[Reporter's View] Delays in medication switching for eczema

(atopic dermatitis)

When patients switch from their current medication to a different medication, the switched products are not covered by insurance reimbursement.

 

This non-reimbursed status of medication switching has been a long-standing issue in South Korea.

 

The field most impacted is atopic dermatitis.

 

Treatment options had been limited for atopic dermatitis, but various new drugs became available over the past years.

 

New medications, such as interleukin (IL)-inhibitors and JAK inhibitors, have relieved patient burdens, and fortunately, these drugs are listed for reimbursement.

 

However, an issue related to medication switching recently surfaced.

 

When a patient switches prescriptions to a different medication after initially using biologic mediation, such as interleukin (IL)-inhibitors, or oral medication, such as JAK inhibitors, reimbursement is no longer provided.

 

As a result, patients cannot easily switch to a different drug when they experience adverse reactions during treatments or do not benefit from the drugs.

 

Individuals respond differently to all drugs.

 

This could be due to genetic differences or various factors such as age, gender, and race.

 

Having many treatment options means that patients can choose from a pool and anticipate other possibilities when they do not respond to a particular drug.

 

The current Korean policy may be limited to offering this type of 'expectancy.' Additionally, this policy leads to prescription bias.

 

Conventional biologics are more expensive than chemically manufactured medicines.

 

If two medications have equivalent therapeutic status but vary significantly in price, and medication switching is not covered, most patients may be biased towards biologics.

 

In the first half of the year, the Korean Atopic Dermatitis Association stepped forward.

 

The Association submitted an opinion report to the Ministry of Health and Welfare (MOHW) demanding medication switching in treating atopic dermatitis.

 

Furthermore, the Association clarified that there are no differences in therapeutic status between biologic agents and oral medication through the guideline revision made in 9 years.

 

The government initiated a review.

 

Presumably because it has decided that demands and needs are precise.

 

Previously, the government had hesitated to provide reimbursement approval for medication switching due to the "shortage of scientific evidence regarding medication switching." Of course, medication switching is not backed up by clinical studies.

 

However, South Korea is the only country not approving medication switching.

 

Indeed, a study cannot be conducted every time new drugs are introduced and cannot wait for real-world data or other literature review.

 

Ultimately, the speed matters.

 

We have records of wasting close to 10 years in approving reimbursement for medication switching of TNF-alpha inhibitors to treat rheumatoid arthritis.

 

Medication switching of JAK inhibitors in other autoimmune diseases, including ankylosing spondylitis, is already allowed.

 

If the government hesitates, it will take a long time.

 

Furthermore, companies must put efforts into increasing volume of use and finance.