The government has granted health insurance benefits to Tecentriq and Avastin combination therapy to treat hepatocellular carcinoma (HCC) and Tecentriq monotherapy to treat non-small cell lung cancer (NSCLC), effective from may. The government has also lowered the maximum reimbursement rates for each drug.
Last year, the government reduced the price of Avastin by 30% due to the advent of a biosimilar to Avastin. As the price of Avastin has dropped by 5% this time, its price is almost the same as that of Onbevzi, a biosimilar.
The Department of Health and Welfare announced revised maximum reimbursement rates for certain drugs on Friday.
According to the review, Roche’s anti-PD-L1 immunotherapy Tecentriq (atezolizumab) will be priced at 2,271,109 won ($1,793) per 20ml/bottle at most, down 1% from the previous cap of 2 296,369 won.
In addition, the upper limit of Avastin (bevacizumab) will be reduced by 5% to 218,782 won per 4ml/bottle and 712,098 won per 16ml/bottle from the previous 231,271 won and 752,746 won, respectively.
The government has authorized insurance benefits for the combination Tecentriq plus bevacizumab as first-line treatment for unresectable or metastatic HCC and Tecentriq alone as primary treatment for metastatic PD-L1 positive NSCLC without an EGFR or ALK mutation.
With an expected increase in the use of these drugs, the government had to lower the upper limit on reimbursement rates, he said.
The Tecentriq plus bevacizumab combination obtained local approval in August 2020 after proving clinical utility over sorafenib in the Phase 3 IMbrave 150 study in 501 patients with locally advanced or unresectable HCC.
So far, the combination of Tecentriq and bevacizumab has been the only therapy to improve overall survival (OS) in the first-line treatment of HCC, compared to sorafenib.
This has caused Korean oncologists and patients to constantly demand reimbursement for the combination therapy.
Tecentriq monotherapy demonstrated clinical benefit in the Phase 3 IMpower110 study in treatment-naïve patients with stage IV non-squamous or squamous NSCLC, compared to Tecentriq plus platinum-based chemotherapy.
In the high PD-L1 expression group, Tecentriq significantly improved objective response rate (ORR), progression-free survival, and OS compared to the control group. Additionally, Tecentriq monotherapy has drawn attention because it can rule out painful chemotherapy for patients.
With the latest price cut, the price of Avastin will not differ from Onbevzi, a biosimilar developed by Samsung Bioepis. This will hurt Onbevzi’s price competitiveness, observers said.
Onbevzi’s maximum refund rate is 208,144 won per 4ml/bottle and 677,471 won per 16ml/bottle.
Since Korean cancer patients pay 5% of the cost of cancer treatment, patients will have almost no reason to choose a biosimilar instead of the original drug Avastin.
Avastin’s lower price is likely to affect Korea’s nascent biosimilar market as well.
There are three licensed biosimilars containing bevacizumab in Korea. The three are Onbevzi from Samsung Bioepis, Zirabev from Pfizer and Arimsis from Avogen.
The government set prices for Zirabev and Arimsis based on the Avastin reimbursement rate. Thus, observers said the two biosimilars are expected to be marketed at much lower prices in Korea.
The government has granted health insurance benefits to the combination therapy of Tecentriq and Avastin to treat hepatocellular carcinoma (HCC) from this month.