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KMID : 1170320140200020001
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Korean Journal of Health Economics and Policy
2014 Volume.20 No. 2 p.1 ~ p.20
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Review of reimbursement recommendations of the oncology and the orphan drug in Korea, Australia, Canada and Britain
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Bae Green
Bae Seung-Jin
You Mi-Young
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Abstract
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Oncology drugs and orphan drugs are usually very costly, while their clinical benefits are marginal or uncertain, resulting in high incremental cost-effectiveness ratios(ICER) and unfavorable reimbursement recommendations. This study sought to compare the reimbursement criteria and recommendations of the oncology and the orphan drugs in Korea (Drug Reimbursement Evaluation Committee) with Australia (Pharmaceutical Benefit Advisory Committee), Canada (pCODR (the pan-Canadian Oncology Drug Review) and Common Drug Review) and Britain (National Institute for Health and Clinical Excellence), where economic evaluation process has been formally considered as part of the drug reimbursement decision process, by referring to publicly available information. Criteria for life saving drugs, as well as drugs that are categorized as life saving drugs and recommended to be reimbursed regardless of the economic evaluation, were identified; Criteria for life saving drugs are similar across four countries, which includes the availability of the alternative treatment, the number of patients, the severity of diseases, and the clinical improvements of the drug. Of those 14 drugs which were reimbursed under the special criteria, all of them were reimbursed in Korea, 9 of which were reimbursed under the special criteria, whereas 3 of them were reimbursed under rule of rescue in Australia and 3 of them were covered under the End of Life program in Britain. Of those 14 drugs, 8 of them were considered and 6 of which were reimbursed in the Britain and 12 of them were considered and all of them were reimbursed in Australia. Korea does not have a separate funding program such as life saving drug program in Australia, yet most of the drugs that were reimbursed under the special funding program in Australia and Britain were already reimbursed in Korean National Health Insurance Program. In conclusion, there were insufficient evidence to conclude that oncology drugs and orphan drugs are less likely to be reimbursed in Korea compared with other agencies where economic evaluation has been formally implemented.
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KEYWORD
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Oncology drug, orphan drug, reimbursement, HTA recommendation
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FullTexts / Linksout information
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