Reported by Chiu Zong-Hao

After the drug companies’ announcements of withdrawing Prozac and Tienam from the Taiwan market, the NHIA is now considering revising the drug price adjustment formula, said Dr Lee Po-Chang, the Director General of NHIA.  Dr Lee promised that the price adjustment operation will be carried out more sensibly in the future; and the authority will take a flexible and individually-based approach to the management of drug prices.

Dr Lee Po-Chang pointed out that drug prices are adjusted according to a pre-determined formula.  In order to change the formula so as to protect the prices of certain drugs, the authority needs firstly to revise the relevant regulations.  For the time being, essential drugs will be handled separately.  The NHIA will also use the cloud-based patient medication records to closely monitor the situations of duplicate prescriptions with a view to reducing unnecessary spending.  Most savings will be directed to the reimbursement of new drugs.

Healthcare professionals often deride NHI-reimbursed drugs as being cheaper than sweets.  Dr Lee Po-Chang said that he was quite upset at hearing such a remark.  He conceded that when he was working in the hospital, he had complaints about drug price cuts.  But, after taking the office of the MOHW, he understood that drug price cut is a necessary measure for sustaining the NHI finance.

Low drug prices are actually the results of the market mechanism as some hospitals have the bargaining power to request lower prices from suppliers, said Dr Lee.    Taking Norvasc for example, the NHI reimbursement price is NT$5 per tablet; but the NHI survey data showed that some were sold at NT$1 per tablet to hospitals.  The profits from the price gap were pocketed by hospitals.  “It is not a good thing,” said Dr Lee.  He hoped that domestic drug companies could also enjoy a reasonable margin.

According to Dr Lee, the market share of the original Prozac is 24%, and the market is mostly dominated by generic drugs (76%).  The original manufacturer of Prozac is communicating with its head office in the US to work out a solution for patients in Taiwan who prefer the original drug. As for Tienam, it has a market share of 86% with just a few generics as substitutes.  Its withdrawal will certainly affect the patients’ treatment.  The NHIA will continue negotiating an agreement with the drug company.

【2019-03-22 / Commercial Times】