Korea’s Health Ministry Announces 2026 Drug Reimbursement Re-evaluation Plan

The Ministry of Health and Welfare has announced its plan to conduct a comprehensive re-evaluation of drug reimbursement appropriateness for 2026. This initiative aims to ensure the continued efficiency and sustainability of the National Health Insurance (NHI) system by reassessing the clinical efficacy and cost-effectiveness of currently covered pharmaceutical products.

Korea’s National Health Insurance is a compulsory social insurance program that provides universal healthcare coverage to all citizens. Under this system, the government subsidizes a significant portion of drug costs, making regular evaluations crucial to manage public expenditure and ensure that only genuinely effective and appropriately priced medications are included on the reimbursement list.

The re-evaluation process, mandated by articles of the National Health Insurance Act and its related regulations, periodically reviews drugs that are already covered by the NHI. This helps maintain a balance between providing wide access to necessary medicines and preventing unnecessary financial burdens on the health insurance fund and taxpayers.

While the Ministry’s notice, issued on May 8, 2026, officially publicizes the re-evaluation plan, specific details regarding the target drugs, detailed methodology, and timelines for pharmaceutical companies to submit their data for review are contained in supplementary documents. These documents, which were not provided in the original announcement text, typically outline the precise criteria and procedures for the reassessment.

Pharmaceutical companies whose products are slated for re-evaluation will likely be required to provide updated evidence on their drugs’ clinical value, cost-effectiveness, and market impact. The outcome of such re-evaluations can lead to adjustments in reimbursement prices, changes in coverage criteria, or even the delisting of certain drugs from the NHI benefit list if they are deemed no longer appropriate for public funding.

Source: 보건복지부 — Original Article (Korean)