CONTENTS
- 1. Reduction in health insurance drug prices | ‘Complete reform’ of the drug pricing system… Structural impact across industries
- - Major reorganization details
- 2. Reduction in health insurance drug prices | The key issue is “industry structure policy, not price policy”
- - Risks and response strategies of pharmaceutical companies
- 3. Reduction in health insurance drug prices | Daeryun's assistance
1. Reduction in health insurance drug prices | ‘Complete reform’ of the drug pricing system… Structural impact across industries
The health insurance drug price system has been completely reformed, including lower health insurance drug prices.
The Ministry of Health and Welfare confirmed the plan to completely reform the health insurance drug price system through the Health Insurance Policy Deliberation Committee on March 26, 2026.
The key to this reorganization isSignificantly reducing the generic drug price calculation rate from 53.55% to 45%Therefore, this should be seen as a policy that fundamentally changes the profit structure of the pharmaceutical industry.
In particular, as all-round reforms are taking place, including listing new drugs, adjusting prices of existing drugs, and supply and demand stabilization policies, the impact on the entire industry is inevitable.
Major reorganization details
1) New drugs: Expanding accessibility and strengthening management
In addition, by introducing a post-evaluation system that readjusts drug prices based on clinical performance after registration, it will be converted to a ‘structure that allows rapid market entry but continuous management.’
In addition, higher ICER thresholds and the introduction of a flexible drug price contract system will reduce high prices. Opportunities for innovative new drugs to enter coverage are also expected to expand.
2) Generics: Reduced profitability and suppressed market entry
In particular, as policies such as suppressing multiple product listings, strengthening cascading drug price cuts, and expanding disadvantages for not meeting standard requirements are implemented in parallel, a simple strategy to expand the number of products is likely to no longer be effective.
3) Already listed drugs: Phased price reduction expansion
This includes not only new drugs but also products that have already established themselves in the market, so companies must respond to changes in their long-term sales structure.
In addition, a regular drug price re-evaluation system every 3 to 5 years is scheduled to be introduced, so the drug price cut will not be a one-off. It is being converted into a ‘permanent risk’.
4) Stable supply and demand of medicines: expansion of selective incentives
In other words, selective compensation is provided in areas linked to supply stability and industrial strategy.
2. Reduction in health insurance drug prices | The key issue is “industry structure policy, not price policy”
This health insurance drug price cut represents the following structural changes.
first,Weakening of generic-centered industry structureno see. Previously, it was possible to secure stable profits through a multi-item strategy, but this reorganization has made the model less sustainable.
Second,Pressure to transition to an innovation-driven industryno see. The preferential drug price policy for innovative and semi-innovative pharmaceutical companies is interpreted as a signal that effectively forces expansion of R&D investment.
Third,Strengthening regulations centered on follow-up managementno see. The combination of expedited listing with post-marketing and price adjustments is transforming pharmaceuticals into ‘assets that continue to be managed after launch.’
Risks and response strategies of pharmaceutical companies
This health insurance drug price reduction policy is a structural change that affects the overall profit structure, product strategy, and regulatory response system of pharmaceutical companies.
Therefore, it is necessary to establish a comprehensive response strategy including portfolio, regulation, finance, and supply chain, rather than a piecemeal response.
especiallyLowering the drug price calculation rate, gradual reduction of already listed drugs, and introduction of periodic drug price reevaluation are likely to act as factors that go beyond short-term profit reduction and require long-term business restructuring.This is high.
Accordingly, companies must establish a preemptive response system centered on the following key risks.
1. Health insurance drug price reduction risk inspection
2. Portfolio reorganization strategy
3. Response to innovative and semi-innovative pharmaceutical companies
4. New drug registration and follow-up management response
5. Re-evaluation of benefits and response to periodic drug price adjustments
6. Supply chain and supply stability strategy
7. Compliance and rental response
3. Reduction in health insurance drug prices | Daeryun's assistance
Daeryun, the 9th largest law firm in Korea (based on 25 years of VAT reporting to the National Tax Service)Has a variety of practical experience, including response to regulations across the healthcare and pharmaceutical industries, drug price negotiation, response to salary adequacy evaluation, and advisory on certification of innovative pharmaceutical companies.I'm doing it.
In particular, lawyers with medical doctor qualifications, lawyers with pharmacist qualifications, and lawyers with experience working in pharmaceutical companies provide integrated legal services, including risk analysis due to changes in drug price reduction policy, portfolio strategy advice, administrative response, and dispute response.
As health insurance drug price reduction is a key variable that directly affects a company's profit structure, establishing a strategy at the early stage is more important than anything else.do.
🔗Medical lawyer legal consultation reservationPlease receive a professional legal review and prepare a response strategy.
See More
