The increase in the number of precocious puberty patients in Korea is unusual. As the number of patients, which was 80,000 in 2015, exceeded 130,000 in 2020, there are opinions that it should now be recognized as a social problem. In response, some in the medical community and clinical sites predict that the number of precocious puberty patients will increase further as outdoor activities decrease due to the prolonged COVID-19 pandemic. Amid this situation, it has been confirmed that confusion is occurring at front-line medical sites due to the recent suspension of the supply of "diagnostic reagents" that can identify patients with precocious puberty.

With the suspension of the supply of diagnostic reagents, which were the only health insurance coverage targets, even the diagnosis of precocious puberty patients, which is rapidly increasing due to prolonged COVID-19, is developing. According to the medical and pharmaceutical industries on the 4th, clinical doctors are suffering from the suspension of supply of injection items that are prescribed precocious puberty as a "diagnostic reagent" since March.

The item is Relefact LH-RH supplied by Handok in Korea. As Sanofi, the original developer, decided to suspend the supply of this item in March, stock of reagents for diagnosing precocious puberty has disappeared in Korea. According to the MFDS, the import performance of Relefact LH-RH in 2020 is about 1.132.26 billion won. Considering that it was 650.58 million won in 2015, the performance has increased, but it is lower than expected.

The problem is that Relefact LH-RH is the only item as a diagnostic reagent for precocious puberty. Lutrelef of Perring Pharmaceutical Korea, which can be said to be the same ingredient, has already been withdrawn from the domestic market due to the expiration of its validity period.

For this reason, medical sites are unable to diagnose precocious puberty patients due to a lack of diagnostic reagents. In the diagnosis of precocious puberty, LH and FSH are measured in the blood for 2 hours at intervals of 15 to 30 minutes after administration of "sexual stimulation hormone secretion hormone." If the maximum concentration of sulfonation hormone is 5 IU/L or higher, it is judged to be activated and diagnosed with precocious puberty.

#i2, that is, "sexual stimulation hormone secretion hormone" plays a role in the diagnosis process of precocious puberty, and it is Relefact that diagnoses it.

As Relefact has not been imported into Korea, it is difficult to diagnose precocious puberty nationwide, said a professor of pediatrics in a province who asked for anonymity. "As the number of precocious puberty patients has already increased rapidly through the COVID-19 pandemic, I wonder what preparation the health authorities have made." It is prescribed as an "off label" for precocious puberty, which has become difficult to diagnose.

If so, how is the medical field responding to the suspension of the supply of diagnostic reagents? As a result of the coverage, it was found that some hospitals and clinics are prescribing other drugs offline as the supply of Relefact has been stopped.

In fact, it has been confirmed that some hospitals and clinics apply for approval for excessive use of Ferring's Decapeptyl Depot and use it as a reagent for diagnosing precocious puberty.

Decapeptyl is a specialized drug licensed for hormone-dependent prostate cancer, endometriosis and uterine myoma, central puberty early onset in girls under the age of 9 and boys under the age of 10.

Another professor who runs a clinic said, "As papers have been presented that they have obtained good results in Thailand, some hospitals in Korea are already receiving health insurance benefits by submitting approval to the HIRA for the use of non-reimbursed drugs beyond the scope of reporting."

In fact, the HIRA official also said, "As the supply of Relefact injections has been suspended, off-label use through Decapeptyl is being carried out. Currently, we are considering approving the use of hospitals and clinics that submit overseas papers."

It was found that the seriousness of the problem was recognized and countermeasures began to be prepared, focusing on related societies such as the Korean Society of Pediatric Endocrinology.

If it is no longer possible to secure Relefact, the use of off-label for Decapeptyl is suggested as an alternative, and some pharmaceutical companies are requesting the re-import of related items. It is only hoped that the suspension of supply will end in a short period of time as a pharmaceutical company that resupplies the drug to Korea.