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- by Eo, Yun-Ho Apr 23, 2026 10:50am
Insurance reimbursement criteria for the breast cancer drug Perjeta may be expanded to cover its use as postoperative adjuvant therapy.The breast cancer division of the Korean Society of Medical Oncology submitted an application to expand reimbursement for the postoperative adjuvant use of Roche Korea’s HER2-positive breast cancer drug, Perjeta (pertuzumab). The society has previously submitted a reimbursement application for the early-stage breast cancer indication of the CDK4/6 inhibitor ‘Verzenio (abemaciclib).’Perjeta’s adjuvant therapy indication was expected to be presented to the Cancer Disease Deliberation Committee of the Health Insurance Review and Assessment Service (HIRA) last October, but the discussion itself was canceled due to revisions to Korea’s positive listing reimbursement criteria.Consequently, it remains to be seen whether discussions regarding Perjeta’s reimbursement as postoperative adjuvant therapy will proceed this time.Currently, Perjeta is reimbursed for HER2-positive metastatic or unresectable locally recurrent breast cancer. In addition, Perjeta is reimbursed as neoadjuvant therapy in early breast cancer at a 30% patient co-insurance rate.However, postoperative adjuvant therapy, a critical treatment step to prevent recurrence, remains non-reimbursed (100% patient coinsurance rate) since the indication was added in Korea in 2018, limiting patient access.This is because its use as postoperative adjuvant therapy lacked long-term follow-up data or a high recommendation grade in global guidelines at the time of the 2019 review, unlike its use as neoadjuvant therapy (preoperative adjuvant therapy), which is covered with 30% selective reimbursement.However, the 10-year follow-up results from the global Phase III APHINITY study that was released last year are expected to fill this gap.According to the study, the Perjeta and Herceptin combination as adjuvant therapy demonstrated clear benefits, including a 21% reduction in the risk of death compared to monotherapy in patients with lymph node-positive early-stage breast cancer at high risk of recurrence.Meanwhile, the Perjeta-Herceptin combination therapy is currently recommended as Category 1 in the U.S. NCCN guidelines for postoperative adjuvant therapy in patients with HER2-positive early-stage breast cancer who have lymph node metastasis. It is also recommended as Category 1 for postoperative adjuvant therapy in high-risk patients with lymph node metastasis who achieved a pathological complete response (pCR) following neoadjuvant chemotherapy.