Reported by Liu Chia –Yun from Taipei
The NHI global budget was NT$660 billion in 2017. Among them, NT$150 billion were spent on drugs. The NHIA carries out an annual review and a consequent drug price adjustment every year in order to contain the increasing drug spending. This year’s drug price adjustment results were announced on May 1. This price adjustment affects 7,566 drug items, 90 of which are adjusted upwards and 7,476 are adjusted downwards. This price adjustment is expected to save NT$7.38 billion a year on NHI drug spending.
However, 9 out of the top 10 most-prescribed NHI drugs are facing a price cut, including Norvasc and Crestor. The public worry that this drug price cut may lead to a new wave of drug substitution in hospitals.
Chu Chien-Kuang, the Vice CEO of the Taiwan Healthcare Reform Foundation, expresses that some hospitals may substitute drugs, especially those for chronic conditions, with more profitable ones. He advises patients to check their medication collected after the implementation of the new drug prices, and see if their usual medication is changed. If so, they should enquire their physicians about the effectiveness, dosage, side effects, etc. of the new medication.
Dr Hsieh Yi-Chang of Lin-Kou Chang Gung Memorial Hospital points out that this price cut will hit hard on patients with the “3-hihg” conditions. Taking Crestor for example, it is a potent drug and is very effective in controlling LDL cholesterol. Other generics may not be as effective.
Dr Hsieh says that patients with hyperlipidemia and cardiovascular problems are susceptible to stroke and myocardial infarction. Therefore, they should be particularly careful about their blood cholesterol level control. In situations where the treatment results are compromised by the substitute drugs, patients should try to fill their prescriptions somewhere else, for example a bigger pharmacy which might still stock the patients’ usual medication. Patients should also raise this issue to hospitals.
【2018-05-02/ United Daily News】
