Next-generation anti-cancer drug Kymria, cost burden is reduced by health insurance coverageJung Jin-hee, Pharmacist

It is a new drug that can cure blood cancers that often recur with just one shot, and it is a next-generation anticancer drug CAR-T therapy that is in the spotlight worldwide.

Kymria, a leukemia drug that was called the dream anti-cancer drug and the miracle anti-cancer drug, is now covered by health insurance. Kymria has been called a 'one-shot anti-cancer drug' as it has shown amazing therapeutic effects with a single dose. The cost of a single dose was about 400 million won, which was a high cost burden. As a result of the hospitalization reimbursement decision, the cost to patients has been significantly reduced to about 6 million won.

1. What is CAR-T cell therapy?

So what kind of drug is this, so expensive and so effective? Kymriah is completely different from existing anticancer drugs in terms of mechanism of action and production method. This drug is the world's first CAR-T cell therapy developed by Novartis. CAR-T cells are prefixed with the modifier 'CAR', which stands for chimeric antigen receptor (Chimeric Antigen Receptor T cell therapy) on a patient's T cells. If you look closely, it means that a new gene has been inserted and redesigned like a chimera so that normal T cells can find and attack specific parts of cancer cells

* Chimera: The coexistence of cells with different genetic traits in a single organism.

The biggest difference from existing anticancer drugs is that it uses the patient's immune cells rather than foreign substances to kill cancer cells. Therefore, in order to make this treatment, it is necessary to first extract the T cells of cancer patients. They inject genetic material designed to respond specifically to cancer cells, multiply these cells in large numbers, and then re-inject them back into the original patient. As such, CAR-T cell therapy is a completely personalized treatment and cannot be mass-produced, so the price is bound to go up like this. Instead, it's also very effective.

2. Effects of CAR-T Cell Therapy

In a study of patients with relapsed or refractory, obese, large, and non-cellular lymphomas with no treatment options, the overall response rate at 3 months was 52%, and a whopping 40% achieved complete remission. Complete remission is a condition in which no cancer is detected. So it means that the cancer is completely gone. In addition, patients who were in remission at 3 months had an 81% chance of remaining in remission at 12 months. In a study of pediatric patients with relapsed or refractory, acute lymphoblastic leukemia, 81% of patients achieved complete remission within 3 months of treatment, and the event-free survival rate at 6 months was 73%. And the overall survival rate reached 90%.

Kymriah has shown amazing results since the clinical trial stage and has been highly anticipated by many patients. With this reimbursement decision, the cost burden on patients will be greatly reduced, and it is expected that the administration of Kymria will begin in earnest at large hospitals in Korea, such as Seoul National University Hospital. I hope this was a little bit of good news for the patients and their families who may have been waiting for Kymria's insurance coverage.