Reported by Lee Shu-Jen from Taipei

From April 1st, 3 immunotherapies will be available under the NHI, with a budget of NT$800 million for this year for the treatments of 10 indications of 8 cancers at advanced stage. The NHIA estimated that about 800 patients are to benefit from the new regulation.

This news is welcomed by patients as some of them are currently paying for the treatments which cost about NT$2.5 million a year.   The NHI will help to reduce the cost by NT$0.5 million a year for every qualified patient.  Due to the budget constraint, only a limited number of patients will receive the NHI-reimbursed treatments.  Dr Lee Po-Chang, the General Director of the NHIA, suggested that patients with advanced cancer should consult their doctors about the availability of the NHI-reimbursed treatments as soon as possible, and request the doctors to file an application for the treatments if they are eligible for the reimbursement.

Dai Xuei-Yung of the NHIA expressed that the 3 immunotherapies are to be reimbursed for 8 cancers, including melanoma, non-small cell lung cancer (first to third-line treatment), classical Hodgkin lymphoma, urothelial carcinoma (first and second-line treatment), recurrent or metastatic squamous cell carcinoma of the head and neck (second-line treatment), advanced renal cell carcinoma (third-line treatment), advanced hepatocellular carcinoma (second-line treatment ) and metastatic gastric cancer (third-line treatment).

Dai Xuei-Yung pointed out that in order to maximize the benefit of the immunotherapies, all applications received by the NHIA will be reassessed by another doctor to ensure the patient’s liver function and health condition are suitable for the treatments.

Patients with advanced non-small cell lung cancer, squamous cell carcinoma of the head and neck or urothelial carcinoma will have to take the PD-L1 biomarker testing.  Those whose results are over 50% will then be considered for the reimbursement.  Patients with other cancers are exempt from this additional test, giving them an advantage in the application procedure.

The NHI reimbursement regulation stipulates that each patient is eligible for only one immunological checkpoint inhibitor for each cancer.  Exchanges of treatments or the concomitant use of target therapies are not allowed.   If the treatment is ineffective for a patient, the NHI will not provide him/her any other target therapies for the same indication.

The maximum treatment course is 52 weeks.  The NHIA only accepts electronic applications.  A prior-approval is required for the reimbursement.  Patients who receive the NHI-reimbursed immunotherapies will be assessed once every 12 weeks.  Those whose conditions are stable will be given another 4-week treatments; and the treatment course may be extended into another 12 weeks if the results are satisfying.

【2019-03-15/ United Daily News】