Reported by Lin Hui-Cin from Taipei
According to the NHIA, the decision on whether the new drugs for hepatitis C will be available under the NHI scheme is to be concluded in October.
The prevalence rate of hepatitis C is about 4% in Taiwan. The new oral treatments require fewer administrations, and offer a higher cure rate (over 90%) with fewer side effects than the conventional concomitant treatment of long-acting Interferon and Ribavirin. However, the new oral drugs come with a huge price tag. Therefore, many people welcome the news that the MOHW is now considering including the new treatments into the NHI reimbursement scheme.
This issue was on the agenda for the PBRS meeting on the 18th. The meeting was moderated by Janice Chen. Chen expressed that there were four suggestions on the funding of the new treatments: 1. the budget for public affairs, 2. the budget for public affairs + the NHI global budget for other departments, 3. the budget for public affairs + the NHI global budget for other departments + co-payment, 4. the NHI global budget for other departments + co-payment.
Janice Chen pointed out that the first option is to fund the new treatments by the budget for public affairs. However, the administrative procedure will delay the implementation until 2018. If the authority intends to start the reimbursement from next year, the option of using “the budget for public affairs + the NHI global budget for other departments + co-payment” is more feasible.
As for the co-payment rate, a proposal of 20 -30% was put forward in the Joint Meeting. It means every patient will have to pay NT$50,000-75,000 for a treatment course provided that the payment price of NT$250,000 is accepted by the drug companies. Details will be discussed in the NHI Board Meeting scheduled in September; and the results will be discussed in the Joint Meeting in October for conclusion.
Janice Chen stressed that Taiwan has a higher prevalence rate of hepatitis C than other countries; and there is a consensus on the cost-effectiveness of the new treatments. However, the funding method has to be agreed. The NHIA suggests gradually including patients into the treatment scheme. The top priority will go to those who fail to respond to the concomitant treatment of long-acting interferon and Ribavirin. The new treatment will be gradually extended to those who have severe liver fibrosis and at high risk of liver cancer or cirrhosis, those who have received liver transplant, those who are waiting for liver transplant, those who have other systematic diseases, HIV-positive patients, etc. The NHIA estimates that 32,000 patients will be able to access the new treatments in 3 years.
It means that the new treatments for hepatitis C will cost the NHI NT$2.5 billion a year. The NHI global budget for other departments was just NT$10.4 billion last year. However, after paying other reimbursement items, there is not much left for the new drugs for hepatitis C, said Shih Ru-Liang from the NHIA.