(Health Korea News / Lim Doi) Starting December 1, health insurance will cover Camzyos (ingredient name: mavacamten), a treatment for improving motor function and symptoms in patients with obstructive hypertrophic cardiomyopathy.
The Ministry of Health and Welfare held the 23rd Health Insurance Policy Deliberation Committee for 2024 at 2 p.m. on the 28th (Chairman: Second Vice Minister Park Min-soo) and deliberated on the ‘Drug Reimbursement List and Reimbursement Ceiling Amount Table Amendment (Plan)’ containing these contents. , it was decided.
(Decision to apply Kamzios benefits)
|
Product name (Ingredient name) |
efficacy·effect |
Pharmaceutical company name |
upper limit(one) |
Effective date |
|
Camgios Capsule2.5,5,10,15mg(Mavacamten) |
Obstructive hypertrophic cardiomyopathy |
BMS Koreapharmaceutical |
61,619one/capsule |
2024-12-1 |
In order to alleviate the symptoms of patients with obstructive hypertrophic cardiomyopathy, the use of treatments (beta-blockers, calcium channel blockers) used for hypertension and arrhythmia has been recommended, but treatment has been difficult for patients who are ineffective or have severe side effects.
However, with the recent development of Camgios, a treatment for improving motor function and symptoms in patients with obstructive hypertrophic cardiomyopathy, and its listing on insurance, treatment opportunities for patients are expected to expand.
This disease is a disease subject to special calculation for rare diseases, and when a person subject to special calculation uses Kamzios, the out-of-pocket cost is 10% of the total nursing care benefit cost.
The annual medication cost per person is approximately 22.49 million won, and if the 10% special calculation method is applied, the out-of-pocket cost is approximately 2.25 million won.
Health insurance will also apply to Qarziba (main ingredient: dinutuximab beta), a drug used in the approval-evaluation-negotiation pilot project to treat neuroblastoma patients, from the 1st of next month.
‘Kwazibaju’ was previously decided to be covered by health insurance as a treatment for neuroblastoma patients at the ’22nd Health Insurance Policy Review Committee’ (Geonjeongsim) held on November 19, 2024.
(Decision to apply Kwazibaju benefits)
|
Product name (Ingredient name) |
efficacy·effect |
Pharmaceutical company name |
upper limit(one) |
Effective date |
|
Kwazibaju4.5mg/mL(Dinutuximab Beta)_(20.25mg/4.5mL) |
neuroblastoma remedy |
Recordati Korea |
11,482,566one |
2024-12-1 |
The treatment for neuroblastoma is ▲ among patients aged 12 months to less than 20 years, ▲ who previously ▲ showed more than a partial response after induction chemotherapy ▲ and ▲ with a history of hematopoietic stem cell transplantation ▲ for neuroblastoma, relapsed or refractory neuroblastoma. Salary standards have been established to enable compensation.
Neuroblastoma patients had to pay about 350 million won in annual medication costs per person, but with this decision to apply health insurance, the patient’s annual medication costs will be reduced to about 10.5 million won (5% out-of-pocket cost, when the out-of-pocket limit system is applied). It happens.
In order to support the rapid listing of treatments for serious diseases, ‘Kwazibaju’ was selected as a drug for the ‘approval-evaluation-negotiation parallel pilot project’, which simultaneously conducts approval from the Ministry of Food and Drug Safety and reimbursement evaluation from the HIRA and negotiation with the National Health Insurance Corporation, and was approved by the Ministry of Food and Drug Safety. The decision to list benefits was made 5.5 months later.
For reference, the Ministry of Health and Welfare recently completed the second pilot project demand survey, and plans to select target drugs within the year and then proceed with the pilot project.
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