Korea did not widen the net this year. It narrowed it by a third and collected the same money, which means the mechanism has stopped sampling the market and started aiming at it.

• The trigger is commercial success, stated as such. Rosuvamibe passed ₩100bn in annual prescription value for the first time in 2025, the first of Yuhan’s own combination products to do so since its 2016 launch, and four strengths were cut. Nothing about efficacy or safety changed. Volume growth alone moved the price, and the same logic now runs in Japan, where label expansions trigger cuts on the existing book.
• Counting by item hides how few brands absorb this. Each strength and pack is a separate line, so Dongkook’s Mediray contrast agent range accounted for 12 of the 80, Telminuvo for 6 and Rosuvamibe for 4. An average of 4.6% across 80 items is a much heavier number for the handful of brands that repeat on the list.
• The fertility exception is the precedent worth filing. One sponsor kept its listed price and repaid the excess in cash, justified by supply stability and the government’s fertility support policy. Korea has now written a confidential-style rebate into guidance revised in June after discussions between the ministry and the industry association, which gives every future Type C target an argument to make before accepting a list price cut.