According to the NHI Act, instruction drugs are not included in the NHI Benefit Scheme. However, the NHI currently provides over 800 instruction drugs. Pharmacists claim that patients should buy instruction drugs from pharmacies; but doctors are worried about disputes with patients over prescriptions. The NHIA held a meeting on June 7th to try to reach a consensus on this issue. The meeting agreed to delist 15 instruction drugs from the NHI Benefit Scheme, including vitamin B complex and digestive enzymes. The NHIA requested medical and pharmacist associations to make a list of instruction drugs whose annual usage is fewer than 5,000 units for the NHIA’s consideration.
Tsai Shu-Ling, the Deputy Director General of the NHIA, expressed that many of the delisted items can be substituted by prescription drugs; therefore, patients’ medication right won’t be affected. This meeting was chaired by Tsai Shu-Ling and attended by over 30 representatives from the NHIA, TFDA, Taiwan Medical Association, Federation of Taiwan Pharmacists Associations and various medical associations. The meeting lasted 3 hours. Participants were divided into small groups to discuss the NHI reimbursement of over 800 instruction drugs.
Dr Lin Ying-Ran, the President of the Primary Care Clinic Association, said that vitamin B complex are usually prescribed to relieve nerve pain or neuritis associated with deficiency of vitamins B1, B6 and B12. As there are many vitamin B complex products available on the market and people have a generally balanced diet, patients are less likely to suffer from vitamin B deficiency. Hence, the meeting decided to stop reimbursing vitamin B complex. It is the same reason for delisting digestive enzymes, such as protease, amylase, lipase, as they are not considered essential.
There were also discussions about the reimbursement of instruction drugs for motion sickness, bromelain enzyme, acetaminophen, cold medicine, stomach medicine and other medicines which are of concern to the general public. The Federation of Taiwan Pharmacists Associations accepts a phased review; however, they argued that the authority should consider the impact on the society and should work hard to change the public’s medication habits.
Dr Lin Ying-Ran said that the meeting also reviewed the drugs which are listed as both prescription drugs and instruction drugs. He is worried that delisting some instruction drugs will exacerbate the current drug shortage problem and will affect patients’ medication. Therefore, he suggests continuously monitoring the drug supply situation and review the decision accordingly.
As for some of the popular drugs that people are most concerned about, such as magnesium oxide, prolactin, cold medicines and cough syrups for children, the NHI will continue to pay for them for the time being.
【2023-06-07 / United Daily News】
