OBJECTIVES: South Korea has a single drug pricing system while there is an increasing number of innovative new drugs approved with multiple indications. And the drug price usually gets lower as it expands additional indications. Therefore, multinational companies that are hesitant to expand due to the international reference price will delay the launch in Korea, creating obstacles to Korean patients' access. To assess the viability, this study conduct a survey about 'Indication Based Pricing' such as weighted average pricing across indications and indication-based rebates.

METHODS: A focus group interview was conducted first with five experts, divided into five groups: government, healthcare physician, patient advocacy groups & media, academia, and pharmaceutical industry. Based on the opinions obtained here, the final questionnaire was organized, and an online survey was conducted on 202 experts and stakeholders from October 5, to November 10, 2022.

RESULTS: As a result of the survey, an average of 62.9% of the respondents said the introduction of a drug pricing system by indication was necessary only for drugs that met certain criteria. All groups except the government responded that it was most appropriate to pay the government a different refund rate for each indication while leaving the list price intact. Expected effects include ‘improving patient access to drugs’, ‘value-based evaluation’, and ‘high feasibility using existing system’. Concerns include ‘administrative cost and infrastructure construction’, ‘the burden of repetitive cost-effectiveness assessment’, ‘equality and capacity of social members among patients’, ‘disturbing drug claims’, ‘supplier-oriented drug price calculation’, and ‘excessive drug price’.

CONCLUSIONS: If the operational aspects of the academic and the government can handle the indication-based pricing indication-based pricing will be an alternative to increase access to innovative new drugs desired by the industry and patients.