South Korea’s Reimbursement Mechanism for Pharma Products and Its Benefits

  • South Korea’s governing bodies and reimbursement mechanisms and policies
  • Parameters used to determine the appropriateness of reimbursement and setting the reimbursement price
  • Types of reimbursement agreements
  • Assessment and lessons from previous reimbursement approvals

Key Takeaways

  • Reimbursement assessment takes approximately 240 days from new drug approval to reimbursement approval
  • First-level assessment involves checking the appropriateness of reimbursement before setting the reimbursement price
  • To gain faster access, a company may choose to accept a price that is 90–100% of the WAP of substitutes
  • South Korea considers external reference pricing from A7 countries (the US, Japan, Germany, France, Switzerland, the UK and Italy) as one of the models for setting the reimbursement price
  • Positive recommendations by the NHI service increased to 78% over 2014–18 from 70% over 2007–13
  • 60% of approvals were made in the budget range of KRW1–10bn and 20% in the >KRW10bn range during 2014–18

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