The Hope Foundation for Cancer Care (HOPE) indicated that despite its expansion to above NT$800 billion, the National Health Insurance (NHI) global budget still cannot cover many new drugs and medical technologies in a timely manner due to mounting financial strain on the system, resulting in high out of pocket charges that often compel patients to forgo treatment. HOPE proposes the establishment of a Cancer Drug Fund and outlined its recommendations to supervise the allocation of medical resources, in a bid to prevent patients from becoming impoverished because of illness.
Sammy Tsai, Director of the Research and Development of HOPE, stated that the foundation had recently proposed three major health insurance reform initiatives, including adjusting NHI copayments, which call for copayments to combine all outpatient, emergency, traditional Chinese medicine, dentist, rehabilitation, medicine, and other services to be calculated under a fixed rate, specifically 20 percent for transfer patients and 30-50% for non-transfer patients. Moreover, HOPE maintains that the catastrophic illness designation is not always synonymous to being financially disadvantaged, therefore, copayments should be dependent on each patient’s financial capabilities, with some potentially subject to an additional 5 percent in premiums.
In addition, Hope also recommended for gaps in NHI coverage to be filled by commercial health insurance. HOPE maintained that while the NHI should provide universal coverage of basic health care services, commercial health insurance should be purchased to hedge against unknown risks, provide payouts to fund out-of-pocket items as well as protection. Furthermore, the U.K.’s Cancer Drugs Fund (CDF) provides an example that allow patients to have access to new drugs earlier and minimize the economic impact of uncertain effectiveness of new drugs.
Yang Wen-wen, secretary general of Health Outcomes and Technology Teaching and Education Alliance (HOTTEA), said that Taiwan’s version of the CDF should be an established as an independent unit that works with the Center for Drug Evaluation that does not draw funding from the NHI global budget. Instead, potential funding sources include the tobacco tax, contribution from lottery revenues, managed entry agreement rebates for cancer drugs, among other sources. The fund should operate under the premise of sustainability to promote access to cancer treatments and elevate the quality of health care.
[2021-10-9/SETN]
