{
  "schema_version": "1.0",
  "last_updated_mock": "2026-05-14",
  "currency_notes": {
    "GBP": "£/QALY (NICE)",
    "USD": "$/QALY (ICER value framework)",
    "CAD": "C$/QALY (CADTH)",
    "AUD": "A$/QALY (PBAC/MSAC)",
    "EUR": "€/QALY (HAS/G-BA/REA)",
    "KRW": "원/QALY (HIRA/NECA)",
    "JPY": "¥/QALY (C2H/MHLW)"
  },
  "decisions": [
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "NICE", "agency_id": "TA875", "sponsor": "Novo Nordisk", "decision_date": "2026-03-12", "decision_type": "restricted", "indication": "obesity", "indication_population": "BMI>=35 + 1 comorbidity, 2yr max", "ICER_QALY": 24800, "ICER_currency": "GBP", "budget_impact_5yr_local": 412000000, "reimbursement_tier": "secondary care only", "patient_co_pay_pct": 0, "notes": "Tier 3/4 weight management only"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "CADTH", "agency_id": "CDR-0682", "sponsor": "Novo Nordisk", "decision_date": "2026-02-20", "decision_type": "conditional", "indication": "obesity", "indication_population": "BMI>=30 + T2DM or CVD", "ICER_QALY": 48900, "ICER_currency": "CAD", "budget_impact_5yr_local": 980000000, "reimbursement_tier": "limited use", "patient_co_pay_pct": 25, "notes": "Conditional on price reduction"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "ICER", "agency_id": "ICER-2026-OBE-01", "sponsor": "Novo Nordisk", "decision_date": "2026-01-15", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 87400, "ICER_currency": "USD", "budget_impact_5yr_local": 18400000000, "reimbursement_tier": "value-based", "patient_co_pay_pct": 30, "notes": "Within $50-150k/QALY threshold"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "HIRA", "agency_id": "HIRA-2025-A12", "sponsor": "Novo Nordisk", "decision_date": "2025-11-08", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30 + T2DM", "ICER_QALY": 52000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 1240000000000, "reimbursement_tier": "non-reimbursed", "patient_co_pay_pct": 100, "notes": "ICER QALY > 1x GDP per capita threshold (38M KRW)"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "G-BA", "agency_id": "G-BA-2026-AMNOG-12", "sponsor": "Novo Nordisk", "decision_date": "2026-04-02", "decision_type": "restricted", "indication": "obesity", "indication_population": "BMI>=35 + diabetes", "ICER_QALY": 29800, "ICER_currency": "EUR", "budget_impact_5yr_local": 720000000, "reimbursement_tier": "AMNOG Stufe 4 (minor)", "patient_co_pay_pct": 10, "notes": "Zusatznutzen: gering"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "HAS", "agency_id": "HAS-2026-SMR-08", "sponsor": "Novo Nordisk", "decision_date": "2026-03-28", "decision_type": "conditional", "indication": "obesity", "indication_population": "BMI>=35 + comorbidity", "ICER_QALY": 31200, "ICER_currency": "EUR", "budget_impact_5yr_local": 540000000, "reimbursement_tier": "SMR modere, ASMR IV", "patient_co_pay_pct": 35, "notes": "Remboursement 30%"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "PBAC", "agency_id": "PBAC-2026-Mar-04", "sponsor": "Novo Nordisk", "decision_date": "2026-03-18", "decision_type": "resubmission", "indication": "obesity", "indication_population": "BMI>=35", "ICER_QALY": 62000, "ICER_currency": "AUD", "budget_impact_5yr_local": 480000000, "reimbursement_tier": "rejected pending RSA", "patient_co_pay_pct": 100, "notes": "Defer for managed entry agreement"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "NICE", "agency_id": "TA889", "sponsor": "Eli Lilly", "decision_date": "2026-04-22", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=35 + comorbidity", "ICER_QALY": 22400, "ICER_currency": "GBP", "budget_impact_5yr_local": 528000000, "reimbursement_tier": "secondary care, 3yr cap", "patient_co_pay_pct": 0, "notes": "Within NICE £20-30k/QALY threshold"},
    {"drug_id": "tirzepatide_15mg", "brand": "Mounjaro", "jurisdiction": "CADTH", "agency_id": "CDR-0701", "sponsor": "Eli Lilly", "decision_date": "2026-03-30", "decision_type": "recommended", "indication": "obesity+T2DM", "indication_population": "BMI>=27 + T2DM", "ICER_QALY": 42000, "ICER_currency": "CAD", "budget_impact_5yr_local": 1100000000, "reimbursement_tier": "step therapy after metformin", "patient_co_pay_pct": 20, "notes": "Within C$50k threshold"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "ICER", "agency_id": "ICER-2026-OBE-02", "sponsor": "Eli Lilly", "decision_date": "2026-02-08", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 71200, "ICER_currency": "USD", "budget_impact_5yr_local": 22600000000, "reimbursement_tier": "value-based", "patient_co_pay_pct": 25, "notes": "Strong RWE 22% weight loss"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "HIRA", "agency_id": "HIRA-2026-A21", "sponsor": "Eli Lilly", "decision_date": "2026-02-25", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 41800000, "ICER_currency": "KRW", "budget_impact_5yr_local": 1850000000000, "reimbursement_tier": "non-reimbursed", "patient_co_pay_pct": 100, "notes": "ICER QALY ~1.1x GDP per capita threshold (38M KRW), 비급여"},
    {"drug_id": "tirzepatide_15mg", "brand": "Mounjaro", "jurisdiction": "G-BA", "agency_id": "G-BA-2026-AMNOG-14", "sponsor": "Eli Lilly", "decision_date": "2026-04-15", "decision_type": "recommended", "indication": "obesity+T2DM", "indication_population": "BMI>=30 + T2DM", "ICER_QALY": 27500, "ICER_currency": "EUR", "budget_impact_5yr_local": 980000000, "reimbursement_tier": "AMNOG Stufe 3 (considerable)", "patient_co_pay_pct": 5, "notes": "Zusatznutzen: betrachtlich"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "PBAC", "agency_id": "PBAC-2026-Mar-08", "sponsor": "Eli Lilly", "decision_date": "2026-03-22", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=35 + comorbidity", "ICER_QALY": 44000, "ICER_currency": "AUD", "budget_impact_5yr_local": 612000000, "reimbursement_tier": "Section 100 highly specialised", "patient_co_pay_pct": 15, "notes": "RSA active"},
    {"drug_id": "tirzepatide_15mg", "brand": "Mounjaro", "jurisdiction": "MSAC", "agency_id": "MSAC-1734", "sponsor": "Eli Lilly", "decision_date": "2026-04-05", "decision_type": "conditional", "indication": "obesity surgery alternative", "indication_population": "BMI>=40 pre-surgery", "ICER_QALY": 38000, "ICER_currency": "AUD", "budget_impact_5yr_local": 280000000, "reimbursement_tier": "MBS new item", "patient_co_pay_pct": 10, "notes": "Bridging therapy"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "HAS", "agency_id": "HAS-2026-SMR-12", "sponsor": "Eli Lilly", "decision_date": "2026-04-12", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=30 + comorbidity", "ICER_QALY": 26800, "ICER_currency": "EUR", "budget_impact_5yr_local": 720000000, "reimbursement_tier": "SMR important, ASMR III", "patient_co_pay_pct": 15, "notes": "Remboursement 65%"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "REA", "agency_id": "REA-EU-JCA-2026-04", "sponsor": "Eli Lilly", "decision_date": "2026-04-30", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=30 + comorbidity", "ICER_QALY": 28000, "ICER_currency": "EUR", "budget_impact_5yr_local": 4200000000, "reimbursement_tier": "EU JCA positive", "patient_co_pay_pct": null, "notes": "EU joint clinical assessment HTAR Regulation 2021/2282"},
    {"drug_id": "tirzepatide_15mg", "brand": "Mounjaro", "jurisdiction": "JP", "agency_id": "C2H-2026-08", "sponsor": "Eli Lilly", "decision_date": "2026-02-12", "decision_type": "conditional", "indication": "obesity+T2DM", "indication_population": "BMI>=27 (Asian-specific)", "ICER_QALY": 6200000, "ICER_currency": "JPY", "budget_impact_5yr_local": 142000000000, "reimbursement_tier": "Chuikyo price adjustment", "patient_co_pay_pct": 30, "notes": "C2H price reduction 15%"},
    {"drug_id": "liraglutide_3.0mg", "brand": "Saxenda", "jurisdiction": "NICE", "agency_id": "TA664", "sponsor": "Novo Nordisk", "decision_date": "2025-10-08", "decision_type": "restricted", "indication": "obesity", "indication_population": "BMI>=35 + pre-diabetes + CVD risk", "ICER_QALY": 22900, "ICER_currency": "GBP", "budget_impact_5yr_local": 168000000, "reimbursement_tier": "specialist obesity service", "patient_co_pay_pct": 0, "notes": "Tier 3 weight management"},
    {"drug_id": "liraglutide_3.0mg", "brand": "Saxenda", "jurisdiction": "HIRA", "agency_id": "HIRA-2025-B04", "sponsor": "Novo Nordisk", "decision_date": "2025-08-20", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 44000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 280000000000, "reimbursement_tier": "비급여", "patient_co_pay_pct": 100, "notes": "비급여 약 60만원/월"},
    {"drug_id": "liraglutide_3.0mg", "brand": "Saxenda", "jurisdiction": "PBAC", "agency_id": "PBAC-2025-Nov-12", "sponsor": "Novo Nordisk", "decision_date": "2025-11-25", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 78000, "ICER_currency": "AUD", "budget_impact_5yr_local": 210000000, "reimbursement_tier": "private only", "patient_co_pay_pct": 100, "notes": "ICER above willingness to pay"},
    {"drug_id": "CagriSema", "brand": "CagriSema (investigational)", "jurisdiction": "NICE", "agency_id": "TA-PEND-CGS-01", "sponsor": "Novo Nordisk", "decision_date": "2026-05-10", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "GBP", "budget_impact_5yr_local": null, "reimbursement_tier": "scoping consultation", "patient_co_pay_pct": null, "notes": "Phase 3 REDEFINE awaited"},
    {"drug_id": "CagriSema", "brand": "CagriSema (investigational)", "jurisdiction": "ICER", "agency_id": "ICER-PEND-CGS", "sponsor": "Novo Nordisk", "decision_date": "2026-05-05", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "USD", "budget_impact_5yr_local": null, "reimbursement_tier": "horizon scanning", "patient_co_pay_pct": null, "notes": "expected 2026 H2 review"},
    {"drug_id": "MariTide", "brand": "MariTide (investigational)", "jurisdiction": "ICER", "agency_id": "ICER-PEND-MAR", "sponsor": "Amgen", "decision_date": "2026-04-28", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "USD", "budget_impact_5yr_local": null, "reimbursement_tier": "horizon scanning", "patient_co_pay_pct": null, "notes": "GIPR antagonist + GLP-1RA, monthly dosing"},
    {"drug_id": "retatrutide", "brand": "retatrutide (investigational)", "jurisdiction": "NICE", "agency_id": "TA-PEND-RTR-01", "sponsor": "Eli Lilly", "decision_date": "2026-05-02", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "GBP", "budget_impact_5yr_local": null, "reimbursement_tier": "scoping", "patient_co_pay_pct": null, "notes": "TRIPLE-G TRIUMPH program"},
    {"drug_id": "retatrutide", "brand": "retatrutide (investigational)", "jurisdiction": "ICER", "agency_id": "ICER-PEND-RTR", "sponsor": "Eli Lilly", "decision_date": "2026-04-18", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "USD", "budget_impact_5yr_local": null, "reimbursement_tier": "horizon scanning", "patient_co_pay_pct": null, "notes": "24% weight loss in Phase 2"},
    {"drug_id": "orforglipron", "brand": "orforglipron (investigational)", "jurisdiction": "NICE", "agency_id": "TA-PEND-ORF-01", "sponsor": "Eli Lilly", "decision_date": "2026-05-08", "decision_type": "pending", "indication": "obesity+T2DM", "indication_population": "BMI>=30 + T2DM", "ICER_QALY": null, "ICER_currency": "GBP", "budget_impact_5yr_local": null, "reimbursement_tier": "scoping", "patient_co_pay_pct": null, "notes": "Oral non-peptide GLP-1RA, lower BIA"},
    {"drug_id": "survodutide", "brand": "survodutide (investigational)", "jurisdiction": "ICER", "agency_id": "ICER-PEND-SUR", "sponsor": "Boehringer Ingelheim", "decision_date": "2026-04-10", "decision_type": "pending", "indication": "obesity+MASLD", "indication_population": "BMI>=30 + MASH", "ICER_QALY": null, "ICER_currency": "USD", "budget_impact_5yr_local": null, "reimbursement_tier": "horizon scanning", "patient_co_pay_pct": null, "notes": "GCGR+GLP-1RA dual agonist for MASLD"},
    {"drug_id": "amycretin", "brand": "amycretin (investigational)", "jurisdiction": "ICER", "agency_id": "ICER-PEND-AMY", "sponsor": "Novo Nordisk", "decision_date": "2026-05-12", "decision_type": "pending", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "USD", "budget_impact_5yr_local": null, "reimbursement_tier": "horizon scanning", "patient_co_pay_pct": null, "notes": "Amylin+GLP-1RA, oral and SC formulations"},
    {"drug_id": "setmelanotide", "brand": "Imcivree", "jurisdiction": "NICE", "agency_id": "HST24", "sponsor": "Rhythm Pharma", "decision_date": "2025-12-05", "decision_type": "recommended", "indication": "obesity (rare genetic)", "indication_population": "POMC/LEPR/PCSK1 deficiency", "ICER_QALY": 95000, "ICER_currency": "GBP", "budget_impact_5yr_local": 38000000, "reimbursement_tier": "highly specialised technology", "patient_co_pay_pct": 0, "notes": "HST ultra-rare premium"},
    {"drug_id": "setmelanotide", "brand": "Imcivree", "jurisdiction": "ICER", "agency_id": "ICER-2025-RARE-08", "sponsor": "Rhythm Pharma", "decision_date": "2025-09-12", "decision_type": "recommended", "indication": "obesity (rare genetic)", "indication_population": "BBS, POMC, LEPR", "ICER_QALY": 280000, "ICER_currency": "USD", "budget_impact_5yr_local": 420000000, "reimbursement_tier": "ultra-rare exception", "patient_co_pay_pct": 5, "notes": "Beyond traditional threshold but rare exception"},
    {"drug_id": "setmelanotide", "brand": "Imcivree", "jurisdiction": "HIRA", "agency_id": "HIRA-2026-RARE-02", "sponsor": "Rhythm Pharma", "decision_date": "2026-03-15", "decision_type": "conditional", "indication": "obesity (rare genetic)", "indication_population": "POMC/LEPR confirmed", "ICER_QALY": 380000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 18000000000, "reimbursement_tier": "희귀의약품 산정특례 본인부담 10%", "patient_co_pay_pct": 10, "notes": "산정특례 적용"},
    {"drug_id": "naltrexone_bupropion", "brand": "Contrave", "jurisdiction": "NICE", "agency_id": "TA-WD-2025-NB", "sponsor": "Currax Pharma", "decision_date": "2025-07-20", "decision_type": "withdrawn", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "GBP", "budget_impact_5yr_local": null, "reimbursement_tier": "withdrawn from appraisal", "patient_co_pay_pct": null, "notes": "Manufacturer withdrew submission"},
    {"drug_id": "naltrexone_bupropion", "brand": "Contrave", "jurisdiction": "CADTH", "agency_id": "CDR-NB-2025", "sponsor": "Bausch", "decision_date": "2025-06-10", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 92000, "ICER_currency": "CAD", "budget_impact_5yr_local": 84000000, "reimbursement_tier": "private only", "patient_co_pay_pct": 100, "notes": "Modest weight loss vs cost"},
    {"drug_id": "naltrexone_bupropion", "brand": "Contrave", "jurisdiction": "HIRA", "agency_id": "HIRA-2025-NB-01", "sponsor": "광동제약", "decision_date": "2025-05-30", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 62000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 92000000000, "reimbursement_tier": "비급여", "patient_co_pay_pct": 100, "notes": "비급여 약 18만원/월"},
    {"drug_id": "phentermine", "brand": "phentermine (short-term)", "jurisdiction": "HIRA", "agency_id": "HIRA-2025-PHEN", "sponsor": "various", "decision_date": "2025-04-12", "decision_type": "restricted", "indication": "obesity short-term", "indication_population": "BMI>=30, <12 weeks", "ICER_QALY": null, "ICER_currency": "KRW", "budget_impact_5yr_local": null, "reimbursement_tier": "처방전문약 비급여", "patient_co_pay_pct": 100, "notes": "Schedule IV, 단기 사용"},
    {"drug_id": "phentermine", "brand": "phentermine", "jurisdiction": "PBAC", "agency_id": "PBAC-PHEN-OLD", "sponsor": "various", "decision_date": "2024-03-20", "decision_type": "not_recommended", "indication": "obesity short-term", "indication_population": "BMI>=30", "ICER_QALY": null, "ICER_currency": "AUD", "budget_impact_5yr_local": null, "reimbursement_tier": "private prescription", "patient_co_pay_pct": 100, "notes": "Limited evidence"},
    {"drug_id": "orlistat", "brand": "Xenical/Alli", "jurisdiction": "NICE", "agency_id": "CG189", "sponsor": "GSK/Roche", "decision_date": "2024-11-08", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=28+comorbidity or BMI>=30", "ICER_QALY": 14200, "ICER_currency": "GBP", "budget_impact_5yr_local": 68000000, "reimbursement_tier": "primary care", "patient_co_pay_pct": 0, "notes": "First-line pharmacotherapy"},
    {"drug_id": "orlistat", "brand": "Xenical", "jurisdiction": "HIRA", "agency_id": "HIRA-ORL-2024", "sponsor": "Roche Korea", "decision_date": "2024-09-15", "decision_type": "not_recommended", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 28000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 45000000000, "reimbursement_tier": "비급여", "patient_co_pay_pct": 100, "notes": "OTC + 처방 둘 다 비급여"},
    {"drug_id": "orlistat", "brand": "Xenical", "jurisdiction": "PBAC", "agency_id": "PBAC-ORL-OLD", "sponsor": "Roche", "decision_date": "2023-11-12", "decision_type": "restricted", "indication": "obesity", "indication_population": "BMI>=30", "ICER_QALY": 32000, "ICER_currency": "AUD", "budget_impact_5yr_local": 42000000, "reimbursement_tier": "private only", "patient_co_pay_pct": 100, "notes": "Authority required"},
    {"drug_id": "tirzepatide_15mg", "brand": "Zepbound", "jurisdiction": "NECA", "agency_id": "NECA-2026-OB-01", "sponsor": "한국릴리", "decision_date": "2026-05-08", "decision_type": "pending", "indication": "obesity surgery alternative", "indication_population": "BMI>=35 + 합병증 (한국 기준 BMI>=30)", "ICER_QALY": null, "ICER_currency": "KRW", "budget_impact_5yr_local": null, "reimbursement_tier": "신의료기술평가 진행중", "patient_co_pay_pct": null, "notes": "NECA 비교효과연구"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "KFDA", "agency_id": "KFDA-2025-OB-12", "sponsor": "노보 노디스크 코리아", "decision_date": "2025-04-25", "decision_type": "recommended", "indication": "obesity", "indication_population": "BMI>=30 또는 BMI>=27+합병증", "ICER_QALY": null, "ICER_currency": "KRW", "budget_impact_5yr_local": null, "reimbursement_tier": "허가완료, 급여 미적용", "patient_co_pay_pct": 100, "notes": "허가 후 HIRA 별도 평가 필요"},
    {"drug_id": "tirzepatide_15mg", "brand": "Mounjaro", "jurisdiction": "KFDA", "agency_id": "KFDA-2026-OB-03", "sponsor": "한국릴리", "decision_date": "2026-01-18", "decision_type": "recommended", "indication": "obesity+T2DM", "indication_population": "BMI>=27 + T2DM", "ICER_QALY": null, "ICER_currency": "KRW", "budget_impact_5yr_local": null, "reimbursement_tier": "허가완료, 비만 비급여", "patient_co_pay_pct": 100, "notes": "당뇨 적응증만 부분 급여"},
    {"drug_id": "semaglutide_2.4mg", "brand": "Wegovy", "jurisdiction": "MSAC", "agency_id": "MSAC-1712", "sponsor": "Novo Nordisk AU", "decision_date": "2026-01-22", "decision_type": "not_recommended", "indication": "obesity surgery alternative", "indication_population": "BMI>=40 pre-surgery", "ICER_QALY": 82000, "ICER_currency": "AUD", "budget_impact_5yr_local": 180000000, "reimbursement_tier": "rejected", "patient_co_pay_pct": 100, "notes": "Insufficient evidence for surgical alternative"},
    {"drug_id": "liraglutide_3.0mg", "brand": "Saxenda", "jurisdiction": "G-BA", "agency_id": "G-BA-AMNOG-LIRA-2024", "sponsor": "Novo Nordisk", "decision_date": "2024-12-10", "decision_type": "restricted", "indication": "obesity", "indication_population": "BMI>=35 + comorbidity", "ICER_QALY": 38200, "ICER_currency": "EUR", "budget_impact_5yr_local": 280000000, "reimbursement_tier": "AMNOG Stufe 5 (no add'l benefit)", "patient_co_pay_pct": 30, "notes": "Zusatznutzen: nicht belegt"},
    {"drug_id": "semaglutide_1.0mg", "brand": "Ozempic", "jurisdiction": "HIRA", "agency_id": "HIRA-OZE-2024", "sponsor": "노보 노디스크 코리아", "decision_date": "2024-08-22", "decision_type": "recommended", "indication": "T2DM", "indication_population": "T2DM + 비만 동반 BMI>=25", "ICER_QALY": 18000000, "ICER_currency": "KRW", "budget_impact_5yr_local": 380000000000, "reimbursement_tier": "당뇨 적응증 급여", "patient_co_pay_pct": 30, "notes": "당뇨 적응증만 급여 — 비만 적응증 비급여"}
  ]
}
