The Taiwanese government has set a target to reduce the cancer mortality rate by one-third by 2030. To achieve this, the Executive Yuan will launch the New Cancer Drug Fund with an initial budget of NT$5 billion next year. Dr Lin Ching-Yi, Deputy Minister of Health and Welfare, noted that the NHIA is currently drafting the Fund's operational guidelines. She indicated that the Fund will prioritize new drugs that address unmet medical needs but whose clinical outcomes, cost-effectiveness, and financial impact are not yet certain.
The number of patients receiving NHI-reimbursed cancer treatments increased from 800,000 in 2021 to 880,000 in 2023. However, NHI expenditure on cancer drugs decreased from NT$40.3 billion to NT$39.4 billion. During the same period, the cancer mortality rate rose from 220.1 to 227.6 per 100,000 people. The NHIA explained that the higher cancer drug expenditure in 2021 was due to the listing of several expensive drugs in 2019, while the lower expenditure in 2023 resulted from the NHIA's ongoing negotiations with pharmaceutical companies and various price-cutting measures.
To improve patients’ access to new cancer drugs, the Executive Yuan will allocate NT$5 billion to the New Cancer Drug Fund next year, intended for the "temporary reimbursement of new cancer drugs." Over the next three years, the Executive Yuan plans to gradually increase the annual budget to NT$10 billion. Dr Lin noted that the NHIA is currently collaborating with experts to draft the Fund's operational guidelines, which will be published for public comment. The NHIA aims to finalize and announce the guidelines by the end of this year.
The operational guidelines will establish the rules for the Fund. Dr Lin explained that an assessment committee will be set up to evaluate applications for eligibility. Since the assessment involves scientific evidence, cost-benefit analysis, expert opinions, and medical needs, the Fund will initially focus on improving access to new cancer drugs, gradually refining the list of covered items over time.
Dr Lin emphasized that the Fund should not be viewed as a supplement to NHI coverage. Instead, it should be seen as a support measure for new cancer drugs that show treatment potential but whose clinical outcomes and cost impact are still unproven. The Fund could also be used to temporarily reimburse new indications for existing drugs while the NHI gathers evidence to inform its reimbursement decisions.
According to Dr Lin, it is difficult for new drugs that have completed phase II or III clinical trials to receive NHI coverage due to financial constraints and strict regulatory requirements. These new drugs could, however, have an opportunity through the Fund while additional clinical evidence is gathered for their NHI reimbursement application.
It has been suggested that social costs should also be considered. For instance, while new drugs may be more expensive, they can enable patients to continue their daily work due to fewer side effects. Dr Lin agrees that these factors should be taken into account, but emphasizes the need for concrete data to support such claims.
【2024-10-21 / Liberty Times】
