Reported by Huang An-Chi
In Taiwan, the number of newly diagnosed cancer patients reached 100,000 a year in 2014, at a rate of one new case every 5 minutes and 6 seconds. However, on average, patients have to wait more than two years for a new drug to be included in the NHI benefit scheme. Target treatments and immunotherapies are too expensive for patients’ access. The Hope Foundation for Cancer Care announced its proposal for increasing the accessibility of cancer drugs in Taiwan. The Foundation urged the government to increase NHI funding, stop reimbursing drugs for ailments, increase the reimbursement for cancer drugs, and consider implementing the co-payment system or using innovative commercial health insurance plans to increase the accessibility of cancer drugs.
Many patients and their families have to give up hope because treatments are too expensive to reach. As the NHI budget is limited, it is quite difficult for a new drug to enter the NHI benefit scheme. The Hope Foundation suggested that the government should consider stopping the reimbursement of drugs for ailments, such as cold and gastrointestinal problems. This will save the NHI about NT$20 billion a year. The government should also consider implementing the co-payment system on cancer drugs, and planning out a commercial health insurance scheme for cancer treatments.
Statistics show that only 55% of new drugs made their way to the NHI benefit scheme. This ratio is even lower for new cancer drugs, just 49%. The Hope Foundation’s survey results show that 45% of the respondents do not want to pay for new drugs completely out of their own pockets mainly because of financial pressure (65%). However, in order to include new drugs into the NHI benefit scheme, 67% of the respondents would like to pay NT$50 more for their monthly insurance premium, and 56% of the respondents agree with a higher co-payment rate for NHI-reimbursed drugs.
Janice Chen, the Chairperson of the NHI Drug Dispensing Items and Fee Schedule Joint Establishment Meeting, expressed that, on average, it takes one more year for cancer drugs to be listed by the NHI than non-cancer drugs. The Joint Meeting discusses the cost effectiveness of a new drug when making the decision of NHI reimbursement. To extend the life of one cancer patient for a year will cost the NHI about NT$1.4-2 million. The financial impact is rather huge, said Chen.
Wang Cheng-Hsu, the President of the Hope Foundation, expressed that the NHI budget is just 3.2% of the GDP in Taiwan. It is lower than the 7-8% in OECD countries, and far lower than the 14-15% in the US. Wang suggested increasing the monthly NHI premium by NT$50.
Wang continued that in Japan and South Korea, patients pay 30% of the drug fees as co-payment. The NHIA should consider implementing the co-payment system on expensive drugs and drugs for severe conditions so as to increase the accessibility of new drugs.
Shih Ru-Liang, a Section Chief of the NHIA, expressed that she personally supported the idea of selected reimbursement, i.e. no reimbursement of drugs for ailments. However, the society needs to form a consensus on this policy. As for the co-payment scheme, the NHIA official said that it is a feasible solution and should be considered by the NHIA.
【2017-05-17 / United Daily】