Lung cancer has long been the number one cause of cancer death in Taiwan.  About 13,000 new lung cancer cases are confirmed each year.  In order to improve the treatments for lung cancer patients, the NHIA is planning to include the next-generation sequencing (NGS) assessment into the NHI Benefit Scheme.  The NGS assessment, which costs about NT$60,000, helps to improve the efficiency of targeted therapies to up to 70%.  The NHIA is also considering gradually extending the reimbursement to other cancers, such as breast cancer, colorectal cancer, etc.

Smoking used to be associated with the prevalence of lung cancer; but the data shows that most lung cancer patients do not smoke.   In fact, the lack of early screening tools contributes to late diagnosis.  As a result, most patients are diagnosed when they are already in late stage.  Therefore, the five-year survival rate of lung cancer is under 20% in Taiwan.

Dr Yang Pan-Chyr, Academician of Academia Sinica, expressed that, in the earlier years, the use of targeted therapies for cancers was like shooting in the dark, with only 25%-30% effectiveness.  As the sequencing technology advances, targeted therapies can now be used more effectively by prior screening patients for certain gene mutation.   It improves the effectiveness to up to 70%.

Dr Tseng Chin-Yuan, the Supervisor of the Taiwan Society of Molecule Medicine, said that the NGS is the best among all existing screening tools.  However, it is quite expensive, costing about NT$100,000 to 150,000.  Nevertheless, in order to improve the effectiveness of targeted therapies, it is necessary to have this assessment.  The NHI should help patients to access the assessment.

In the NHIA’s expert meeting on February 26, participating experts expressed that the knowledge about targeted therapies for lung cancer and gene studies is relatively mature; therefore, the NHIA should provide the NGS assessment for patients in need of targeted therapies.  According to Dr Yang Pan-Chyr, the meeting reached a preliminary consensus that the NHI should provide simple NGS panel for testing fewer than 50 genes.  In the future, the NHIA could consider including other types of cancers and charging for testing additional genes.

【2021-02-27 / United Daily】