Reported by Chen Zi-Hua

Following the NHIA’s announcement of the latest drug price cut which is to take effect in April, Zuellig Pharma announced that Prozac 20mg will no longer be supplied to Taiwan.  This decision raised considerable concerns in the healthcare industry.

Prozac has been on the market for over 40 years.  The price for a 20mg tablet was NT$49 in 1995 when the NHI just started.  However, it spiralled down, especially after the expiry of its patent, to NT$2.08 last year.  According to the NHIA’s announcement, the new price will just be NT$1.96.

Lien Hung-Rong, a section chief of the NHIA, pointed out that there are 14 generic drugs available on the market.  The total claims of the drugs of the same ingredient as Prozac made to the NHIA in 2017 were NT$33.25 million.  Prozac accounted for 24% of the total claims with a patient population of about 15,000. The NHIA expressed that there are plenty of generic substitutes for Prozac.

However, Dr Chang Chia-Ming, the Secretary General of the Taiwanese Society of Psychiatry, said in an interview, ‘Doctors prefer original drugs to generic drugs because of its quality and effectiveness.  In theory, generic drugs should have similar therapeutic effects; however, our clinical experiences tell us otherwise.  Also, it is not easy to change patients’ medication.  The NHIA’s price cut will compromise on the medication quality.’

Dr Chang said that one of his patients used to take just one tablet of an original drug, now he needs two tablets of generic drugs for the same effect.  There are similar stories for hypertensives.  ‘The government is concerned about the unit price, but ignores the quality,’ said Dr Chang.

Shen Tsai-Ying, the CEO of the Taiwan Pharmacist Association, expressed that the NHI drug price cut seems to sustain the NHI system; but, it is actually a risky tactic as it may push international pharmaceutical companies out of the market in Taiwan.

Dr Chang said, ‘There must be a limit for the drug price cut.  It is incomprehensible that life-saving drugs should be cheaper than sweets. Some of our members suggest persuading drug companies to stay in the private market in Taiwan after withdrawing from the NHI so that patients could at least have an option.  We are now working on this.’

Prozac’s decision of leaving Taiwan is just the first case.  There could be more to come after the new drug prices take effect in April. 

【2019-03-18/ CMMedia】