New ovarian cancer therapies are continuing to emerge, but Korean patients still face limited access to treatment because of high drug costs and lengthy reimbursement procedures.
In particular, experts warned that access to targeted therapies and antibody-drug conjugates (ADCs) for advanced ovarian cancer patients remains restricted because many treatments have yet to receive National Health Insurance reimbursement coverage.
The government said it plans to convene a Pharmaceutical Reimbursement Evaluation Committee meeting later this month to discuss coverage for related therapies.
During a National Assembly forum held Tuesday, experts said that although new ovarian cancer therapies are emerging, many patients still cannot access treatment in time because the drugs have yet to receive National Health Insurance reimbursement coverage. (KBR photo)
At a National Assembly forum titled “Understanding Women’s Cancers That Disrupt Everyday Life -- Ovarian Cancer, the Silent Killer,” held Tuesday, Lee Yoo-young, director of international affairs at the Korean Society of Gynecologic Oncology and professor of obstetrics and gynecology at Samsung Medical Center, raised concerns about limited access to ovarian cancer treatment.
The event was hosted by Rep. Lee Ju-young of the New Reform Party and jointly organized by the Korean Society of Obstetrics and Gynecology and the Korean Society of Gynecologic Oncology.
Professor Lee emphasized that ovarian cancer is difficult to detect early because it rarely presents clear symptoms beyond nonspecific signs such as abdominal bloating or indigestion. As a result, more than half of patients are diagnosed only after the disease has already advanced.
Given that multiple clinical studies have demonstrated the limitations of early detection strategies, improving treatment outcomes has become increasingly important, she said.
“Seven out of 10 ovarian cancer patients are diagnosed at stage 3 or 4,” Lee said. “Because the disease is often already advanced at diagnosis and recurrence is common, prognosis is generally poor.”
She added, “Stages 1 and 2 have relatively favorable outcomes, but once the disease progresses to stage 3 or 4, only one or two out of 10 patients survive beyond five years. Global studies have essentially concluded that early diagnosis is nearly impossible. The only option is to treat aggressively.”
Lee cited surgery, chemotherapy, gene-based targeted therapy and maintenance therapy as key pillars of advanced ovarian cancer treatment. Particular emphasis was placed on homologous recombination deficiency (HRD) testing and PARP inhibitor-based therapy.
HRD, a biomarker used to assess defects in DNA damage repair mechanisms, has recently become a critical factor in determining targeted treatment strategies for ovarian cancer.
“Ovarian cancer generally responds well to initial chemotherapy, but most patients eventually relapse without additional treatment,” Lee said. “Ultimately, the possibility of cure depends heavily on access to targeted therapy.”
She continued, “Ovarian cancer treatment is no longer an era of repeatedly administering chemotherapy alone. It has evolved into an era of precision medicine, where patients are selected based on biomarkers and proceed to maintenance therapy accordingly.”
Lee noted that PARP inhibitors can reduce recurrence rates by up to 70 percent and mortality by 40 percent in HRD-positive patients.
“About half of ovarian cancer patients are estimated to be HRD-positive, but in actual clinical practice, many patients discontinue or forgo treatment because of financial burdens,” she said. “Medically, the standard of care has already been established, but institutional barriers are limiting patient access.”
She also highlighted the growing role of Elahere (mirvetuximab soravtansine), an innovative ADC therapy targeting FRα (folate receptor alpha)-positive tumors, as a new option for patients with platinum-resistant recurrent ovarian cancer, a condition known for poor response to conventional chemotherapy. However, she noted that Elahere’s high out-of-pocket costs and lack of reimbursement have severely restricted its use in clinical practice.
“Platinum-resistant ovarian cancer is an area where both patients and clinicians acutely feel the limitations of existing therapies because response rates are low and progression-free survival is short,” Lee explained. “In actual clinical settings, treatment options are extremely limited.”
Referring to clinical trial data for Elahere, she added, “Compared with conventional treatments, nearly half of patients experienced tumor reduction, and overall survival also improved meaningfully.”
Still, she stressed the need for greater flexibility in cost-effectiveness evaluations.
“Despite its clinical value, actual access to Elahere remains very poor,” Lee said. “From this perspective, more flexible approaches to cost-effectiveness assessment are needed.”
She added, “The ovarian cancer treatment paradigm has been changing rapidly in recent years, but Korea’s reimbursement system has not fully kept pace. Patient access must improve alongside advances in medical science.”
Park Jeong-yeol, chair of the research committee at the Korean Society of Gynecologic Oncology and professor at Asan Medical Center, also voiced frustration.
“It is unfortunate when patients cannot receive treatment because there is no available drug, but it is even more heartbreaking when effective drugs exist yet remain inaccessible,” Park said. “Medical professionals feel helpless seeing these situations repeatedly in clinical practice.”
He urged policymakers to prioritize patients’ rights to life and well-being alongside financial considerations.
Lee Eun-young, director of the Korea Alliance of Patient Organizations, also stressed the burden of recurrent disease.
“As recurrence continues, the lives of both patients and their families are profoundly shaken,” she said. “There is a fundamental difference between having no treatment available and having treatment that patients simply cannot access.”
She specifically referenced delays in reimbursement decisions for olaparib combination therapy and Elahere, emphasizing that “for patients, treatment time is directly tied to survival,” and called for faster reimbursement decisions.
Kim Min-jung, a section chief at the Ministry of Health and Welfare’s Pharmaceutical Benefits Division, said the government would work to address gaps in ovarian cancer treatment access. (KBR photo)
Government to review ovarian cancer therapies this month
The government acknowledged the need to improve reimbursement procedures and accelerate the listing of ovarian cancer therapies, announcing plans to review related treatments, including Lynparza and Elahere, later this month.
Kim Min-jung, a section chief at the Pharmaceutical Benefits Division of the Ministry of Health and Welfare, said, “Ovarian cancer is an area with significant unmet medical needs, and the government fully understands the difficulties patients face.”
She also noted growing calls for expanded access to genetic testing and targeted therapies.
“There were discussions on this issue last year as well, and we are aware of ongoing demands to improve treatment accessibility and broaden testing coverage,” Kim said. “We will carefully examine ways to address the current shortcomings.”
Regarding the reimbursement review process for olaparib-bevacizumab combination therapy, Kim said, “An application for reimbursement was submitted early last year, and economic evaluation is currently underway. The agenda is scheduled to be presented to the Drug Reimbursement Evaluation Committee this month.”
“As far as we understand, there are no major disagreements regarding pricing,” she added. “The process had been delayed partly because of issues related to HRD testing in the past, but overall, the review is currently moving in a positive direction.”
On Elahere, Kim said, “The therapy is currently under review by the Cancer Disease Review Committee.”
“The government fully recognizes that the medical community views this treatment as highly innovative and potentially game-changing,” she said. “From the ministry’s perspective, it is important first to clearly define reimbursement scope and eligible patient populations. We will continue reviewing what institutional roles can be played in the next stages.”
Kim Eun-young
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