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- by Eo, Yun-Ho Jun 05, 2026 09:35am
The pulmonary arterial hypertension (PAH) therapy 'Opsynvi' is being prescribed across major tertiary referral hospitals following its inclusion on the reimbursement list.According to industry sources, Janssen Korea’s Opsynvi (macitentan·tadalafil) has passed the drug committee (DC) review at Seoul National University Hospital.The company accepted the 'price below evaluated amount' proposed by the Health Insurance Review and Assessment Service (HIRA)'s Pharmacuetical Reimbursement Evaluation Committee in December last year, and subsequently finalized price negotiations with the National Health Insurance Service (NHIS) in March. Opsynvi obtained a reimbursement listing effective April.Consequently, Opsynvi can be prescribed for the 'long-term management of adult patients presenting with WHO Functional Class II to III PAH.'Opsynvi, which received US FDA approval in March 2024 and Korean MFDS approval in July last year, is a combination therapy containing the PDE5 inhibitor 'Cialis (tadalafil) and the endothelin receptor antagonist (ERA) 'Opsumit (macitentan), improving patient convenience.Opsynvi demonstrated its efficacy through a Phase 3 study named A DUE. The clinical trial was conducted to evaluate and compare the efficacy and safety profiles of the Opsynvi group with those of control groups receiving either Opsumit or Cialis monotherapy. Following 24 months of patient follow-up, Opsynvi demonstrated up to a 29% reduction in the primary endpoint pulmonary vascular resistance (PVR) compared with the Cialis or Opsumit monotherapy groups. As of 2023, the number of PAH patients in South Korea is approximately 3,600, with the mean age of patients being women in their 40s who lead pivotal roles in society and their families. While the 5-year survival rate has vastly improved compared to the past, three out of ten South Korean PAH patients still die within five years.Pulmonary arterial hypertension is a rare, intractable, and progressive disease, where delaying disease deterioration directly impacts patient quality of life and survival. There is no known pharmacotherapy cure, and the mechanism of action (MOA) of conventional agents primarily focuses on alleviating symptoms by dilating the thickened pulmonary arteries.Meanwhile, with the emergence of novel therapeutics, changes are anticipated in the domestic PAH treatment landscape.In June 2025, Bayer's 'Adempas (riociguat)' was added to the reimbursement list nearly 10 years after its domestic regulatory approval, while MSD Korea's 'Winrevair (sotatercept),' a drug selected for the second phase of the 'Approval-Evaluation-Negotiation Concurrent Pilot Program,' is currently undergoing the reimbursement listing process.