Since the pilot program for hospital-specific global budgets took effect in 2025, some hospitals have reportedly adjusted outpatient surgeries to maintain profitability. Pharmaceutical experts warn that hospitals may next turn to drug procurement to protect margins, favoring medicines with larger “drug price gaps.”

Clinicians note that the issue stems from Taiwan’s National Health Insurance (NHI) system, which sets a single reimbursement price for each drug. For example, if a drug’s NHI reimbursement is NT$10, hospitals receive NT$10 regardless of whether they procured the drug at a lower price via bulk purchasing or manufacturer discounts, allowing them to pocket the difference as profit. Professor Shen Li-jiuan of National Taiwan University’s Department of Pharmacy expressed concern that hospitals may become reluctant to prescribe new cancer drugs—often low-volume, rapidly consuming individual hospitals’ global budgets, and having small price gaps—potentially harming patient access and rights.

In response, National Health Insurance Administration (NHIA) Deputy Director General Parng I-ming said the NHIA launched a series of drug policy reform discussions starting July 16, with drug price gaps included on the agenda. Parng added that the NHIA will review hospitals’ drug procurement data and actively monitor the situation to avoid unintended consequences. He noted, however, that given the complexity of the price gap issue, further discussion and additional time are needed to gather and assess information.

[2025-8-4/Public Television Service]