Korea Expands National Insurance Coverage for Rare and Advanced Cancer Treatments

South Korea will broaden national health insurance coverage for several high-cost cancer therapies from October, a change intended to lower treatment expenses and improve access for patients with rare or advanced cancers.

The Ministry of Health and Welfare said the expansion covers Retevmo, Vyloy and a first-line combination of Padcev and Keytruda. The Health Insurance Policy Deliberative Committee approved the decision, which takes effect Friday.

Retevmo is a targeted therapy for non-small cell lung cancer and medullary thyroid cancer associated with rare alterations in the RET gene. RET fusion-positive non-small cell lung cancer represents only 1 to 2 percent of lung cancer cases, and fewer than 300 patients are estimated to have the condition in South Korea.

By targeting specific cancer cells, Retevmo is designed to improve treatment effectiveness while reducing side effects, according to the ministry. Its oral capsule form may also reduce the need for hospital visits and time spent waiting for injections.

Coverage will also extend to Vyloy for patients with unresectable advanced or metastatic gastric cancer. Although the five-year relative survival rate for gastric cancer overall was 78.6 percent during 2019-2023, the outlook is substantially worse for patients whose disease cannot be removed surgically or has spread. The ministry said such patients have a median survival period of six to 10 months and a five-year relative survival rate of about 10 percent.

The ministry said Vyloy reduced the risk of developing treatment resistance by 41 percent and roughly doubled overall survival compared with existing treatments.

For urothelial cancer, national insurance will cover Padcev and Keytruda together as a first-line therapy. Urothelial cancer accounts for about 2.5 percent of all cancer cases. Padcev directly targets cancer cells, while Keytruda helps the immune system identify and attack them.

Keytruda was previously covered for urothelial cancer only as a second-line option after an earlier treatment failed. The new decision extends reimbursement to its first-line use in combination with Padcev. The ministry described the change as effectively the first national insurance coverage of a combination therapy involving patented new medicines made by different pharmaceutical companies.

Second Vice Health Minister Lee Hyung-hoon said the expanded coverage is expected to ease the burden on patients and families who delay or give up treatment because of high drug costs. The measure reflects a broader effort to make newer precision and immunotherapy-based cancer treatments available to patients whose options have been limited by both disease severity and price.