Patients with small cell lung cancer (SCLC) and their caregivers have submitted a public petition to the National Assembly, urging faster reimbursement coverage for Imdelltra (tarlatamab) under Korea’s national health insurance system.
Given the aggressive nature and high recurrence rate of SCLC, petitioners argue that delays in treatment access directly reduce patients’ chances of survival, calling for institutional reforms to improve access to innovative therapies.
A public petition has been submitted to accelerate national health insurance reimbursement coverage for Imdelltra, a third-line treatment for small cell lung cancer. (Captured from the National Assembly public petition website)
A petition calling for reimbursement coverage of tarlatamab, a third-line treatment for SCLC, was posted on the National Assembly’s public petition platform last Wednesday. As of Friday, the petition had secured the 100 signatures required for public disclosure. If it gathers more than 50,000 signatures, it will be referred to the relevant parliamentary committee.
The petitioner, whose family member has extensive-stage SCLC, said, “Small cell lung cancer progresses extremely rapidly, and treatment options are especially limited for patients with extensive-stage disease,” adding that “tarlatamab is being used as a last-line treatment option, but the cost of a single administration reaches about 50 million won ($33,948), making it unaffordable for most patients and families.”
SCLC is a highly aggressive cancer subtype accounting for roughly 15 percent of all lung cancers. It is characterized by rapid progression and early metastasis, frequently spreading to the liver, brain, and bones. Once the disease recurs, patients often experience a sharp deterioration in condition.
The five-year survival rate for extensive-stage SCLC remains around 4 percent, to the extent that clinicians often consider one-year survival more meaningful than five-year survival. Current standard treatment generally involves first-line therapy, including immune checkpoint inhibitors, followed by second- and third-line chemotherapy upon relapse. However, only about 20 percent of patients who begin treatment ultimately reach third-line therapy.
Against this backdrop, tarlatamab, a bispecific antibody-based immunotherapy, has emerged as a promising option. The drug works by linking cancer cells with T cells, enabling the immune system to attack tumors. It has drawn attention for demonstrating meaningful survival benefits in patients with relapsed SCLC.
The issue, however, is that the therapy remains a costly non-reimbursed treatment in Korea. The petitioner said their father, who has extensive-stage SCLC with multiple metastases, is currently receiving tarlatamab as a third-line therapy after failing first- and second-line treatments, but the financial burden has become a major obstacle.
“This is not simply an economic issue, but a matter of patients’ right to receive treatment,” the petitioner stated. “Under the current system, where patients are forced to bear the entire cost, many are compelled to discontinue life-extending therapies for financial reasons despite the existence of effective treatment options.”
The petitioner also urged authorities to consider selective reimbursement or a risk-sharing agreement if full reimbursement cannot be implemented immediately.
“At the very least, until formal reimbursement is granted, we ask the government to consider selective reimbursement or risk-sharing programs for patients with severe diseases,” the petitioner said. “For conditions like SCLC, where treatment options are extremely limited, a faster reimbursement evaluation system must be established.”
“Time is life for patients with small cell lung cancer,” the petitioner added. “We sincerely ask for swift institutional improvements.”
Meanwhile, at a policy forum on improving the treatment environment for SCLC held at the National Assembly Members’ Office Building on Friday, experts also emphasized the need for phased approaches such as selective reimbursement so that patients can access treatment opportunities even before final reimbursement decisions are made.
Professor Ahn Myung-ju of the Department of Hematology and Oncology at Hanyang University Hospital said, “Tarlatamab only works in a subset of patients, but among responders, long-term survival may be possible, making it a miracle-like drug in the field of small cell lung cancer.”
“Because it is effectively the only therapy with the potential to offer long-term survival, reimbursement coverage is necessary,” Ahn added.
Acknowledging that reimbursement decisions inevitably take time, Ahn said, “Even before a final reimbursement decision is made, there should be systems such as selective reimbursement that allow patients to receive treatment earlier.”
She also stressed the need for broader social discussions involving experts, government authorities, pharmaceutical companies, and patients to determine which therapies should be prioritized for reimbursement.
Kim Eun-young
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