Reported by Chen Yu-Hsin from Taipei
Are new cancer drugs a miracle cure? There are common myths of new and expensive drugs. Dr Wang Cheng-Hsu, President of the Hope Foundation, expressed that though he has been campaigning for including new cancer drugs into the NHI Benefit Scheme, he would like to remind patients of not being too optimistic about new cancer drugs. There should be an overall assessment of each cancer case; and treatments should be prescribed according to doctors’ assessment and treatment guidelines. New cancer drugs are not the only remedy, said Dr Wang
Cancers have been the number one cause-of-death in Taiwan for years. The medical and pharmaceutical industries have been dedicated to the search for new cancer treatments. However, new treatments always come with a huge price tag.
In order to prevent the “financial side effect” of new cancer drugs, each patient’s treatment needs should be assessed individually and comprehensively. This year, the NHI’s ring-fenced budget for new drugs is NT$2.5 billion. As new cancer treatment costs a patient about NT$100 thousand a month, it is a tough job to decide which new drugs have the priority over others to be reimbursed.
Doctors hope to give patients the most effective treatments; however, they have to take into account factors such as drug resistance, relapse, etc. How to formulate a fair reimbursement guideline and to spend the resources wisely and efficiently is a challenge commonly faced by the governments around the world.
In order to contain the costs, the NHIA is studying the possibility of implementing the Managed Entry Agreement (MEA) and the Price Volume Agreement (PVA). The NHIA hopes drug companies would provide the data of overall survival of a new drug. If a patient outlives the median survival, the NHIA will consider the treatment effective, and will consequently make the payment. Otherwise, the NHIA will refuse to pay. Dr Wang Cheng-Hsu expressed that he partly supported the MEA system.
Dr Wang explained that he supported the MEA because it could help the NHI to cut spending. As for the reasons against the MEA, Dr Wang expressed that there would be concerns of moral issues as doctors might unethically prolong patients’ life so as to pass the reimbursement threshold.
Dr Lee Po-Chang, the Director General of the NHIA, suggested medical societies should establish treatment guidance for each individual cancer so as to make it clear for patients to follow.
In reply to Dr Lee’s suggestion, Dr Wang said that the treatment guidance for each cancer is already in place. Doctors need to assess each case and take into account the type of cancer, stage, patient’s age, health condition, financial issues, etc., before they can prescribe treatments through thorough communication with patients. However, the time and effort made by doctors for assessing each case are not paid by the NHI. As a result, some doctors could not afford, or be bothered, to carry out detailed assessment, hence, opt for the easiest way by prescribing the newest and most expensive drug.
Any efficacy claim of a new treatment should be backed by sufficient clinical evidence. The Hope Foundation will continue to educate the public and disseminate accurate knowledge about cancers.
The Access to New Cancer Drugs Forum is to be held in Taipei City and Kaohsiung City. The organizer welcomes cancer patients, families, friends and anyone who is concerned about this issue to attend the discussion meetings.
The Access to New Cancer Drugs Forum
Taipei City
Time: Saturday, May 19, 13:30-16:30
Place: B1 Lecture Hall, NTU Children’s Hospital
Kaohsiung City
Time: Saturday, June 16, 14:00-17:00
Place: First Conference Room, 6F, Chuan-Chi Building, KMU Chung-Ho Memorial Hospital
【2018-05-07/United Daily】
