Most newly listed medicines in South Korea see their reimbursement prices cut within a few years of entering the national formulary, according to a longitudinal analysis of the country’s post-listing price reduction system published in the journal Cost Effectiveness and Resource Allocation. Among 212 new drugs approved by the Ministry of Food and Drug Safety and listed for reimbursement between 2013 and 2022, 160 drugs, or 75.5 percent, experienced at least one post-listing price reduction. Reimbursement prices were followed through September 30, 2024, using administrative data from South Korea's National Health Insurance system.
Transaction price-based adjustments were the most frequent mechanism, accounting for 202 of 494 adjustment events, or 40.9 percent, yet they produced the smallest average reduction, just 0.5 percent per event. Reductions following patent expiry showed the opposite pattern: they accounted for only 44 events, or 8.9 percent, but delivered the largest average reduction, 28.7 percent per event.
The timing of reductions followed a clear life-cycle pattern. The first price reduction occurred at a median of 29 months after listing, with an interquartile range of 20 to 36 months, and indication expansion was the trigger associated with the earliest initial reductions. By 36 months after listing, 115 of the 194 products still under observation, or 59.3 percent, had undergone at least one price reduction, and the mean cumulative price reduction stood at 6.0 percent. By 84 months, the share had risen to 93 of 114 products under observation, or 81.6 percent, with the mean cumulative reduction climbing to 15.0 percent.
The analysis also revealed sharp differences across drug subgroups. Whether any reduction occurred at all varied markedly by therapeutic category: 33 of 34 oncology drugs underwent at least one reduction during the observation period, whereas 17 of 30 orphan drugs, or 56.7 percent, and 10 of 26 orphan–oncology drugs, or 38.5 percent, underwent none.
The authors conclude that post-listing price reductions in South Korea cumulatively shape drug prices over the product life-cycle, and that policy-driven adjustment mechanisms and competition-driven reductions differ markedly in both how often they apply and how much they reduce prices. Considering frequency and magnitude together, they suggest, may support more effective pharmaceutical expenditure management. The study’s context is a broader policy concern: pharmaceutical spending has risen steadily across health systems, intensifying concerns about patient access to medicines and the financial sustainability of health insurance systems, and newly listed drugs are a major contributor to expenditure growth.
Subject of Research: Post-listing drug price reductions under South Korea's National Health Insurance reimbursement system
Article Title: Comparative analysis of post-listing drug price changes under South Korea’s price reduction system
Article References: Yang, S., Kim, M. J., Jang, Y.-A., Jung, J. W., Lee, S. H., & Lee, J. H. (2026). Comparative analysis of post-listing drug price changes under South Korea’s price reduction system. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00838-6
Image Credits: AI Generated
DOI: 10.1186/s12962-026-00838-6
Keywords: South Korea, drug pricing, National Health Insurance, reimbursement, post-listing price reduction, patent expiry, generic entry, price–volume agreements, oncology drugs, orphan drugs, pharmaceutical spending, health policy
News Source: Courtney Benton. (October 29, 2026). Most New Drugs in South Korea See Prices Cut After Listing, Study Finds. Scienmag.
