Pharmaceutical News
Medication reform: a proposal to apply balance-billing to original drugs

Reported by Lee Shu-Jen

A major healthcare reform is on the horizon.  Upon the MOHW’s request, the NHIA is to pilot a balance-billing scheme on drugs.  According to the NHIA’s preliminary plan, the pilot scheme will mainly target on commonly used drugs, such as antihypertensives and antihyperlipidemics.  Under the pilot scheme, patients who prefer original drugs to generic drugs will be able to swap generics for original drugs by paying the price difference, about NT$10-20 for a 3-5-day dose.  Millions of patients will be affected. 

Lin Tzou-Yien, the Deputy Minister of the MOHW, pointed out that this pilot scheme will restore patients’ rights to choose medicines. The long-term objectives are to improve drug quality and to protect patients’ medical rights.  Chiang Been-Huang, the Minister of the MOHW, is to convene a meeting when he comes back from the APEC Health Ministers Meeting in Philippines to discuss a formal proposal of this pilot scheme put forward by the NHIA and the TFDA. 

Lin Tzou-Yien pointed out that balance billing has been implemented on five major types of medical devices, including crystalline lens and stents; and it has proved effective.  The next stage is to extend the implementation to drugs, said Lin.  He hopes the new scheme will succeed in diverting the profit from drug price difference to the improvement of drug quality. 

Lin Tzou-Yien expressed that the extended balance billing scheme is similar to the system for medical devices.  The NHIA will set a reimbursement baseline; and patients who prefer using original drugs can do so by paying the price difference.  

The NHIA held an expert meeting earlier.  Representatives from the medical and the pharmaceutical industries were invited to the meeting.  A preliminary proposal for the pilot scheme was drawn up.  It will mainly target on common drugs for chronic diseases, such as antihypertensives, antihyperlipidemics and antihyperglycemics. 


Thinking ahead, the MOHW is contemplating a 3-in-1 pilot scheme to further improve healthcare quality through an incentive program.


For example, monetary incentives might be available to reward hospitals’ price negotiation performance, provided that the surplus is ring-fenced as the budget for improving healthcare quality and introducing new drugs. 


【2015-09-02 / United Daily News】