The National Health Insurance Administration (NHIA) Pharmaceutical Benefit and Reimbursement Scheme Joint committee (PBRS) in a recent meeting did not approve coverage for the rare disease familial adenomatous polyposis (FAP). The outcome prompted some patients to complain that the lack of coverage for new drugs that are available leaves them at the mercy of their disease and eventually death. However, a petition on the government’s official public policy forum calling for accelerated NHI coverage for FAP drugs garnered enough signatures to warrant a response from competent authorities, bringing a glimmer of hope for patients.

The proposal was rejected during a recent PBRS meeting, with members citing strained NHI finances and the high price of FAP drugs, which could cost more than NT$10 million per patient each year. If all of Taiwan’s estimated 60 to 70 FAP patients were to receive NHI-covered drugs, total expenditure could increase by NT$600 million to NT$700 million each year, potentially displacing funding to other new drugs. Despite these concerns, Mr. Liang Ting-chi, head of a Taiwan-based FAP patients association, expressed hopes for the government to negotiate for lower prices with drug manufacturers so that patients have a chance at living with their disease.

NHIA Director General Lee Po-chang said that currently, drug expenditure already accounts for almost 30 percent of the NHI global budget with spending seeing continuous growth, adding that many people have joked that the NHI is mainly used to purchase drugs. Further, due to the high cost, spending on new cancer drugs has severely squeezed coverage for commonly prescribed drugs. According to aggregated data, the prices for around 5,600 drugs have been slashed to unreasonably low levels, with NHI pricing at between NT$1.5 and NT$5 per pill, affecting treatment regimens.

To allow FAP patients to access new drugs as soon as possible, Director General Lee Po-chang said that he will proactively communicate with pharmaceutical companies and negotiate prices. If drug prices can be successfully lowered to a reasonable price, NHI coverage will certainly be accelerated, which will benefit more patients with rare diseases.

[2022-1-13/United Daily News]