Pharmaceutical News
New National Health Insurance rules implemented July with copayment on prescription drugs capped at NT$300

Regarding the upcoming changes to National Health Insurance copayments, Minister of Health and Welfare Hsueh Jui-yuan on May 16 said that the new rules will be finalized in the next two or three days for a 30-day notice-and-comment period. If there are no major dissenting opinions, the first phase of the changes, covering prescription drugs and emergency room visits, will be implemented on July 1.

Under the new rules for prescription drugs, copayments will be capped at NT$200 for clinics and district hospitals and NT$300 for regional hospitals and above. As for refillable prescriptions for chronic conditions, copayments are waived for clinics, and limited to a one-time copayment charge at hospitals of all scales. Separately, to avoid potential conflicts between providers and patients, the National Health Insurance Administration has cancelled a requirement for hospitals to base copayment charges on emergency room visits on the triage level of patients. Instead, clinics and district hospitals will charge a copayment of NT$150, with regional hospitals charging NT$400 and medical centers charging NT$750. Patients of near-poor households and those with disabilities are also subject to lower copayments, set at NT$150 for clinics and district hospitals, NT$300 for regional hospitals and NT$550 for medical centers.

Taiwan College of Healthcare Executive (TCHE) President Hung Tzu-jen said that due to its limited scope that does not include diagnostic exams, the new copayment rules will do little in combatting the wastage of medical resources. Further, under the fixed global budget system, it is inevitable that the value of medical points will see dilution, which will further strain hospital finances. TCHE President Hung urged the government to reexamine the new copayment rules with the medical community and expedite efforts at implementing the second phase of copayment rule changes, which will cover diagnostic examinations.

[2023-5-17/China Times]