Pharmaceutical News
Medical community urges for National Health Insurance coverage of lung squamous carcinoma treatments
2022/11/18

Formosa Cancer Foundation Vice President Tsai Li-chuan said that among the applications for new cancer drugs to be included on the National Health Insurance fee schedule between 2013 through April 2022, around 70 percent were approved, with each application taking an average of 787 days. However, following approval for inclusion on the NHI fee schedule, the actual terms of NHI reimbursement turned out to be more stringent, with access of the new cancer drugs being available to only 30 percent of patients.

The NHI’s 2022 new drug budget was set at NT$2.26 billion, however, as of the end of the second quarter, only NT$86 million were used, representing a budget execution rate of 5 percent. In recent years, drug expenditures have amounted to 28.9 percent of the NHI global budget, while the National Health Insurance Administration (NHIA) have set a goal to contain that figure at below 25 percent of the global budget. According to foundation Vice President Tsai, these constraints could hamper patients’ access to new drugs, which are priced well out of the reach of many disadvantaged patients, while also acknowledging that some of the new drugs have yet to establish a track record of efficacy. To address the issue, foundation Vice President Tsai hopes to implement the Taiwan modified Cancer Drug Fund to ease the financial burden on patients and to collect real world evidence for reference in decisions on wider NHI reimbursement.

Democratic Progressive Party Legislator Liu Chien-kuo said that the NHI reform requires new perspectives on Taiwan’s health care system and that he has proposed a bill to amend Article 16 of the Cancer Control Act, which recommends the government to establish the Taiwan modified Cancer Drug Fund to make up current gaps in coverage. The bill is slated to be reviewed by the legislature’s health committee to benefit more patients. The NHIA explained that this year’s drug price adjustment resulted in a NT$7.46 billion reduction in total drug expenditure, with a smaller number of drugs seeing price adjustments. The savings were then returned to the NHI global budget. While these changes make the new drug budget execution rate appear low, there has been no reduction in the amount of resources dedicated to cancer drugs.

[2022-11-15/Liberty Times]