[Newsmp] The coverage recognition for the oral immunosuppressant everolimus and the contrast agent iodized oil, used to inhibit the immune system after a transplant, will be expanded.
The reimbursement criteria for Tremfya (ingredient: Guselkumab), an IL-23 inhibitor manufactured by Janssen, will be eased for specific indications, and the addition of the SGLT-2 inhibitor and DPP-4 inhibitor combination, Sugadapa (ingredient: Dapagliflozin/Evogliptin), will be included in the reimbursement criteria for diabetes medications.
The Ministry of Health and Welfare announced an administrative notice on the 15th of ‘Notice of the Review Results of a Healthcare Service Claim’ and began collecting opinions by May 26 for its implementation on the 1st of the next month.
The reimbursement criteria for oral everolimus medications, including Certican (Novartis), will be expanded to include the provision of reimbursing the treatment when used in combination with tacrolimus and corticosteroids for heart transplant patients, beyond the approved indications.
Furthermore, if gastrointestinal adverse reactions occur when tacrolimus and mycophenolate mofetil oral medications are co-administered after transplantation, the coverage for mycophenolate sodium, when used in combination with tacrolimus, will be extended to include heart transplantation.
Regarding the reimbursement criteria for Tremfya, for the treatment of palmoplantar pustulosis, the previously recognized medications were limited to acitretin as a therapeutic option for cases where previous treatments failed or were ineffective. However, the reimbursement coverage has now been expanded to include methotrexate (MTX) and cyclosporine.
Accordingly, if there is no response or the treatment cannot be continued due to adverse effects or other reasons, even after a duration of three months or longer with one of the three medications, reimbursement will be granted.
In addition, the reimbursement coverage for iodized oils, including Lipiodol Ultra (Guerbet Korea) and Fattiodol (DongKook Pharmaceutical), will now include hysterosalpingography for women undergoing infertility diagnostic tests. However, the reimbursement will be limited to one procedure.
For the administration of gonadotropin-releasing hormone agonists (GnRH agonists) in the treatment of central precocious puberty, the eligible recipients are limited to girls younger than 8 years (7 years and 365 days) and boys younger than 9 years (8 years and 365 days).
The upcoming additions include the Verassil Prefilled Syringe Kit 2ml, which will be recognized within the range of locally administered hemostatic agents per surgical procedure, following the general principles. Furthermore, the ingredient of Sugadapa Tab. Dapagliflozin+Evogliptin will be included as part of the general principles for oral antidiabetic medication, specifically in the category of combination therapy for diabetes.
