As patients wait for the lifesaving drugs to become more accessible, authorities have continued to cut the National Health Insurance (NHI) global budget. Taiwan Alliance of Patients’ Organizations President Wu Hong-Lai said that patients are faced with a difficult situation as they worry about both the NHI’s shaky fiscal condition as well as the exit of pharmaceutical companies from the Taiwan market due to excessively low NHI drug reimbursement.

Janice Chen, who chairs the Pharmaceutical Benefit and Reimbursement Scheme Joint Committee (PBRS), said that the committee’s meetings focus on safety and relative efficacy, pharmacoeconomics, and financial impacts to the NHI. Among them, financial impact often take priority in the meetings. As a result, the pragmatic approach to expanding NHI coverage for new drugs is to limit their indications, such as by prioritizing review for non-first line use or limiting their use to last-line use and the duration of treatment. The goal is to prioritize treatment to patients with the most urgent needs and those who are likely to see favorable treatment outcome. However, it is likely that the new drugs will be made accessible to wider groups of patients if authorities are able to secure price cuts and clawbacks with drug manufacturers to minimize financial impacts.

Ministry of Health and Welfare Institute of Social Insurance Director-General Shang Tung-fu stated that because next year’s new drug and new health technology budget is as high as three to four billion New Taiwan dollars, there is fewer chance that a new drug could displace another due to funding constraints, and that patients’ interests will be ensured under fair reimbursement terms. Authorities said that it is necessary to allocate a higher proportion of the global budget towards new drugs and that in accordance with horizon scanning, the NHIA has allowed pharmaceutical companies to provide estimates on the timetables in which new drugs will be introduced to Taiwan. That way, the NHIA may have a head start in its review of new drugs’ efficacy and market availability to accelerate the marketing approval of new drugs.

[2021-9-14/United Daily News]