[Reporter’s Notebook] Global Cutting-Edge Cancer Drugs Remain a "Pie in the Sky" in Korea

"A pie in the sky."

This was the thought I kept having while covering the 2024 European Society for Medical Oncology (ESMO) conference held over five days from the 13th in Barcelona, Spain. Global big pharma companies eagerly presented research results showing that their latest anticancer drugs can safely prolong the lives of cancer patients. With a flood of research results related to antibody-drug conjugates (ADC) and immuno-oncology drugs, I became convinced that "cancer is no longer a death sentence." The advancement of various technologies is enriching our lives, but this conference also confirmed that the pharmaceutical and biotech industry is the only sector capable of saving lives that would otherwise be lost.

However, upon returning home after the event, I was faced again with a grim reality. Even drugs proven effective through long-term administration of 5 to 10 years at ESMO are still mostly "drugs to only watch" in Korea because they are not yet covered by national health insurance. Recently, a petition was submitted to the National Assembly by a patient’s child, saying, "An immuno-oncology drug costing 10 million won per month saved my mother," but "we can no longer afford the treatment costs." Ironically, because the drug efficacy is "too" good, patients live longer, and as the treatment period extends, it becomes harder to apply insurance coverage.

It is naturally difficult to guarantee the latest anticancer drugs, which cost hundreds of millions of won, to all patients under limited health insurance finances. Our government demands price reductions from big pharma, but some companies are withdrawing their drugs altogether, saying, "We have already offered the global lowest price in Korea and cannot lower it further."

Considering this situation, I felt disappointed about the reality of anticancer drug new drug development by domestic pharmaceutical and biotech companies revealed at this conference. Unlike the major announcements such as HLB’s rivoceranib two years ago and Yuhan Corporation’s Lekraza last year, most of this year’s results were still in the early stages of research. While applauding Lekraza’s recent approval by the U.S. Food and Drug Administration (FDA) as the first domestically produced anticancer drug, I recalled the bittersweet feeling of thinking, "Only now?" while in Barcelona.

The reason domestic new drug development is essential is that the pharmaceutical market is also a competitive market. No matter how expensive anticancer drugs are overseas, if there is a drug in Korea with similar efficacy but a much lower price, consumers will choose that drug, and big pharma will have to lower their prices. A representative example is Lekraza, which, after simultaneously receiving national health insurance coverage with AstraZeneca’s Tagrisso, a global standard lung cancer treatment, significantly lowered Tagrisso’s price. Generics or biosimilars can also have this effect, but price reductions after several decades inevitably have less impact. This is a critical moment that demands greater efforts from domestic pharmaceutical and biotech companies to provide patients who want to live longer not with a "pie in the sky" drug but with a "usable drug."