Novartis’ Kymriah to be covered by Japan’s national insurance system

pharmafile | May 16, 2019 | News story | Medical Communications, Sales and Marketing CAR T, CAR-T, Japan, Kymriah, Novartis, pharma 

Japan’s national medical insurance system will pay for Novartis’ CAR-T therapy Kymriah following approval from the Central Social Insurance Medical Council.

Kymriah, which costs 33.49 million yen ($305,455), will be covered by Japan’s national health insurance from the 22 May. Kymriah will thus become the most expensive treatment covered by Japan’s system.

Coverage will however be limited to leukaemia patients under the age of 25 who have failed to respond to other therapies.

Current estimates place the number of eligible patients at 216, meaning the Japanese market will be worth around 7.2 billion yen ($64 million).

The one off treatments have however shown to be 80% effective in treating certain cancers in clinical trials.

The decision will relieve the burden placed on Japanese patients who have a copay of around 30% on medical bills. This is however capped for certain expensive treatments at a rate based on income.

For example, a patient who earns an annual salary of 5 million yen ($45,000) would pay 400,000 yen ($3650) for Kymriah.

The approval comes as the number of Japanese patients whose monthly medical bills exceeded 10 million yen ($90,000) doubled between 2012 and 2017 reaching a total of 532 patients.

Louis Goss

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