tagrisso, with an estimated annual expenditure of 204.6 billion KRW , is also likely to maintain its position as the number two. However, from the third place onwards, there may be fierce competition between drugs such as Prolia, K-Cap, Leclaza, Enhertu, and Tecentriq as they shuffle positions.