Public perceptions of high-cost cancer drugs and the implications for reimbursement decisions

Abstract

Background: Reimbursing high-cost cancer drugs presents challenges in managing uncertainty, setting appropriate prices, and controlling pharmaceutical expenditures. We examined the perspectives of the South Korean public on high-cost cancer drugs and policy options to improve reimbursement for these treatments. Methods: We conducted a self-rated, web-based survey from November to December 2023. We used a quota sampling method based on South Korean census data to recruit study participants. The questionnaire comprised four sections: socio-demographics, definitions of high-cost cancer drugs and reasons for their reimbursement, uncertainties associated with high-cost cancer drugs, and policy options to improve reimbursement for these treatments. Results: Of the 11,974 invitations sent, 1,000 participants completed the survey, resulting in a response rate of 8.35%. Three-quarters of the respondents agreed or strongly agreed that high-cost cancer drugs should be reimbursed. More than 70% accepted the need for price negotiations, even if they lead to drug withdrawals or delays in reimbursement decisions. A similar proportion agreed that new policy options, such as dual pricing and additional funding, should be introduced with caution. Conclusion: The South Korean public perceives the reimbursement of high-cost cancer drugs as both a human rights measure and a government responsibility. However, they support reimbursement only when they are confident that the drug is safe, effective, and cost-effective. © The Author(s) 2025.