A discussion has been advancing to allow drug switching between a biological agent and a JAK inhibitor for treating atopic dermatitis (hereafter referred to as atopy), and there have been further suggestions for the revision.

The Health Insurance Review and Assessment Service (HIRA) has already established reimbursement criteria, but concerns have been raised about potential challenges in the effective use of the drug, including drug switching between drugs of the same class.


The Embassy of Denmark in Korea met with the Severe Atopic Dermatitis Association (SADA) to discuss potential improvements to atopy treatment settings and systems.

The HIRA has exchanged opinions with experts about allowing drug switching between a biological agent and a JAK inhibitor since September, and they have established the reimbursement criteria based on the latest documents and clinical practices.

According to the pharmaceutical industry, pharmaceutical companies have submitted measures to voluntarily cut drug prices as part of financial allotment following expanded reimbursement. Attention has been drawn to whether it will pass the Drug Reimbursement Evaluation Committee (DREC) review, which is the final step during the appropriateness review process.

However, the Severe Atopic Dermatitis Association (SADA) emphasizes that, while they have positive views towards the ongoing discussion about drug switching between treatments, an additional review of the revision to reimbursement criteria is necessary.

Their chief suggestion for the draft of revision is recognizing the need for drug switching within the same class of drugs in addition to drug switching between different classes.

Currently, drug switching for atopy is approved for drug switching between a biological agent and a JAK inhibitor. As a result, drug switching between drugs of the same class is not allowed.

For instance, drug switching between biological agents such as Dupixent and Adtralza or JAK inhibitors such as Rinvoq and Cibinqo has been limited.

However, drug switching between the same classes must also be considered considering many underlying mechanisms of atopy.

In fact, SADA's '2024 Guidelines for the Treatment of Atopic Dermatitis in Korea,' which has been updated after 9 years, does not provide detailed recommendations for switching drugs between treatments due to the different properties of atopy.

A SADA member said, "We do not have a set order of treatments because it is difficult to decide which drug is more suitable. The associations hope that drug switching becomes possible regardless of the classes."

"Still limited drug switching between atopy treatments, we must consider all aspects"

During the meeting with Daily Pharm, SADA President Joeun Park said, "Due to the nature of atopy, patients have different characteristics of atopy. When treatment options for drug switching are limited, patients may have difficulty in switching drugs." Park added, "Since the discussion about improvements to treatment setting is ongoing, in my opinion, there should be no limitations to the classes of drugs and the number."

Currently, patients are more likely to choose drugs with the greatest market presence within the same class based on their experiences. Therefore, they may not significantly benefit from the treatment.

In other words, Park is concerned that the current revision for atopy drug switching may not produce effective outcomes and could remain merely an administrative action.

However, Park states that the government's draft for revision of six months for switching is sufficient. Park emphasized the need for the government to pay more attention to patients who are unable to receive JAK inhibitors.

"In my opinion, patients typically do not respond to atopy treatment until around four months, with noticeable effects starting to appear around six months. Therefore, I support continuing treatment for up to six months," Park stated. "However, in a few cases, patients become pregnant while undergoing JAK inhibitor treatment. As a result, the government should implement more flexibility concerning these situations."


Regarding this issue, the Embassy of Denmark in Korea plans to collaborate on healthcare issues, including atopy.

"In Denmark, the importance and influence of patient advocacy groups are growing. We are considering including this aspect in next year's business plan when collaborating with the Ministry of Health and Welfare (MOHW)," Mads Friborg, Health & Medical Counselor at the Embassy of Denmark in Korea, said.

"We started to pay attention to atopy when HIRA's agenda was hotly debated. Additionally, we are considering discussing and bringing suggestions about the disease," Joachim Arup-Fischer, Commercial Counselor at the Embassy of Denmark in Korea, said. "Drug pricing was the chief discussion point during the recent meeting with the HIRA. From now on, we expect to discuss various aspects."