When asked if he supports raising National Health Insurance (NHI) premiums, Minister of Health and Welfare Chen Shih-chung did not give a positive response in his exclusive interview with ETtoday, saying only that NHI financial planning is the remit of the National Health Insurance Committee and that right now, the Ministry of Health and Welfare’s (MOHW) goal is to balance NHI finances at a time where expensive new drugs are being launched at an increasing pace.
On drug expenditure, Minister Chen said that his position has consistently been to reimburse drugs that are effective. When asked about the definition of effective, Minister Chen raised as an example the policy to eliminate hepatitis C. “Orally administered direct-acting antivirals are probably the only drugs rolled out in recent history that can completely cure a disease, which is why we have been boldly investing in these treatments.” The efficacy of targeted therapy and immuno-oncology treatments, on the other hand, should be validated prior to reimbursement. “We don’t want to end up paying for 10 when treatment works only for one. This is why ‘precision medicine’ is so important.”
In an effort to identify “effective” drugs, the MOHW this year commissioned the National Health Research Institutes (NHRI) to design a “precision medicine trial program” wherein genetic testing and cancer drugs will be combined. A “life bank” will be established in the near term for researchers to analyze 6,000 genes in order to identify, for reimbursement, drugs to which most genes react. “If this system proves successful, the authorities will be more confident in reimbursing expensive drugs,” Minister Chen confided.
At the helm of the trial program, NHRI Institute of Population Health Sciences Director Chao A. Hsiung said that the program is still under planning but the focus will be on cancer; rare diseases are currently not part of the scope. Aiming for industry-government-academia cooperation, the institute is currently not at liberty to disclose the budget it needs, but further details will be announced at year-end for interested parties to come forward.
The program will have two components, one of which is to zero in on the most common types of cancer in Taiwan and to invest resources in R&D for strongly needed cancer treatments, Director Hsiung said. Just as lung cancer patients who have been confirmed with EGFR mutation are eligible for NHI-reimbursed targeted therapies, the upcoming program will aim to establish reimbursement policies by leveraging companion genetic diagnostics.
【2019-10-19 / ETtoday】
