Pharmaceutical News
NHI relaxes reimbursement condition of biologics for treating psoriasis

Reported by Wu Chia-Chen from Taipei


The NHIA recently announced that a more relaxed reimbursement condition of biologics for treating psoriasis will start from April.  The current existing reimbursement condition only provides patients with 6-month treatments.  Under the new regulation, patients showing certain degree of treatment effectiveness are able to apply for further treatment for up to two years.  Doctors urge those who recently terminated treatment to consult with their doctors in order to see whether they are eligible for further treatment. 

The patient population of psoriasis is estimated to be 70,000 in Taiwan.  Among them, 1-2% of the patients are classified as severe cases which require treatments of biologics.

According to Dr. Tsai Cheng-Fang, a dermatologist of the NTUH, the current reimbursement condition of biologics is that patients must have at least 10% affected skin area after receiving conventional treatments and phototherapy.  A prior approval on the use of biologics from the NHIA is also required.  

At present, there are 3 biologics available under the NHI: Stelara, Humira and Enbrel.  The treatment costs NT$30-40K a month if patients go private. 

Dr. Tsai Cheng-Fang pointed out that under current reimbursement condition, patients are forced to terminate treatment after 6 months.  However, most patients have a relapse in 3-6 months after stopping the treatment.  Patients cannot apply for NHI-reimbursed treatment until their conditions reach the criteria of a severe case.  This regulation inflicts repeated attack on patients, affecting their quality of life.  As a result, some patients gave up treatment of biologics completely. 

Kuo Chei-Wen , a specialist from the NHIA, expressed that the current reimbursement condition is based on the clinical data which covered 6 months.  However, the NHIA found that 80% of the patients have a relapse after stopping the treatment.  As new research data suggesting longer usage became available, the NHIA adopted specialists’ suggestions and decided to relax the reimbursement conditions for patients’ interests.


【2015-03-27/ United Daily News】