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Opinion
[Reporter’s View] Why set deadlines in pricing negotiations
by Eo, Yun-Ho Feb 17, 2022 05:53am
A deadline is a pre-determined set amount of period. If this period is extended frequently, what meaning would setting a ‘deadline’ have? This question arises with the uprise of deadline extensions being made in the drug pricing negotiations between the National Health Insurance Service and pharmaceutical companies for reimbursement listing or reimbursed indication extensions. Simply put, too many ‘exceptions’ are being made. When the drug pricing negotiation period for the 3rd generation lung cancer treatment ‘Tagrisso (Osimertinib)’ was extended five years ago, the media had described the extension as ‘exceptional’ or ‘unprecedented.’ However, so many drugs, especially anticancer drugs, have recently failed to reach negotiations or completed negotiations after the deadline. Even now, more than 3 drugs are in negations past their deadlines. This is why pharmaceutical officials awaiting negotiations sometimes make jokes that “We wouldn’t be able to complete negotiations at once, but maybe during the extended period.” With the introduction of the effective but high-priced drugs, the increased extensions, and exceptions may be implying that the ’60 day’ negotiation period is now not sufficient time for the government pharmaceutical companies to reach an agreement. However still, a deadline is a deadline. Moreover, the reduction of the negotiation period is being used as an incentive and a benefit. In other words, the period was set to accelerate listing and limit the final period of negotiations and allow predictability of listings. However, no either party is fully accountable. The common period extensions, the introduction of more expensive and difficult-to-negotiate drugs, and the lack of determination to produce results within the deadline have led to a repetition of such ‘exceptions.’ Also, the companies’ dragging out negotiations due to delay in communication with its headquarters, and the administrative department’s complacency in postponing the immediate breakdown of negotiations fearing the rush of complaints from patients, undermines the purpose of the system. If discussions became difficult, strengthen the conditions for initiating negotiations. The required documentation should be reviewed and discussed with the NHIS in advance at the HIRA review stage, and the parties should be pressed to complete the negotiations within the set period. Do it “for the patients,’ that both parties have frequently referred to. Frequent exceptions are no longer exceptions.