Reported by Chiang Hui-Chun from Taipei
The NHIA announced the results of the 2016 Drug Price and Volume Survey on Friday (3rd) and the consequential price cut on 7,331 drug items, as well as a price increase in 332 drug items. The average price reduction rate is 3.5%. The NHIA estimated that this price cut could lead to a saving of NT$5.71 billion on drug fees. About 5 million patients’ medications are to be affected. There is a concern that hospitals might change their formulary lists.
The NHIA started piloting the “Drug Expenditure Target (DET) System” in 2013. Under the DET system, drug prices are adjusted according to the actual drug transaction prices and profits between hospitals and manufacturers in the previous year. Shih Ru-Liang of the NHIA expressed that the NHI drug expenditure in 2016 was NT$5.71 billion over the expenditure target; hence, the NHIA brought about this price cut.
The top five drugs subject to the heavies price cut are all for chemotherapies, including Oxaliplatin Injection, Zoladex LA 10.8 mg, Phyxol Injection 6 mg, Formoxol Injection and Genetaxyl Crem Less Injection 6mg.
This price cut also hit some popular drugs for “three-high conditions” and chronic conditions. For example, the price of Cresto is reduced from NT$22.7 to 20.9, Plavix from NT$45.4 to 42.4 and Norvasc from NT$6.4 to 5.7.
Shih Ru-Liang expressed that as more and more new cancer drugs are available and the patents of some original drugs expired, cancer drugs face the highest price cut by the NHIA. The NHIA will direct the savings on drug fees to the reimbursement of new drugs or more relaxed reimbursement regulations, for example, increased access to hepatitis B drugs. The prices of some drugs are adjusted based on the policy that drugs of the same ingredients and the same quality should have the same payment price.
According to Shih Ru-Liang, the NHIA has set the floor prices for some drugs so that manufacturers can recoup the reasonable costs. In addition to the guaranteed prices for tablets, capsules, suppositories, oral liquids and injections, the NHIA this year also set the floor prices for large volume parenteral (LVP) over 1L at NT$35, injections containing penicillin, cephalosporin or estrogen at NT$25, ophthalmic preparations at NT$12, eye lotions in daily dose packaging at NT$4, cream or ointment at N$10.
However, after the price cut, some drugs will be priced under NT$1, cheaper than a sweet even. Shih Ru-Liang explained that instruction drugs are not within the NHI reimbursement scope; therefore, the NHIA will not set a floor price for them. Shih stressed that as more and more new drugs are introduced into the NHI Benefit Scheme, an increase in the drug expenditure is inevitable. The price adjustment is a measure to contain the growth of NHI drug fees and to allow the NHIA to direct the resources to new treatments for severe diseases, rare diseases or age-related diseases.
【2017-03-04/ United Daily News】