“Are Taiwanese worth less than Japanese, Koreans or people from other high-income countries?” asked Prof Chou Yiing-Jenq from the National Yangming Chiao Tung University (NYCT) at a forum organised by the Taiwan Young Patient Association.
Prof Chou pointed out that the growth of a country’s health expenditure reflects the value of life in that country. For example in many western countries, governments spend a higher percentage of GDP on health with a significant growth rate. The amount of health spending has created reasonable value without causing the country’s economy to collapse.
However, Taiwan's medical and health expenditure accounts for only 3.9% of GDP, far lower than Japan's 9.2% and South Korea's 5.0%. In addition, the medical charges are on the low side. It sums up the government’s disregard for the value of people’s lives.
According to Prof Chou, an OECD study pointed out that an increase in health spending could improve life expectancy, a common index for a nation’s health status.
In fact, after the pandemic, many OECD countries began to reflect on the value of healthcare. Many scholars believe that in order to build a robust healthcare system, the government should increase the investment in healthcare by at least 1.4% of GDP with half of the investment going to human resources.
Prof Chou said that there is no such thing as a free lunch. In order to improve the health index, the government must invest in a reasonable increase in health expenditure. By doing so, it will increase expectancy and bring real benefits to the public.
Tsai Li-Chun, Vice CEO of the Taiwan Cancer Foundation, expressed that how to use the NHI resources efficiently presents a big challenge, especially when new drugs are getting more and more expensive and the NHI global budget is limited. She hopes there would be a transitional mechanism outside of the NHI resources, for example a cancer drug fund to help patients to access new drugs more quickly.
In fact, the NHIA has made a lot of efforts in improving the access to new drugs and new technologies and in helping young patients to get treatments. Tsai Shu-Ling, the Vice Director of the NHIA, expressed that the NHIA is working on improving the drug price adjustment mechanism, the instruction drug payment policies, the speed of drug listing and the use of generic drugs and bio-similars.
In the aspect of speeding up the listing of NHI new drugs, the NHIA’s main approaches are to accelerate the reimbursement applications, to promote the temporary NHI reimbursement scheme, to make better use of the risk-sharing model and to improve the health technology assessment (HTA).
Tsai explained that for new drugs which meet unmet medical needs but whose safety and effectiveness are still uncertain, the NHIA will offer a temporary reimbursement for 2 years until more real-world evidence is collected for further review.
Looking into the future, Tsai Shu-Ling expressed that the NHI is moving towards holistic care, scientific-evidence-based payment, digital health and regulatory robustness.
【2023-08-15 / United Daily】