The NHI sets a special budget for new drugs every year; however, at a press conference, several rare disease organisations and patient groups criticized the NHIA for spending too little on new drugs. According to them, last year’s budget was NT$2.268 billion; but as of the end of the 2nd quarter, the actual expenditure was only NT$86 million. They predicted that the 2020 budget exaction rate could be below 10%, which would be an all-time low.
In addition, at a public hearing on the current status and the prospects of the NHI system, hospital representatives also criticized the NHIA for its low spending on new drugs and new medical technologies, as well as a low ratio of NHI expenditure to GDP in comparison with other developed countries.
Dr Hsueh Jui-Yuan, the MOHW Minister, stressed that the authority will continues to address this issue and to engage in dialogue with stakeholders. However, any changes to the regulations of the global budget will involve law amendment which requires social consensus.
Over the past few years, the government has been promoting the domestic biomedical industry and the development of new drugs. So far, the government and the industry have invested over hundreds of billion in the R&D of new drugs and have achieved many successful results. However, the NHIA only allocates N$2-3 billion a year for new drugs. Even so, the budget execution rate in 2022 is likely to remain under 10%. The amount received by domestic new drug developers is negligible.
In fact, since the implementation of the NHI new drug budget, the execution rate has hardly exceeded 10%. After four months of the press conference, the rare disease groups are still waiting for a reply from the NHIA.
Dr Chang Hong-Jen, a former Director General of the NHIA, reckoned that the NHIA should have properly implemented the budget. But, Dr Chang pointed out a more serious problem: the NHI budget for new drugs is actually too low. This is because the NHI resources are quite limited. As the global healthcare spending continues to grow (OECD average 12.6%), Taiwan is lagging far behind (6.6%).
The advances in health technology and an ageing population both augment healthcare spending. As the NHI global budget remains more or less static in the past 20 years, the gap between healthcare spending and the public’s demands for healthcare is widening.
Hung Tzu-Jen, the President of the Taiwan College of Healthcare Executive, pointed out that smart health and digital health will dominate the future trend. If the government insists on a cost-based budgeting method, no drug companies would be willing to invest in new drug R&D, said Hung.
【2023-01-03 / Economic Daily】
