As part of the NHIA’s plan to phase out the reimbursement of instruction drugs, the NHIA recently invited the healthcare stakeholders to discuss about the possibility of delisting 356 instruction drugs whose annual usage volume is under the threshold of 5000 patients/year. The NHIA estimated that it could save NT$7.51 million a year.  Hospital representatives expressed their concerns over increasing financial burden on patients; while the pharmaceutical representatives suggested fully following the NHI Act.  The NHIA will collects their comments and arrange further discussions.

According to the NHI Act, instruction drugs are not included in the NHI Benefit Scheme.  However, the NHIA has been reimbursing some instruction drugs for patients’ interests.  Due to financial strain, the NHIA decided to phase out the reimbursement of instruction drugs.  In 2005, the NHIA provided over 1200 instruction drugs, costing about NT$2.3 billion a year.  The number dropped to 851 items and NT$1.47 billion in 2021, and will reach 495 items if this suggestion of a further reduction is accepted and implemented.

According to the NHIA, the top 3 instruction drugs in terms of usage volume in 2021 was stool softener (annual drug fees NT$240 million), stomach pain relief (annual drug fees NT$144 million) and pain killers (annual drug fees NT$91 million).  Among the top 10 most used instruction drugs, four of them are stool softeners with a total cost of NT$361 million.  It might be associated with an ageing population and the stress from daily life.

Chang Wen-Ching, President of the Taipei Pharmacists Association, said that the cancelation of the reimbursement of the instruction drugs is based on the fact that such drugs are relatively safe; and besides, it is necessary to encourage the public to practice self-medication. 

Dr Lin Ying-Ran, the President of the Primary Care Association, expressed that many patients visit clinics for ailments, such as cold and indigestion, which can often be treated by instruction drugs.  If such drugs are not available under the NHI, patients will have to buy them from pharmacies which could be a hassle and could increase their financial burden.  The NHIA needs to take all these into account.  As the opinions are divided, the NHIA will carefully assess the information and arrange further discussions.

【2022-03-13 / United Daily News】