Myasthenia Gravis Treatment Cost and Ravulizumab Coverage Calculator helps estimate Korea-related chronic treatment, biologic drug, dialysis, obesity medication, and long-term management assumptions in English.
Enter Korea-related chronic care, eldercare, therapy, procedure, fertility, diagnostic, or medical tourism assumptions. Results are simplified planning estimates.
Treatment cost over period
₩40,453,572
Monitoring or support cost
₩0
Increase reserve
₩0
Planning window cost
₩40,453,572
12 months
This English page explains South Korea cost planning and HIRA reimbursement checkpoints for intravenous ravulizumab (Ultomiris) in adult anti-AChR antibody-positive generalized myasthenia gravis. The HIRA public benefit-ceiling prices currently shown are KRW 5,044,087 for 300 mg/3 mL (code 650701301, effective December 1, 2025) and KRW 17,149,895 for 1,100 mg/11 mL (code 650701311). Adult loading and maintenance doses are 2,400/3,000 mg at 40 to under 60 kg, 2,700/3,300 mg at 60 to under 100 kg, and 3,000/3,600 mg at 100 kg or more. Maintenance begins 14 days after loading and continues every 8 weeks. A 70 kg 12-month example has eight infusions and a KRW 404,535,759 public-list drug total; the simplified monthly default is one-twelfth of its 10% drug-only special-case share. HIRA Notice No. 2025-224, effective January 1, 2026, requires adult AChR-positive generalized disease, MGFA class II-IV, baseline MG-ADL at least 6, a qualifying crisis in the previous year, and failure or intolerance after corticosteroid plus at least two non-steroid immunosuppressants used for at least three months each. Current crisis and the first 12 months after thymectomy are exclusions. Continuation requires an MG-ADL improvement of at least 2 points after the first six months and maintenance at each six-month review. Registered G70.0 myasthenia gravis is listed under V012 at a 10% copay for related covered care. Public ceiling prices are not necessarily the confidential negotiated or risk-sharing amount, and plasma exchange, plasma infusion, or IVIG can require an extra dose not modeled here. The shared English input is a simple budget scenario; the deep guide preserves exact vial, schedule, eligibility, V012, ceiling, and worked-cost details. Verified July 23, 2026; not medical advice, a prescription, or a HIRA coverage decision.
Myasthenia gravis is an autoimmune neuromuscular disorder that can make repeatedly used muscles weaker and may improve partly with rest.
Ocular symptoms can include drooping eyelids and double vision, while generalized disease can affect speech, chewing, swallowing, limbs, and breathing muscles.
A diagnosis alone does not make every high-cost medicine reimbursable in South Korea.
A useful budget must distinguish the MFDS-approved indication, the narrower HIRA reimbursement rule, the V012 special-case registration, and the amount that a hospital actually claims.
This guide uses official information checked on July 23, 2026 to explain adult ravulizumab dosing, the infusion schedule, public benefit-ceiling prices, and the current generalized myasthenia gravis coverage checklist.
The compact English estimator above is a planning aid, while the detailed Korean calculator models exact weight bands, vials, dates, eligibility phases, and calendar-year costs.
Neither result is a diagnosis, prescription, reimbursement approval, or hospital quotation.
A clinician may use a cholinesterase inhibitor such as pyridostigmine to improve neuromuscular signaling and reduce symptoms.
Corticosteroids and non-steroid immunosuppressants such as azathioprine, cyclosporine, mycophenolate mofetil, or tacrolimus may be used for longer-term immune control.
Selection, combination, tapering, and monitoring depend on the disease pattern, other conditions, infection risk, pregnancy plans, and adverse effects.
Plasma exchange or intravenous immunoglobulin may be used as rescue treatment during rapid deterioration or a myasthenic crisis.
Ravulizumab is a terminal complement C5 inhibitor approved as an add-on to standard therapy for adults with anti-AChR antibody-positive generalized myasthenia gravis.
The Korean reimbursement checklist is narrower than the approved indication and examines crisis history, prior immunosuppressants, MGFA class, and MG-ADL score.
New or rapidly worsening shortness of breath, difficulty breathing while lying down, inability to handle saliva or food, or a rapidly weakening voice can require immediate assessment for a myasthenic crisis.
Current crisis is also an exclusion from this HIRA initial ravulizumab criterion, but urgent respiratory and emergency care is the first priority.
Do not delay care while waiting for a cost estimate.
HIRA Notice No. 2025-224 applies the current ravulizumab generalized myasthenia gravis reimbursement criteria from 2026-01-01.
Every item below must be supported by the medical record rather than by a self-assessment.
An input marked eligible means only that the entered facts cross the public thresholds.
It cannot verify antibody reports, treatment dates, crisis records, adverse-effect documentation, clinical suitability, or the insurer review.
MG-ADL records the impact of myasthenia gravis across eight daily activity domains, each scored from 0 to 3 for a total from 0 to 24.
Copy the scores from a clinical record instead of using the descriptions to diagnose or grade the condition yourself.
| Domain | Function observed | Score |
|---|---|---|
| Talking | Change in voice and sustained speech | 0 to 3 |
| Chewing | Loss of chewing strength during meals | 0 to 3 |
| Swallowing | Difficulty with food, water, or saliva | 0 to 3 |
| Breathing | Breathing symptoms during activity or rest | 0 to 3 |
| Brushing or combing | Repeated activity with raised arms | 0 to 3 |
| Rising from a chair | Leg and trunk strength | 0 to 3 |
| Double vision | Frequency of diplopia | 0 to 3 |
| Eyelid droop | Frequency and persistence of ptosis | 0 to 3 |
After the first six months, MG-ADL must improve by at least 2 points from the documented baseline.
A change from 8 to 7 is only 1 point and fails the public boundary, while a change from 8 to 6 is exactly 2 points and meets it.
The achieved response must be maintained at each later six-month review.
A new myasthenic crisis or missing six-month assessment data is a public stopping condition.
The current MFDS product information, item sequence 202204679, divides the adult loading and maintenance doses into three body-weight bands.
The first maintenance dose is given 14 days after loading, followed by maintenance every 56 days, or every 8 weeks.
| Body weight | Loading dose | Maintenance dose | Maintenance timing |
|---|---|---|---|
| 40 to under 60 kg | 2,400 mg | 3,000 mg | Day 14, then every 8 weeks |
| 60 to under 100 kg | 2,700 mg | 3,300 mg | Day 14, then every 8 weeks |
| 100 kg or more | 3,000 mg | 3,600 mg | Day 14, then every 8 weeks |
The approved information permits limited timing adjustment for scheduled doses after the first maintenance dose, but the calculator displays the unadjusted reference dates for consistent comparison.
Plasma exchange, plasma infusion, or IVIG can require an extra ravulizumab dose based on the procedure and most recent dose.
That extra dose is deliberately excluded because the required amount cannot be inferred safely from a general budget input.
The current HIRA price history shows KRW 5,044,087 for 300 mg per 3 mL under product code 650701301, effective 2025-12-01.
It shows KRW 17,149,895 for 1,100 mg per 11 mL under product code 650701311.
The calculator tests integer vial counts that prepare at least the target dose and selects the combination with the lowest public list cost.
| Vial | Product code | Public ceiling price | Effective date |
|---|---|---|---|
| 300 mg per 3 mL | 650701301 | KRW 5,044,087 | 2025-12-01 |
| 1,100 mg per 11 mL | 650701311 | KRW 17,149,895 | Current HIRA history |
Prepared mg = 300 × count of 300 mg vials + 1,100 × count of 1,100 mg vials
Public drug cost = KRW 5,044,087 × 300 mg count + KRW 17,149,895 × 1,100 mg count
Calculated waste = prepared mg − target dose
The 1,100 mg vial has a lower public price per milligram, so the least-cost combination can prepare slightly more than the target.
For a 70 kg loading dose of 2,700 mg, two 1,100 mg vials plus two 300 mg vials prepare 2,800 mg at a public cost of KRW 44,387,964.
This is a mathematical list-price choice rather than an instruction about compounding, sharing, discarding, or hospital billing.
Ravulizumab may be subject to a separate negotiated amount or a risk-sharing arrangement that is not represented by the public benefit-ceiling price.
Infusion services, tests, supplies, other medicines, rounding, and claim decisions can also change the receipt.
Ask the hospital billing office for a written estimate and treat the calculator result as an auditable reference, not a payable invoice.
A 70 kg adult is in the 60 to under 100 kg band, so the loading target is 2,700 mg and the maintenance target is 3,300 mg.
A 12-month window normally contains the loading infusion and seven maintenance infusions, for eight infusions in total.
| Phase | Infusions | Public cost per infusion | Subtotal |
|---|---|---|---|
| Loading, 2,700 mg target | 1 | KRW 44,387,964 | KRW 44,387,964 |
| Maintenance, 3,300 mg target | 7 | KRW 51,449,685 | KRW 360,147,795 |
| Twelve-month drug total | 8 | — | KRW 404,535,759 |
A hypothetical 10% drug-only V012 share is KRW 40,453,576 before calendar-year ceiling treatment and before any confidential settlement changes the claim base.
A 30% ordinary outpatient drug-only scenario is KRW 121,360,728, and a non-covered comparison is the full KRW 404,535,759 public list total.
These comparisons explain the scale of the rules but do not predict an actual receipt.
The current Ministry of Health and Welfare special-case notice lists myasthenia gravis under diagnosis code G70.0 and special code V012.
Registered care directly related to the listed rare disease can use a 10% covered copayment under the applicable rule.
This does not make every service, non-covered item, or outside-criteria medicine payable at 10%.
An application completed within 30 days after confirmed diagnosis can generally apply from the diagnosis confirmation date, while a later application generally applies from the application date.
The usual rare-disease registration period is five years, subject to the current registration and re-registration rules.
Confirm the effective date and code on the registration document or with the National Health Insurance service before using a 10% scenario.
The Korean annual out-of-pocket ceiling is calculated by calendar year, not by a rolling 12-month treatment window.
If treatment starts late in a year, the calculator separates covered copay amounts into the start year and the following year before applying the selected planning ceiling.
The calculator offers 2026 planning ceiling options from KRW 900,000 to KRW 8,430,000, but the final tier depends on the insurer's income and eligibility determination.
A displayed refund is therefore a comparison estimate rather than a guaranteed payment.
Bring the antibody result, MGFA record, itemized MG-ADL baseline and follow-up scores, crisis discharge record, plasma exchange or IVIG record, medication dates and adverse effects, thymectomy date, V012 registration details, and an itemized hospital estimate.
Dates and objective records are especially important because the HIRA rule uses one-year, three-month, six-month, and 12-month boundaries.
The product information calls for meningococcal vaccination at least two weeks before starting ravulizumab when treatment can wait.
If urgent treatment cannot wait, the approved precautions include vaccination and appropriate antibiotic prophylaxis under medical direction.
Vaccination reduces risk but does not eliminate it.
No.
Adult age, generalized disease, MGFA II-IV, baseline MG-ADL of at least 6, a qualifying recent crisis, prior treatment, and both exclusion checks must also be documented.
The plan includes loading on day 0, the first maintenance dose on day 14, and later maintenance every 56 days while the date remains inside the 12-month window.
It meets the numeric public continuation boundary, but the clinical record, timing, maintained response, absence of a new crisis, and insurer review still matter.
No.
Registration must be active, the care must relate to the registered disease, and each medicine or service must separately qualify as covered.
A confidential negotiated amount or risk-sharing arrangement may differ from the public ceiling price, and the exact hospital claim can use different billing inputs.
No.
The required extra amount depends on the procedure and recent ravulizumab dose, so it must be confirmed and added from the treatment record.
Prices, notices, labels, and registration rules can change after the review date.
Confirm the current official pages and the hospital claim before making a financial decision.
Enter the documented weight, dates, MGFA class, MG-ADL scores, prior treatment, and registration status.
Then compare the public-price result with a written hospital estimate and ask the neurology and billing teams to verify every boundary.