As the National Health Insurance (NHI) global budget continues to increase year after year, cancer treatment costs reached NT$140 billion last year. However, cancer drug expenditures decreased from NT$40.3 billion in 2021 to NT$39.4 billion in 2023. Patient advocacy groups urge the government to align late-stage lung cancer treatment with international standards. Dr Shih Chung-Liang, the Minister of Health and Welfare, noted that reimbursement for immunotherapy may expand early next year to include combination therapies and remove the criterion of high PD-L1 expression levels.

Among the total NHI-reimbursed cancer drug expenditures of NT$39.4 billion in 2023, targeted therapies (including immune checkpoint inhibitors) accounted for the largest share at 65.9% (NT$25.96 billion). This was followed by chemotherapies at 21% (NT$8.26 billion) and hormone treatments at 10.6% (NT$4.15 billion).

Dr Shih acknowledged that there is still room for improvement in NHI-reimbursed cancer treatments and emphasized the importance of aligning with international standards. The authorities will continue to assess the gap between Taiwan and global practices. Taking into account the variations among different treatment guidelines, the authorities will also refer to recommendations from major international health technology assessment (HTA) centers, including those in the UK, Canada, and Australia.

Dr Shih explained that while treatment guidelines focus on treatment outcomes, health technology assessments (HTAs) also consider cost-benefit efficiency. Therefore, it is crucial to conduct a comprehensive review before submitting a proposal to the expert committee for discussion and subsequent budgeting.

Dr Shih noted that, using lung cancer as an example, eight different drugs are currently undergoing NHI reimbursement review, with five of them under accelerated review.

Regarding the highly anticipated immunotherapies, Dr Shih stated that the reimbursement policy might expand in the first quarter of next year. Each reimbursement decision requires funding of NT$2–3 billion a year. As a result, the NHIA will negotiate prices with pharmaceutical companies. Additionally, the NHIA plans to collaborate with the Financial Supervisory Committee to explore how private health insurance policies can complement the NHI. Dr Shih emphasized that this will be one of the key tasks for next year.

【2024-11-27/ Liberty Times】