In the post-pandemic era, whether new drugs and new special medical materials can be quickly listed in the NHI Benefit Scheme is a key concern of the general public.  The NHIA is considering a method called “horizon scanning” by which the NHIA will be able to assess the financial impact of potential new drugs and new indications, and to use the results to negotiate an annual global budget with the representatives of fee payers and hospitals.  Hsueh Jui-Yuan, the MOHW Minister, expressed that the new system would facilitate the issuance of temporary NHI reimbursement authorizations.  This means that certain new drugs, new special materials, regenerative medicines, etc. can be conditionally authorized for NHI reimbursement based on medical needs and the MOHW’s assessment results.

The MOHW Minister made the above comments on the future development of medical technology in the post-pandemic era at a committee meeting of the Legislative Yuan.

Under the current system, drug companies have to provide sufficient data to support the application of the NHI listing of a new drug.  This requirement actually hinders patients’ access to new drugs as data from actual clinical use are usually not yet widely available.  Therefore, the NHIA plans to revise the review process by using the health technology assessment (HTA) to estimate the costs and benefits of potential new drugs, new special materials and new indications.  The results will be used to support the decision-making process of the NHI Drug Dispensing Items and Fee Schedule Joint Establishment Meeting.

Going forward, the issuance of a temporary NHI reimbursement authorization is a possible approach.  A full authorization will be considered if the follow-up real-world evidence is satisfactory, said the MOHW Minister.  The NHIA will create a dedicated pathway to speed up the listing of new drugs for unmet medical needs, special materials for children and special materials for severe injuries. 

Regarding expensive medical devices/materials, the NHIA will introduce the balance billing and will continue collecting real-world evidences.

In order to use the NHI resources more efficiently, newly listed new drugs, new materials, etc. are subject to continuous HTA evaluations.  If the HTA results are satisfactory, the NHIA may improve the reimbursement conditions; otherwise, the NHIA may cut the reimbursement.  By doing so, the NHIA seeks to maximize the efficiency of the NHI resources.

【2022-10-12 /  United Daily News】