Starting October 1, patients with rare and neglected cancers will find relief from the high costs of treatment. The South Korean government is expanding health insurance coverage for the latest targeted and immunotherapy drugs used to treat rare genetic mutations in lung cancer, advanced stomach cancer, and urothelial carcinoma. Notably, this marks the first instance of health insurance benefits being applied to combination therapies involving high-cost drugs developed by different global pharmaceutical companies, enhancing access to treatment for patients with severe conditions.
On September 30, the Ministry of Health and Welfare announced that the Health Insurance Policy Review Committee approved the expansion of coverage for the rare genetic mutation lung cancer drug 'Letermovir Capsules', the treatment for unresectable advanced and metastatic stomach cancer 'Biloey', and the first-line combination therapy of 'Padsepp + Keytruda' for urothelial carcinoma. This decision will take effect on October 1.
First, health insurance will cover 'Letermovir Capsules', a treatment for non-small cell lung cancer and medullary thyroid cancer caused by the rare RET fusion mutation. RET mutation non-small cell lung cancer occurs in only 1-2% of all lung cancer patients, with fewer than 300 patients in South Korea, making it a neglected area.
The new drug, Letermovir Capsules, is a targeted therapy that precisely attacks cancer cells without damaging normal cells, unlike traditional cytotoxic chemotherapy drugs. This reduces side effects and significantly improves treatment efficacy, and it is available in an oral form, alleviating the inconvenience for patients who previously had to wait for long periods in hospitals for intravenous treatments.
The targeted chemotherapy drug 'Biloey' for patients with unresectable advanced or metastatic stomach cancer has also crossed the insurance threshold. While the five-year relative survival rate for stomach cancer is relatively high at 78.6%, metastatic stomach cancer, which cannot be surgically removed, has a median survival period of only 6-10 months, with a five-year relative survival rate of around 10%, often referred to as a 'despairing cancer.'
Biloey has demonstrated strong clinical utility by reducing the risk of resistance by 41% compared to standard treatments and extending overall survival by approximately twofold. The inclusion of this drug in health insurance is expected to provide significant help in extending the lives of late-stage stomach cancer patients and reducing their medical expenses.
A groundbreaking development has also emerged in the treatment of urothelial carcinoma (including bladder cancer), which accounts for about 2.5% of all cancer cases. The first-line combination therapy of the next-generation drug 'Padsepp' (Korea Astellas Pharma) and the immunotherapy 'Keytruda' (Korea MSD) will now receive health insurance benefits.
Urothelial carcinoma progresses and metastasizes rapidly, making early intervention essential. However, previously, Keytruda was only covered for second-line treatment after failure of first-line therapy, often causing patients to miss critical treatment windows. With this new coverage, patients can now receive combination therapy with Keytruda and Padsepp from the initial treatment stage.
The synergistic effect of Padsepp, which targets cancer cells like a guided missile, and Keytruda, which activates immune cells in the body, is expected to double overall survival compared to traditional chemotherapy.
Notably, this insurance coverage is the first instance in South Korea where health insurance applies to combination therapies involving patented drugs from different pharmaceutical companies. Despite the complexities of negotiating individual drug prices with each company, a compromise was reached in the interest of 'addressing treatment gaps.'
The government plans to continue promoting institutional improvements to activate combination therapies involving different new drugs.
Lee Hyung-hoon, the Second Vice Minister of Health and Welfare, stated, "We hope that this expansion of health insurance coverage will alleviate the burden on patients and families who have delayed or given up treatment due to high drug costs. We will continue to work to strengthen health insurance coverage for rare and severe disease treatments."
* This article has been translated by AI.
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