Although many drugs have left their mark on the domestic pharmaceutical market, it is difficult to talk about the last decade without mentioning the immuno-oncology drug, Keytruda (pembrolizumab).

As a drug that holds the title of the No. 1 in global sales, it has left various milestones in Korea, from sales to approved indications.

This year marks the 10th anniversary of Keytruda’s approval in Korea, and the company is gearing up to drive another decade. The fact that Keytruda has recently been approved for a number of indications by the Cancer Disease Deliberation Committee is one of the reasons why the company's progress is drawing attention.

The Oncology Business Unit of MSD Korea has been delivering its sincerity with the mindset that “cancer treatment is KEY TRUE DA (Key to the truth).”

Dailypharm met with Min-kyung Kim, Associate Director (oversees lung cancer, gastrointestinal cancer, head and neck cancer, etc), and Joo-hyun Shin Associate Director (oversees breast cancer, gynecological cancer, urinary cancer, etc) of the Oncology Business Unit at MSD Korea to hear about the company’s blockbuster treatment, Keytruda.

Keytruda’s 10-year approval holds title for being the immuno-oncology drug with the most indications in Korea

As of February 2025, Keytruda is the most widely prescribed immuno-oncology drug in Korea indicated for 34 indications in 18 cancer types. In addition to the 2 directors who act as managers for the many indications, a total of 11 product managers (PMs) are in charge of Keytruda at MSD Korea.

Specifically, under Director Kim, there are a total of 5 PMs for lung cancer, stomach cancer, biliary tract cancer, and head and neck cancer, and under Director Shin, there are a total of 6 PMs for breast cancer, gynecological cancer, and urinary cancer.

Keytruda is regarded to have changed the paradigm of cancer treatment. How do the two directors feel about this?

“Immunotherapy drugs are more effective when used early in the treatment process, when the patient's condition is good, and when used at the front line of treatment, they can bring the patients a step closer to a complete cure than before,” said Shin. “I am proud to be part of a team that is leading this change in the treatment paradigm and saving many lives.”

Kim added, “I have been working at MSD for about 19 years, and I felt that all the team members are elite members who work with a great sense of mission because Keytruda is a treatment that is closely related to life. I joined the team in 2021, and I found that the team members are even more committed than they appear, and I think this is the driving force behind the growth of Keytruda over the past decade.”

However, due to the vast indications for Keytruda, it is positive that there is a PM for each indication, but conversely, there may be concerns about a lack of communication or synergy between the PMs. This means that there may be concerns about the size of sales and team management.

In response, the two directors emphasized that, although the role of each indication is important, a long-term strategy matters most due to the nature of Keytruda.

“As the No. 1 drug, the company has organized the team with passionate and proactive PMs for the drug that collects industry-wide attention,” said Kim. “Sales are important, but we need to adjust our focus and efforts depending on new indications and momentum, and are trying to operate with clear standards while thinking about the results that can be achieved over the long term.”

“The indications that are reimbursed and non-reimbursed, and the cancer types that have synergistic effects and those that do not, are creating a market or producing results,” said Shin. ”As a leader, we are constantly looking to derive new results through a process of constant feedback to see if there is anything we can do better or if there are any points to consider further.”

The dilemma of expanding a treatment’s indications is 'Competition'... differentiation and market exploitation

Although Keytruda has made great strides in the market over the past decade, its many indications for various types of cancers are also one of the tasks that must be resolved to compete with other treatments.

On this, the two directors each brought up the topics of differentiation and market development, in consideration of the teams they are in charge of.

So far, Keytruda has been the leading brand that has changed the paradigm of the cancer treatment environment, and has been promoting the keywords “first” and “only.” However, as these messages are gradually losing power, the company believes that it needs to promote other keywords.

“Competition can also be interpreted as the threshold for immuno-oncology treatments has been lowered, which is certainly good news in this respect,” said Kim. ”However, the marketing team has a clear goal of gaining an edge over the competition, so we are focusing most on how to communicate the differentiated value of Keytruda (compared to competing products).”

In addition, Shin emphasized, “From a marketing perspective, competition is not simply a matter of dividing up the market pie, but also about growing the overall size of the market, so it may be a little difficult, but we believe that it is the role of the marketing team to pioneer new markets.”

There are also positive factors in the competitive situation in which Keytruda is placed. This is because it has achieved some results after applying for reimbursement for a total of 17 indications in 2023, after the 13 indications it applied for reimbursement in 2023.

The Health Insurance Review and Assessment Service (HIRA) established reimbursement standards for 11 indications at the 1st Cancer Disease Review Committee (CDRC) in 2025 after 6 reimbursement attempts. The indications that passed were also diverse, including stomach cancer, esophageal cancer, endometrial cancer, rectal cancer, squamous cell carcinoma, cervical cancer, breast cancer, small intestine cancer, and biliary tract cancer.

Although there are still many processes to go through, such as the Drug Reimbursement Evaluation Committee (DREC) and the National Health Insurance Service (NHIS) drug pricing negotiations, the fact that the drug passed the Cancer Disease Deliberation Committee review holds significance, as it was regarded as a reckless challenge at the time.

“We took on the challenge literally recklessly with the idea that ‘Keytruda is the only option,’ to improve access to treatment for all cancer types, and I think this was possible because we all worked together with the common goal of improving patient access,” said Kim.

“I feel like we're just getting started. “I think that, as Keytruda has done so far, the remaining procedures should be carried out one by one to pave the path,“ said Shin.


”Keytruda’s approach to the next decade aims to expand accessibility"

The two directors intuitively expressed that Keytruda is the drug that can bring about ”more tomorrows” to patients.

In addition to benefiting patients, this is also the goal of the Oncology Business Unit, which is responsible for Keytruda, which is looking beyond its 10th anniversary to a new decade.

In the short term, the goal is to expand the indications for which it is being reimbursed, as well as newly approved or pending indications such as endometrial cancer and stomach cancer.

“The primary goal is to grow the newly approved indications and to do well until the launch of new indications because there are still indications waiting to be approved,” said Shin. ”The most important thing is to improve patient access to treatment, and we will always think about and work on how to provide good treatment options to more patients.”

Next, Shin cited the birth of new drugs that will bring about another paradigm shift as the most anticipated part of the coming decade.

“MSD is investing heavily in clinical trials in Korea, which is a global leader in clinical trials, with more than 5,000 people in 500 centers in Korea alone. I believe that another innovative drug will arise as a result of this investment and effort, and in that sense, I think it would be good to look forward to the company’s next 10 years.”