Pharmaceutical News
Who decides which drugs to be reimbursed by the NHI?
2018/09/30

Written by Yang Chi-Liang/ Former DOH Minister

Taiwan is very proud of its NHI system, which is the result of all stakeholders’ efforts.  However, the NHI has encountered problems which need to be solved immediately.

Article 1 of the NHI Act clearly states that the purpose of the NHI system is to enhance the nation’s health by providing healthcare services.  Patients are supposed to be the centre of the NHI.  Yet, their rights have been overlooked by the system; and that’s one of the problems of the NHI. 

New drug technology has been advancing swiftly over the past few years.  As more and more innovative therapies are brought to the market, it gives patients new hope.  For example, the precision medicine, which combines conventional examinations, biological tests and genome database analysis, is able to find out the most suitable treatments and drugs for individual patient, and make the most efficient use of the healthcare resources.

As the NHI resources are limited, how to improve the accuracy of the precision medicine becomes a key issue.  Take the latest immunotherapy for example, there has been discussion about the reimbursement criteria, such as first 3-month free, biomarker evaluation, etc.

Meanwhile, patients should be involved in the discussion and be kept well informed of all proposals.  After all, the treatments are for them; and their preference should be taken into account by the NHI.

As the annual NHI Global Budget negotiation is to roll out, the budget for new drugs will surely be on agenda for discussion.  What’s more important is the execution of the budget.  Any unspent money of the budget for new drugs is pooled into the global budget.  This actually affects patients’ rights.

Every dollar of the budget for new drugs is the results of the patients groups’ efforts; hence, it should be spent properly on new drugs.  Any unspent money should be retained for next year’s budget for new drugs.

Also, patients’ voices have to be heard.  At present, the NHI Board has two seats for patients groups.  However, these seats are not reserved.  Patients are not guaranteed to be involved in the decision-making process.

The Taiwan Alliance of Patients’ Organizations, therefore, urges the NHI Board to reserve at least two seats for patients so as to make sure that patients’ voices are heard.

The NHI system is our pride and treasure.  Though more and more new drugs are included into the NHI Benefit Scheme; they may not be right for everyone.  It is important for doctors and patients to work out a most appropriate treatment scheme.  Hence, patients’ opinions are crucial to achieving a win-win situation for the NHI, the government and, foremost, the patients.

【2018-09-24/ United Daily News】