- LOGIN
- MemberShip
- 2026-03-18 07:10:52
- Company
- MNCs bid for ‘themed’ victory with innovation and legacy
- by Eo, Yun-Ho Jun 09, 2021 06:07am
- Whichever the cause, the decision of the Big Pharmas to ‘focus on their strengths’ is more than just a pretext for reorganizing their businesses. Setting a clear ‘theme’ can have a positive effect on the image of a company. Also, dividing its business does not mean a loss of drive. However, such divisions will bring one company to lose its cash cow, and the other to lose its new product line. In this sense, the divisions will intensify companies’ competition for survival and movement to specialize their domain. ◆Reorganizing by theme for a reason=The theme of a company's pipeline leads to consistency of its message. For example, Pfizer’s Upjohn was a spin-off of its off-patent drug business, but its merger with Mylan added biosimilars, generics, and over-the-counter drugs to its pipeline. Organon, which pursues leadership in women’s health, has established its pipeline in the field of cardiovascular, urinary, respiratory, dermatology, and biosimilars. In other words, the spin-offs can let one company can purse innovation, while the other succeeds legacy brands. The brand power held by legacy product lines is also a competitive edge that cannot be ignored. In this sense, the restructuring, which enabled Pfizer and MSD to focus on developing and launching innovative new anticancer and rare disease drugs while their spinoffs - Viatris and Organon - became specialty pharmaceutical companies that focus on chronic disease or women’s health, was a convincing move from the stockholder’s viewpoint. However, there is a loophole in the reasoning of these spin-offs and sales. Ironically that Pfizer’s biosimilar, as well as MSD’s blockbuster drugs such as the diabetic drug ‘Januvia,’ Takeda’s OTC drug ‘Actinum’ remains in the original company. ◆Specificity of the Korean market= Also, the Korean subsidiaries of the multinational pharmaceutical companies may face a different situation due to the inherent characteristic of the Korean market. In Korea, original drugs tend to sell strong regardless of their patent status. This may partially be due to the generic drug pricing policies in Korea, but many Korean subsidiaries of multinational pharmaceutical companies have been enjoying strong sales even after patent expiry. In fact, Viatris Korea accounts for more than half of Pfizer Korea's sales. Just last year, Viatris's lead statin product ‘Lipitor,’ recorded 185.5 billion won in prescription sales. Also, even without the ‘Januvia’ family, Organon Korea’s originals ‘Atozet,’ ‘Cozaar,’ ‘Singular’ had in total recorded around 150 billion won’s worth in sales last year. Launching combination drugs that succeed the originality of originators is therefore a strategy that companies can choose to take in the Korean market. Viatris had recently released ‘Lipitor Plus,’ an atorvastatin and ezetimibe combination drug. Viatris aims to target the Korean market with Lipitor’s brand power and the fact that they use the original API. Under the stepped pricing system that was newly applied, Lipitor Plus’s price was set lower than Atozet. The results remain to be seen, however, Korea is an adequate market for testing new strategies based on manufacturing pharmacy such as by improving the convenience of chronic disease drugs, etc. On the other hand, the Korean subsidiaries that have let go of their cash cows may need to brace for sluggish sales growth depending on their reimbursement situation, as due to the nature of Korea’s national health insurance system, new drugs are not easily prescribed without reimbursement in Korea. Pfizer is currently working to list its ‘Vyndamax,’ and two other follow-on drugs that have been listed are facing RSA re-evaluations soon. MSD recently failed to expand its 'Keytruda' reimbursement to first-line lung cancer, which was key to expanding the scope of prescription for the drug. These are risks that cannot be ignored from the Korean subsidiary’s perspective. An official from a multinational pharmaceutical company said, “The separation of roles seems to be happening between multinational pharmaceutical companies as well. In the future, the companies will be divided into those that reduce their sales division while focusing on reimbursing high-price drugs, and those that increase collaboration with domestic companies and implement various sales strategies.”
- Company
- Patent dispute over Pelubi SR is not over
- by Kim, Jin-Gu Jun 09, 2021 06:07am
- Pelubi SRThe patent dispute of Daewon's anti-inflammatory drug Pelubi SR continues. Youngjin, Huons, and Chong Kun Dang won patent dispute of Pelubi. Among them, Youngjin has received generic for exclusivity alone. According to the pharmaceutical industry on the 7th, at least three companies are considering patent challenges for Pelubi SR: Mothers Huons, and Chong Kun Dang. Although they have not filed a formal patent judgment yet, it is known that they have started developing their own generics. The industry expects the Pelubi SR patent dispute to be fiercer than the previous case of Pelubi. This is because Pelubi SR's Rx performance is higher than that of Pelubi. According to UBIST, a pharmaceutical market research firm, Rx performance of Pelubi SR last year was ₩30.1 billion. Among them, Pelubi SR's sales account for 60-70%. Pelubi & Pelubi SR are registered with composition Patent. The patent for Pelubi SR expires in October 2033. Huons and Mothers are officially in the development of generics for Pelubi SR . Biological equivalence tests were approved in May and July last year respectively. Recently, Chong Kun-dang is said to have started developing its own generic. The pharmaceutical industry understands that these companies' patent challenge for Pelubi SR is imminent. In addition to the three companies, attention is also being paid to whether companies that have challenged existing Pelubi patents such as Youngjin will try again. If one of them files a patent trial, the remaining companies' patent challenges are expected to follow within 14 days. Pelubi and Pelubi SR are said to be difficult to develop due to the nature of the preparation. "It is expected that it will be more difficult to prove biological equivalence than to win a patent dispute," a pharmaceutical industry said. "We understand that three companies voluntarily withdrew their patents in the previous patent dispute for Pelubi because they also failed to develop generics." In the case of Pelubi, which expire in November 2028, Youngjinl, Huons, and Chong Kundang won the first trial. Mothers, Hutecs, and Nexpharm, which challenged patents with them, voluntarily withdrew their judgment on patents. The generic for exclusivity of generic for Pelubi was acquired exclusively by Youngjin. Youngjin received a license for Peluvi's generic Pelps late last month. The MFDS granted Pelps generic for exclusivity on the same day. Huons was also granted Hubirofen, generic for Pelubi on the same day, but generic for exclusivty was not given. It is said that this is because the MFDS ordered supplementation of data. It is known that Chong Kun Dang did not apply for permission for generic for Peluvi.
- Company
- Hemlibra reimbursement disapproval raises anxiety
- by Nho, Byung Chul Jun 08, 2021 06:01am
- The head-on clash between the ‘standard to first consider immune tolerance induction (ITI·antibody removal) therapies’ and the ‘due prescription rights of doctors·convenience in administration·saving NHI finances’ have received industry attention. On the 3rd, the Health Insurance Review and Assessment Service (HIRA) held a Pediatric Department Special Review Committee to review medical benefit reimbursement of Hemlibra and disapproved its reimbursement. Therefore the clash between the industry·patient groups and the authorities in normalizing its reimbursement is deemed inevitable. The reimbursement standard for Hemlibra that was implemented in February this year allows reimbursement for pediatric hemophilia patients ▲who failed ITI therapy; ▲who meet the ITI eligibility requirements but have a doctor’s note proving they cannot receive ITI therapy; and ▲whose antibodies reappeared after a successful ITI therapy. On the other hand, for hemophilia patients with antibodies, the reimbursement guidelines recommend to HCPs to first consider using ITI therapy. HIRA’s regulations prioritize the use of ITI therapy in high-antibody patients in years 1-5, patients with frequent bleeding, and patients with intracranial bleeding. The issue arose regarding the reimbursement standard ‘Those who meet the ITI eligibility requirements but have a doctor’s note proving they cannot receive ITI therapy.' The committee requested objective data proving that it was difficult to secure venous blood vessels and that it was impossible to attempt ITI therapy when administering Hemlibra. However, the medical community and patient groups protest saying that “Most patients are under 5 years of age, therefore, providing data on the state of their blood vessels following intravenous injections and objective measurement of their pain is virtually impossible. The specificity of the circumstances and environment isn't being considered.” In other words, their argument is that requesting data based on scientific grounds when there is no objective data to present is in itself nonsense. Two large hospitals, A and B Hospital in Seoul and Daegu, had administered Hemlibra to 4 hemophilia patients under the age of 12 during the last two months according to doctors’ justifiable opinion. The pharmaceutical cost of Hemlibra amounted to 30 million won per patient for the 2 months, and if the hospitals decided to exercise their right of claim rather than suffer the loss, the cost will solely be imposed on the patients. On this, an official from the Korean Society on Thrombosis and Hemostasis said, “Insisting or forcing pediatric hemophilia patients under the age of 12 to receive intravenous ITI therapy is not a desirable means of treating the disease. Also, the HIRA's disapproval of reimbursement for Hemlibra this time is inconsistent with the reimbursement standard that explicitly states that Hemlibra may be administered with a justifiable doctor’s note." Patient groups also strongly expressed their objection, pointing out that “Current standards do not require ITI therapies before existing bypassing therapies. Making the decision to administer Hemlibra does not mean that the doctors did not consider ITI therapies. The committee’s decision to restrict only Hemlibra with such a condition is unacceptable.” Meanwhile, the deliberation results of the Pediatric Department Special Review Committee will be finalized after resolution by the Central Review & Assessment Coordination Committee, and the claims for re-examination and objections to adjust drug costs may be filed within 60 days. Attention is now on whether the voices of the pediatric patients and their parents will be reflected in addition to the efforts made through Cheong Wa Dae’s public petition and Anti-Corruption and the Civil Rights Commission’s adjustment efforts.
- Company
- Pros and cons of the spin-offs and sales of Big Pharmas
- by Eo, Yun-Ho Jun 08, 2021 06:01am
- Mergers, spin-offs, buying, selling... news shows that global Big Pharmas have been busy constantly changing their shape. In particular, the issue that gained the most attention for the past few years was the companies' spin-offs and sales. Although the companies' made the decision under the premise of ‘focusing on one’s strengths,’ such divisions and sales have brought out both positive and negative views. One thing to note is that these changes have been occurring 'serially' among global pharmaceutical companies. ◆Change in the development trend and surging investment cost = Although it is difficult to pinpoint the root cause of the constant change, a trend is evident. Development of new drugs is difficult, even without specifying the 1 in 10,000 probability of success. Also, successful development does not directly translate to actual sales. And this problem continues to intensify. Hidden within the shadow of the often-discussed ‘open innovation' n the global market. exists the rampant new drug famine. Discovering new substances is difficult and the risk keeps increasing, so ‘sharing’ the burden became the solution. With the field of chronic disease ruled out as ‘drugs in need have already been released,’ the industry's focus is now on anticancer drugs and rare diseases. Also, with the increase of cutting-edge new drugs that have dozens of indications for a single substance, Big Pharmas are now faced with a situation where they would need to spend astronomical amounts just on the Phase III trial of its new drugs. As the direct discovery of candidate substances has become increasingly difficult and buying promising new substances (candidate substances) or venture businesses that own such substances, the companies' investment spending has skyrocketed as well. From the Big pharma’s perspective, this means that their already-high proportion of investments have doubled. Not only Takeda, Pfizer, and MSD, which carried out spin-offs and sales of its business units, but companies that prided in their R&D such as Novartis, Sanofi, and Bayer have announced at least 3-5 acquisitions of drug substances or companies every year. The size of mergers and acquisitions by global companies had already exceeded 400 trillion won in 2019. The advent of the 'age of high-priced drugs’ that is emerging as a social issue is not unrelated to this large amount of investments. A Business Development personnel who returned to the Korean subsidiary after working at its global headquarters said, “Big Pharmas are reducing directly conducted projects that start from substance discovery. The companies have turned their direction to buying promising substances to reduce the investment risk. However, the problem that companies face is that the price of venture businesses that own such substances have also been rising rapidly.” ◆Stock price and stockholders… the BU system and spin-offs = The rise in investment cost and corporate spin-offs may seem unrelated at a glance, but this is also not the case. A company's stock price and its stockholders are currently exerting wider influence on the decision-making process of the Big Pharmas than in the past. For example, when a company maintains its size and only increases investment, investors worry that the stock price will fall due to decreased cash flow. The corporate spin-off is one option that such companies could select in these cases. No matter how promising a new drug may be, investment in its substance eventually affects the financial solvency of the company. Spin-offs allow the company to divide its size and profit structure. In other words, the company can subdivide its business by concept to an investment-focused part and a legacy part – and recreate the company. Equity spin-offs do not burden the company as there is no exercise of appraisal rights. Since the company becomes a legally independent company after the spin-off, the spin-off may go public immediately afterward. Prior to such spin-offs, most multinational pharmaceutical companies first proceed with restructurings that have a split-off tendency that may serve as a foothold for improving the financial solvency of the company or for the sale of its businesses. For example, before Pfizer completed its spin-off of Viatris, it had established a 3-Business Unit system and separated its legacy brand ‘Upjohn,’ then spun-off Upjohn and combined it with Mylan N.V. to form Viatris. The recent MSD’s spin-off of Organon and Takeda’s sale of its diabetes and OTC business, Novartis’ decision to independently operate its pharmaceuticals and oncology division, and Abbott’s separation of ts biopharmaceutical division as Abbvie were all made in the same context. An official from one multinational pharmaceutical company said, “The criticism that the pharmaceutical companies are now acting on behalf of its shareholders rather than their patients also stem from this phenomenon. However, with the proportion of venture capital (VC) investors (financial investors) increasing, the companies do not have many options to choose from with regards to their operations."
- Company
- HPV vaccine market expands 55% midst COVID-19
- by An, Kyung-Jin Jun 07, 2021 06:06am
- The market for the vaccine to prevent cervical cancer has expanded by the greatest amount ever. The increased inoculation rate of the high-priced 'Gardasil 9' has led the total market growth. MSD, which owns two HPV vaccines - 'Gardasil' and 'Gardasil 9' - accounted for 97% of the total market, and boasted its overwhelming influence in the domestic market. According to the industry research institution IQVIA on the 7th, the HPV vaccine market size in Q1 of this year was 22.9 billion won. This was a 55.5% increase from the same quarter of the previous year and the highest-ever quarterly sales record. The COVID-19 outbreak had temporarily slowed down market growth in the first half of last year, but sales turned back upwards in the second half. Since then, the market has been breaking its own record for three consecutive quarters. Compared to the 11.6 billion won in Q1 of 2017, the market size has doubled in 4 years. The high-priced ‘Gardasil 9’ acted as a catalyst in the HPV vaccine’s market growth. In Q1, sales of MSD’s ‘Gardasil 9’ recorded 17.4 billion won, which was a 75.6% YoY increase compared to the 9.9 billion won of the same quarter last year. In the same period, MDS’s other HPV vaccine, ‘Garadsil’ sold 4.8 billion won. Although ‘Garadsil’ also showed a 19.0% YoY increase from the 4.1 billion won in Q1 last year, the market was completely overwhelmed by the surge in sales of ‘Gardasil 9.’ In the same period, GSK’s ‘Cervarix’ sales fell 12.0% in one year to record 0.7 billion won in Q1 this year. Among the three products authorized in the Korean HPV vaccine market, the other two, which are MSD products, account for 97.1% of the domestic HPV vaccine market. In other words, MSD has a monopoly over Korea’s HPV vaccine market. MSD has grasped the lead in Korea’s HPV vaccine market in 2016 with the government selecting ‘Gardasil’ and ‘Cervarix’ as products for Korea’s National Immunization Project, and MSD releasing its follow-up ‘Gardasil 9,’ in the latter half of the same year. After selling 2.5 billion won in the first year of its release, sales of ‘Gardasil 9’ grew rapidly to 15.1 billion won in 2017, and 20.9 billion won in 2018. Since becoming the market leader product in 2019, raising 40.5 billion won in sales, twice the amount compared to the sales of ‘Gardasil,’ it had continued its rise ever since. In Q1 this year, the market share of ‘Gardasil 9’ was 76.0%, which was three times than that of ‘Gardasil.’ ‘Gardasil 9’ is a human papillomavirus virus (HPV) vaccine that was manufactured by adding five HPV serotypes 31, 33, 45, 52, and 58 in addition to the four HPV serotypes 6, 11, 16, 18 already in ‘Garadasil.’ It is being distributed at a high price with the differentiation that it covers the most amount of HPV types among existing HPV vaccines. The cost of inoculation paid by the consumers varies by hospital, but a single shot of 'Gardasil 9' may at most be 100,000 won more expensive than ‘Cervarix.’ Nevertheless, the demand for ‘Gardasil 9’ among adults not subject to NIP increases. News that the vaccine can prevent other HPV-related diseases such as anal cancer, genital warts, premalignant lesion, in addition to cervical cancer had spread through word of mouth, and the ‘couple vaccination’ promotions in obstetrics and gynecology clinics have been increasing the number of male inoculations every year as well. Since last year, the vaccination age for HPV vaccines was expanded to 45 years, and the rate of reinoculations has also increased significantly. One other factor that may have lead to a sales surge in Q1, is the pre-supply orders from hospitals and clinics in preparation for the price hike announced by the pharmaceutical company. MSD Korea has raised the supply price of 'Gardasil 9' and 'Gardasil' by 15% from April this year, citing rising production input costs. MSD Korea has changed its domestic distributor for ‘Gardasil 9' and 'Gardasil' to HK Inno.N this year and has been conducting co-promotion with the company ever since.
- Company
- Sales in the herpes zoster market have halved in 2 years
- by An, Kyung-Jin Jun 04, 2021 06:06am
- Sales in the domestic shingles prevention vaccine market, which had been on the mend, fell again. In December last year, sales of two vaccines to prevent shingles fell as the vaccination rate fell in the wake of the third pandemic of COVID-19. According to IQVIA, a pharmaceutical research institute, the size of the vaccine market for shingles prevention in the first quarter was ₩10.9 billion, down 10.8% from ₩12.2 billion a year earlier. It is down 44.5% from ₩19.7 billion. The first quarter of last year was a time when the economy stagnated sharply as COVID-19 pandemic began around the world. South Korea's two vaccines for shingles prevention were competing, but sales fell to the lowest level. This year's sales declined from the first quarter of last year, further slowing down. Two types of shingles prevention vaccines are being sold in Korea, including MSD's Zostavax and SK Bioscience's Sky Zoster. It was monopolized by Zostavax, but it continued to grow rapidly with the advent of Sky Zoster in late 2017. The successful shingles prevention vaccine market has worsened in the face of an unexpected infection crisis. Its fourth quarter sales increased to ₩27.9 billion and halved to ₩12.2 billion in the early stages of COVID-19 crisis. Although its second quarter sales recovered to ₩22.6 billion, but decreased again to ₩20.3 billion in third quarter and ₩17.3 billion in fourth quarter. Until the first quarter of this year, quarterly sales have fallen for three consecutive quarters, and have rarely recovered. The industry believes that the vaccine market for shingles prevention is more easily affected by factors such as the epidemic of infectious diseases than other drug markets prescribed for chronic diseases. Since it is a vaccine to prevent diseases, not treatments used in urgent situations, the inoculation rate will inevitably fall if patients avoid visits to medical institutions. The fact that the COVID-19 vaccination, developed by Pfizer and AstraZeneca since early this year, has also had some impact on the decrease in the number of other vaccinations. The market for adult vaccines is sluggish, with the exception of pneumococcal vaccines that benefited from COVID-19. Both Zostavax and Sky Zoster have drawn similar quarterly sales distributions since last year. Sales of Zostavax in the first quarter were ₩6.5 billion, down 10.9% from a year earlier. This is a 40.6% decrease from $10.9 billion (10.9 billion KRW) in previous quarter.Sky Zoster posted sales of ₩4.4 billion in the first quarter, down 10.6% from a year earlier. Compared to the previous quarter, it decreased by 30.6%. As sales of the two products showed similar ups and downs, market share was similar. Sky Zoster's share in the first quarter stood at 40.4%, no significant difference from 40.3% a year earlier. There is another variable in the domestic shingles prevention vaccine market. GSK reportedly applied to the MFDS for the approval of Shingrix earlier this year. Starting with FDA approval in 2017, Shingrix is a product that has been sold in major countries around the world. Demand was high enough to cause scarcity overseas. Market competition is expected to intensify if GSK starts selling Shingrix in Korea.
- Company
- Roche Korea conducts the voluntary retirement program
- by Jun 03, 2021 05:56pm
- Roche Korea conducts the Early Retirement Program (ERP). In the first half of this year alone, many multinational pharmaceutical companies, including Viatris, Astellas, and GSK, started reducing the number of people. According to pharmaceutical industry on the 3rd, Roche Korea is currently conducting ERP for reorganization. The first target is the sales department. At the end of last year, Roche reportedly conducted ERP for some manager-level employees in the sales department. It is heard that specific size and conditions of ERP are under discussion. Industries estimate that it will be about 20% of 60-70 employees in sales department. It is heard that ERP will be carried out for desk job departments in second half of this year. In the first half of this year alone, five to six multinational companies conducted ERP to reorganize or sell their business units, including Viatris, Astellas, GSK, Zuellig Pharma, Jansen, and Roche. Viatris, which split from Pfizer and merged with Mylan, operated ERP as part of its global headquarters' massive restructuring plan. In the process, several managers appear to have resigned. GSK also conducted ERP to some sales and marketing executives while reorganizing its business structure. In particular, as telecommuting and non-face-to-face marketing have increased due to COVID-19 outbreak, and the reporting system has changed, management executives are mainly on the ERP list. The reason for the implementation of Astellas Pharma and Zuellig Pharma's ERP is the deterioration of management. In order to overcome the situation in which patents of major items expire or are damaged in the long term, restructuring has begun. Astellas said its goal is to reduce its total staff by 40%. Zuellig announced it would restructure about 80% of its 100 sales staff. It posted operating losses for the third consecutive year last year, with a debt ratio of 30,000%. Janssen is different from other companies. Janssen, which sold its Hyangnam plant to Whanin, added ERP as an option in the process of redeploying its employees. Employees who want to stay will be transferred to the Songdo plant in Incheon. Retention of employment is a fundamental principle. Employees who do not want this can choose the ERP. Meanwhile, Sanofi and Lilly also conducted ERP late last year due to the COVID-19 crisis.
- Company
- Amgen speeds up commercialization of its KRAS drug
- by Eo, Yun-Ho Jun 03, 2021 06:12am
- Amgen is rapidly working to commercialize its KRAS targeted anticancer therapy in Korea. Industry sources have said that Amgen Korea has submitted an application for the marketing authorization of the first-ever KRAS-targeted anticancer therapy, ‘Lumakras (sotorasib),' on the 28th to the Korean Ministry of Food and Drug Safety (MFDS) immediately after receiving accelerated approval from the U.S. FDA. Amgen's actions seem to be an attempt to solidify Lumakras's position as a first-in-class treatment. As the drug had already received orphan drug designation from the Korean Ministry of Food and Drug Safety in March, the approval process is expected to go smoothly unless there is a special reason for its disqualification. Lumakras is the first-ever drug to be introduced since the KRAS gene was discovered about 40 years ago. Its indication is for non-small cell lung cancer (NSCLC), and patients with KRAS G12C-mutated locally advanced or metastatic NSCLC who have received at least one prior systemic therapy may use Lumakras. The KRAS gene was first discovered in a lung tumor in 1982. About 25% of Western patients and 10-15% of Asian patients with lung adenocarcinomas are found to have the KRAS mutation. In Korea, 5-8% of patients have the KRAS mutation. As there had been no suitable targeted therapy for the KRAS mutation, taxane-based chemotherapy was used for its treatment. But Amgen’s CodeBreak 100 trial results showed that the 124 KRAS G12C-mutated NSCLC patients who received Lumakras 960mg had an ORR of 36%, and their median duration of response was 10 months. Despite continuous efforts to develop a KRAS targeted therapy, none had shown promising results in clinical trials. The discovery of the signaling pathway of KRAS afterward led to the development of more specific targeted therapies for various subtypes of KRAS such as G12C, G12D, G12F, etc. Among these, Sotorasib targets the KRAS G12C mutation, which is known to be the most common mutation in lung cancer. Multinational pharmaceutical companies including Amgen, Mirati Therapeutics, and Boehringer Ingelheim have been attempting to develop therapies targeting KRAS, among which Amgen became the first to produce tangible results.
- Company
- Awareness of multiple sclerosis should increase
- by Jun 03, 2021 06:12am
- Today (26th) is World MS Day. Although the treatment environment has improved significantly with the release of more new drugs for multiple sclerosis compared to the past, early diagnosis is not easy due to the low awareness of the disease. The same is true of overseas situations. In response, the International Association for Multiple Sclerosis (MSIF) has designated the last Wednesday of May every year to raise awareness of the disease. This year's theme is 'Connection'. The goal is to challenge the social obstacles and isolation experienced by multiple sclerosis patients and establish relationships for patients' better lives. Multiple sclerosis is a chronic disease in the central nervous system, including the brain, spinal cord, and optic nerve, and an autoimmune disease caused by the immune system attacking healthy cells and tissues. If myelin, which surrounds and protects nerve fibers in the central nervous system, is damaged, unregulated inflammatory reactions cause wounds in various areas such as the brain and spinal cord, leading to diseases that interfere with nerve transmission. Multiple sclerosis has a wide variety of conditions and symptoms depending on where it occurs. Sensory abnormalities, visual impairment, fatigue, motor impairment, balance abnormalities, bowel and bladder problems, sexual dysfunction, and pain are combined, which are characterized by repeated recurrence and remission. In the early stages of the outbreak, it improves without a disorder after a recurrence, but it is also a rare incurable disease that does not fully improve over time and remains disabled as the recurrence repeats. The incidence of women is more than 50% higher than that of men, and it often occurs in young people aged 20 to 40 who are actively engaged in social activities. The number of patients in the country is about 2,500. Rare diseases have low awareness, making it difficult for patients to suspect multiple sclerosis. Difficulties in diagnosis also make early diagnosis difficult. This is because there is no specific test method to confirm multiple sclerosis so far. The doctor should observe various symptoms, medical history, and image findings that the patient appeals to and then determine the disease clinically. It usually applies McDonald standards. Progressive multiple sclerosis is classified as primary and secondary progressive. Primary progression is slow to manifest, while secondary to continuous recurrence and recovery continue to deteriorate over a long period of time. In general, about 50% of patients with recurrent palliative multiple sclerosis progresses to secondary progression within 10 years, and 90% of patients switch to secondary progression after more than 25 years. There is no cure for multiple sclerosis, but treatment options have increased. In the early 1990s, when there was no cure at all, the prognosis of patients was poor, but in 1993, the first multiple sclerosis drug appeared, and the prognosis of patients began to improve. In addition, the half-life of the injection has been extended significantly. Currently, multiple sclerosis treatment relieves the disease with steroids during the acute period, and in the long run, the disease is managed with interferon-like injections and oral drugs (DMT). It is important to curb recurrence so that it does not develop into a permanent disability. Reimbursement standards are also improving. As a representative example, the reimbursement clause of Aubagio, an oral primary treatment drug, has been expanded since February this year, allowing oral formulation to be used from the beginning of treatment. Aubagio is the first oral drug to be launched in Korea, and has more than 16 years of long-term safety data to date, along with features that inhibit recurrence and maintain immune action. As there are more options to choose from depending on the patient's life pattern and condition and the benefit is improving, it is important to find and manage medications that can be conveniently treated by the patient themselves. However, there are still diagnostic and therapeutic limitations that arise from unclear causes of the outbreak. Experts say that improving awareness of the disease is urgently needed to elicit early diagnosis. Multiple sclerosis should be suspected if sensory disorders and muscle weakness occur over several days in situations where symptoms of multiple sclerosis are nonspecific, but there is no pain in the neck or back. In particular, if vision disorders accompanied by sudden eye pain are accompanied by young people aged 20 to 50, optic neuritis and spinal cord, which can be seen as before multiple sclerosis, can be suspected. "Multiple sclerosis is possible to slow down the progress of the disease and maintain daily life without disability when appropriate treatment is started in the early stages of the outbreak," said Kim Byung-joon, chairman of the Korean Society of Neuroimmunology. Early diagnosis by professional neurologists is a very important disease, and medical and social understanding and interest in multiple sclerosis need to be improved to maintain continuous treatment by selecting appropriate treatments.
- Company
- Tecentriq attempts reimbursement after Keytruda fails
- by Eo, Yun-Ho Jun 02, 2021 06:11am
- ‘Tecentriq’ is attempting what ‘Keytruda’ had failed. Industry sources have said that Roche Korea had submitted an application for the reimbursement of its ‘Tecentriq (atezolizumab),’ as monotherapy in the first-line setting for non-small cell lung cancer (NSCLC) patients whose tumors have a programmed death ligand-1 (PD-L1) expression on at least 50% of tumor cells (TC), or tumor-infiltrating immune cells covering at least 10% of the tumor area. The company received approval for this indication this April. The agenda will be put up for deliberation by the Cancer Drugs Benefit Appraisal Committee of the Health Insurance Review & Assessment Service in July. Accordingly, the possibility is rising for Tecentriq's reimbursement to be discussed together with MSD Korea’s PD-1 inhibitor ‘Keytruda,' which failed to be approved for the 8th time at the meeting held on the 26th last month, at the next Cancer Drugs Benefit Appraisal Committee meeting. The authorities may induce competition among pharmaceutical companies to reduce fiscal spending, however, this would lead to a delay in reimbursement listing. This irony often occurs in the process of listing expensive new drugs or expanding reimbursement in Korea. As drugs are expensive, if pricing competition arises between pharmaceutical companies, the government can take advantage of the net function of the market. Fiscal savings under the National Health Insurance system saved from such competition can create additional opportunities for coverage expansion. However, the issue at hand is its timing. It would be optimal if drugs of the same class are approved at a similar period so that they can apply for reimbursement listing at a similar timeframe, but this is not likely in reality. In general, the period of each company's reimbursement listing application varies by 6 months to even over a year. Of course, factors other than the physical 'application' date also do play a role in the reimbursement delay, but this difference is important because there are patients awaiting the approval. Moreover, most of the drugs in issue are anticancer drugs. Attention is on what the results would be for the 2 anticancer immunotherapies that walked very different journeys that are attempting the long-delayed reimbursement in first-line lung cancer. The NSCLC reimbursement expansion for Keytruda had been discussed since September 2017, and it has already been nearly 4 years. Among the many barriers, the biggest issue was the ‘pharmaceutical company taking the burden of the initial 3 cycles’ worth of administration cost’ requested by the government to companies with immunotherapy agents. Roche, which owned the then-latecomer Tecentriq was the only company to accept the government’s proposal, and 2 types of PD-1 inhibitors – Keytruda and ‘Opdivo (nivolumab)’ were unable to accept the offer.
