New drugs could help save life for patients; however, the access to new drugs is hindered by the limited NHI resources.  The health competent authority is constantly facing the challenge of allocating the resources efficiently and effectively under the financial constraints.

Chen Yuan-Chen, Assistant Professor in Biological Big Data Analysis of Fu-Jen Catholic University, pointed out that, this year, the NHI allocated a budget of NT$3.5 billion to new drugs (including new treatments, new medicine and new special materials), and NT$11.7 billion to the drugs and special materials for rare diseases and haemophilia.  The NHI also receives NT$100 million from the Health Promotion Administration from the tobacco taxes.

However, some patients are falling between the cracks.  For example, if a new drug is effective in treating a disease which has a patient population under 500, and the drug is neither listed in the NHI nor classified as an orphan drug, what right do the patients have?

Prof Hsiao Fei-Yuan of the NTU pointed out that the NHIA held 6 meetings every year for “NHI Drug Dispensing Items and Fee Schedule Joint Establishment”.  Last year, the meetings estimated that the NHIA needs to increase the budget for new drugs and new medical technology to NT$4.2 billion; however, the NHI finalized the budget at NT$3.5 billion.

According to a study conducted by the TaSPOR, the benefits of new drugs are in five major areas: clinical efficacy, social impact, patient issues, economics and the healthcare system.  The value of a new drug must be determined through considering not only the medical needs, but also factors such as health impact and patient’s quality of life, etc.

Prof Hsiao said that, under the HTA, the financial impact of a new drug is usually assessed by evaluating the impact of the drug fees on the total budget without completely acknowledging other financial benefits, such as the reduction in hospital revisits.  This is something the authority should rethink.

Chen Yung-Chen pointed out that NICE, the British agency in charge of the HTA, suggested that the government should make the access to innovative new drugs fairer for patients.  This can be achieved by incorporating a diversity of evidences in to the HTA results.  Such a viewpoint is what the stakeholders should work for.

【2021-09-07/ United Daily News】