The Ministry of Health and Welfare’s Health Promotion Administration published the top ten cancers of Taiwan during 2019, with liver cancer ranking second and claiming 7,881 lives that year. As liver cancer does not have clear symptoms in the early stages, many cases are not diagnosed until the latter stages, where treatment options are often limited to targeted therapy that comes with severe side effects. While new therapeutics can bring improvements to quality of life, the National Health Insurance (NHI) system in April of 2020 halted reimbursements. In response, experts said that new drug reimbursement must reflect patients’ needs and more budgets should be allocated to ensure the funding of wider reimbursement inclusion. 

Formosa Cancer Foundation Vice President Tsai Li-chuan said that since 1986, a program to vaccinate infants against hepatitis B has been implemented, and that more recently, the NHI has begun reimbursing hepatitis C drugs. However, despite these efforts, there are still many patients with late-stage liver diseases. In light of the evidence supporting the efficacy of immunotherapies and combinations of targeted therapies and immunotherapies for late-stage patients, these drugs have yet to be included for NHI reimbursement, leading to diminished access for financially strapped patients.

Vice President Tsai said that a person close to her died of late-stage liver cancer four years ago, noting that the patient was administered targeted therapy that caused severe side effects that caused immobilizing blisters to the hands and feet, leading to significant impacts to quality of life.

Currently, there are more effective drugs with less severe side effects, but with steep out of pocket charges. This is likely to add on to the anguish of patients in addition to their illnesses.

Vice President Tsai said that the National Health Insurance Administration (NHIA) must proactively fight for the reimbursement of late-stage liver cancer drugs by negotiating for better pricing with drug manufacturers. She added while the NHIA performs horizon scanning to continuously assess the financial impacts of extending reimbursement to new drugs, the NHIA should also take patients’ needs into consideration.

[2021-4-29/Apple Daily]