Nam Hyun-woo has worked as a staff writer at The Korea Times since 2013, mostly covering business and politics. He currently belongs to the Business Desk where he covers topics such as emerging tech, AI, ICT and Korea's chaebol community. Prior to joining the team, he was the paper's correspondent for the presidential office of Korea during the Yoon Suk Yeol and Moon Jae-in administrations.
Celltrion's Zymfentra covers over 90% of US health insurance market
Celltrion's Zymfentra / Courtesy of Celltrion
By Nam Hyun-woo
Celltrion, a major Korean pharmaceutical company, signed a contract with a U.S. group purchasing organization (GPO) to list Zymfentra, its autoimmune disease drug treatment, on private insurance formularies, the company said on Tuesday. This move is expected to expand the drug's coverage to over 90 percent of the U.S. health insurance market.
According to the company, it reached a final agreement on Friday with the GPO, which represents one of the U.S. top three pharmacy benefit managers (PBMs). With the contract, Celltrion has secured full access to both public and private insurance markets managed by the three most influential PBMs in the U.S. prescription drug market, significantly strengthening its reimbursement framework.
An insurance formulary is a list of prescription drugs that an insurance plan covers. In the U.S. health care system, PBMs negotiate with drug manufacturers to lower medication prices and decide which drugs are covered in insurance formularies, while GPOs arrange bulk purchasing deals for hospitals and clinics to get medical supplies and medications at discounted rates.
Just weeks after launching Zymfentra in the U.S. market in March, Celltrion included the drug on the insurance formularies of Express Scripts, one of the top three PBMs, and signed a separate contract with another PBM in July.
To date, Celltrion has signed deals with a total of 30 small, medium and large PBMs and insurers in the United States, and the combined public and private insurance coverage of these institutions now exceeds 90 percent of the U.S. insurance market.
Zymfentra is the world’s only subcutaneous formulation of infliximab, a monoclonal antibody used to treat various autoimmune diseases such as rheumatoid arthritis, Crohn's disease and ulcerative colitis. Used as an injection under the skin, the product is highly valued by patients and health care providers in the U.S. market for its convenience and easy self-administration, given the relatively limited access to hospitals there.
Celltrion hopes that Zymfentra will become the first global blockbuster product from a Korean drugmaker by surpassing 1 trillion won in sales.
Celltrion USA Chief Commercial Officer Thomas Nusbickel said “this achievement was made possible by the differentiated product competitiveness of Zymfentra, and we plan to expand our efforts to reach as many U.S. patients as possible, ensuring they benefit from its superior therapeutic advantages.”