OBJECTIVES: In South Korea, manufacturers submit clinical and economic data to the Health Insurance Review and Assessment Service (HIRA) for reimbursement of new drugs. HIRA introduced risk-sharing agreements (RSAs) to expand coverage of high-costs drugs for cancer and rare diseases in 2013. RSA schemes include manufacturer refund, expenditure cap, utilisation cap, and coverage with evidence development. This study investigated trends of drug listing with RSAs in South Korea. METHODS: All the drugs listed with RSAs as of 1^st March 2018 were analysed using a publicly available list of reimbursed drugs and evaluation reports from HIRA. The evaluation reports provided information on indications, reimbursement outcome, clinical need, clinical effectiveness, cost-effectiveness, budget impact, and listing status and drug prices in A7 nations. For the drugs that had previously been rejected by HIRA, the current evaluation report was compared with the previous versions. RESULTS: Of 26 drugs currently reimbursed with RSAs with publicly available evaluation reports, 20 (76.9%) were oncology drugs and 5 (19.2%) were for rare diseases. 17 (65.4%) drugs were reimbursed with RSAs between 2017 and 2018. The RSA type in 23 (88.5%) of the drugs that were reimbursed was either a refund or an expenditure cap. Analysis of evaluation reports indicated that for 16 (61.5%) drugs, RSAs were one of HIRA’s key considerations that led to reimbursement approval. 6 (23.1%) drugs had been previously rejected by HIRA despite being clinically efficacious due to their uncertain or unacceptable cost-effectiveness, but were listed following the inclusion of RSAs. CONCLUSIONS: The majority of drugs listed with RSAs are indicated in cancer, and financial types of RSAs predominate in South Korea. The majority of drugs were listed with RSAs between 2017 and 2018, and the implementation of RSAs has increased the listing of high-costs drugs, including those that were previously rejected by HIRA.