Reported by Tsai Min-Hua from Taipei
It is estimated that about 600,000 people in Taiwan have liver diseases; however, only 90,000 people are currently under treatments because most patients are unaware of their conditions. They are susceptible to hepatitis, cirrhosis and liver cancer. Three drug companies have introduced new oral treatments for hepatitis C into Taiwan. The new drugs have lower risk of side effects than conventional treatments. However, they arrive with a huge price tag. A treatment course costs NT$0.8-2.5 million, which is beyond the reach of ordinary people. The NHIA plans to ring-fence a budget of NT$80 billion for a period of 10 years to provide treatments for 135,000 patients with hepatitis C genotype 1b annually.
According to Lin Jun-Yen, the Secretary General of the Taiwan Association for the Study of the Liver (TASL), among all patients with hepatitis C, those with genotype 1 account for 55%. The conventional treatment of Ribavirin with interferon usually leads to side effects of fever, muscle pain and anaemia; and the cure rate is just 70%. The new oral drugs can be used alone, with minor side effects. Most importantly, the cure rate is over 90%. The new drugs can significantly reduce patients’ risks of cirrhosis and liver cancer.
Shih Ru-Liang, an official of the NHIA, expressed that the NHIA has already called an expert meeting to discuss this issue. The expert meeting concluded that the treatment is too costly; however, if the drug companies can reduce the price to NT$300,000 which is similar to the price in South Korea, then the NHIA will try to ring-fence a 10-year budget of NT$80 billion for treating hepatitis C genotype 1b. About 135,000 patients a year will benefit from the public-funded new treatment.
Shih Ru-Liang said that to prevent the expensive medicine from being wasted by patients, the NHIA is considering introducing a deposit system to encourage patients to go through the complete treatment course. Patients will pay NT$10,000 monthly as a deposit and will get their money back if they complete the treatment course. Those who have financial difficulties can get help from patients’ organization.
Lin Jun-Yen added that 60 countries have signed the “Glasgow Statement” in last year’s World Hepatitis Summit. The delegates vowed to reduce the number of new cases of hepatitis B and hepatitis C by 90% before 2030, and to reduce the number of mortality cases of hepatitis B and hepatitis C by 65%. A new research in Taiwan revealed that those targets can be achieved in Taiwan by replacing conventional treatment with the new drugs for hepatitis C and increasing the access to the new drugs by 300-400%.