As the generic market for Visanne, Bayer's endometriosis treatment, is growing rapidly, the status of the original drug is being threatened. According to the pharmaceutical industry, as the number of patients with endometriosis increased significantly, the treatment market was also found to be growing significantly.

Looking at the health insurance treatment status of 'endometriosis (N80)' from 2016 to 2020 announced by the NHIS, the number of endometriosis patients increased by 48.2% from 104,689 in 2016 to 155,183 in 2020. Due to this influence, medical expenses also increased by 79.6% from 56.6 billion won in 2016 to 101.6 billion won in 2020, and outpatient medical expenses surged 147.7% from 16.4 billion won to 40.6 billion won.

Visanne's sales continued to rise during the same period as the number of patients increased. According to UBIST, a drug research institute, Visanne's sales recorded a growth of ▲8.6 billion won in 2017 and ▲10.5 billion won in 2018. Afterward, sales decreased to 7.6 billion won in 2019 when insurance drug prices decreased (53,980 won → 37,786 won), but sales increased again to 7.8 billion won in 2020, 9.5 billion won in 2021, and 9.9 billion won in 2022. Considering the fact that there was another drug price cut to 28,906 won in 2021, the actual amount of prescriptions compared to sales is expected to increase further. It is analyzed that Visanne's growth was largely driven by two factors. The first factor is that since December 2018, even patients diagnosed radiologically using ultrasound or MRI can use Bizan, which has improved the patient discovery and prescription environment. Experts believe that the fact that ultrasound of the female genital organs, including the uterus, was covered in February 2020 as part of strengthening insurance coverage, may have had an impact on increasing patient accessibility.

In fact, according to the NHIS data, the number of patients with endometriosis in 2019-2020 stood out more than in other years. It increased by 12% from 136,144 in 2019 to 155,183 in 2020. Compared to the annual increase of 7-9%, the rate of increase is greater. As the number of endometriosis patients increases, the growth rate of generic products in addition to the original Bizan is also increasing significantly.

According to Ubist, the sales growth of the Bizan generic product line was minimal, with sales of ▲900 million won in 2019 and ▲1.2 billion won in 2021. This is a figure that has grown by about 8.4% from 16.6% in 2021 to 25% in 2022 in terms of sales compared to the total market size. Bayer has no choice but to think about various strategies to continue Bizan's growth. Basically, in this situation, the first thing multinational pharmaceutical companies emphasize is the long-term effect and safety of the original. Bayer announced that Bizan reduced EAPP and improved HRQoL in the long term through the final analysis results of 'ENVISIOeN', a real-world study that evaluated the long-term efficacy and safety of Bizan in 6 Asian countries for 24 months in March last year. did. Along with this, Bayer's more fundamental response strategy is to expand its treatment of endometriosis rather than playing a game of chicken with generics in the market. In December 2018, it was possible to diagnose endometriosis with ultrasound, but the proportion of clinicians is still relatively low when examining the usage performance by a nursing institution with Visanne and Dienogest. Bayer's strategy also starts from this situation. Until now, endometriosis was recognized as a disease that was treated in general hospitals, but the plan is to focus on publicizing it as the paradigm is changing.

A Bayer official said, “The biggest task is to publicize endometriosis as a disease that can be treated in clinics. Now, we are focusing on publicizing it based on a lot of evidence.” As we are at the stage of treatment, we are considering practical measures through a paradigm shift in treatment and RWE."