Pharmaceutical News
Government mulling to implement balance billing to improve access to costly drugs while easing patients’ burden

Between 2014 and 2022, Taiwan’s healthcare expenditures have continued to grow each year, rising from NT$78.3 billion to NT$133.4 billion, of which annual spending on cancer drugs have increased more than twofold from NT$18 billion to NT$39.2 billion, at a yearly pace of 10 percent, outpacing the average annual 4 percent increase for the National Health Insurance global budget. To keep pace with the growing number of cancer patients each year and to speed up the inclusion of new cancer drugs on the NHI fee schedule, the National Health Insurance Administration (NHIA) is mulling to implement balance billing for cancer drugs, new drugs as well as orphan drugs. A cap on balance billed charges will also be implemented to ease the financial burden on patients.

NHIA Director General Shih Chung-liang said that to accelerate the inclusion of new cancer drugs on the NHI fee schedule, the NHIA in the near-term is aiming to grant fast track inclusion on the NHI fee schedule for some new drugs for two years. However, if safety and efficacy data of the new drugs prove to be lacking during the two years, the drugs will be removed from the NHI fee schedule. In the long-term, the NHIA is planning to promote balance billing for cancer drugs, new drugs, and orphan drugs, with caps on balance billed charges. The NHIA has also gathered input on whether its plans to implement balance billing is feasible. As for more costly drugs, the government is planning to launch an independently funded multi-support drugs fund, as well as drawing a special budget.

Furthermore, Director General Shih said that as cancer patients are not able to subscribe to most commercial medical insurance plans following their diagnosis, the government is hoping to work with the insurance industry in coming up with alternative solutions such as a supplemental product to the NHI.

[2023-5-1/United Daily News]