National Health Insurance Administration Director General Lee Po-chang said that compared to other types of cancer, the incidence rate for ovarian cancer is relatively low. However, it has become known that ovarian cancer is relatively more prevalent among woman in their 50s. Therefore, women of this age group should pay extra attention to gynecological and/or gastrointestinal symptoms and undergo regular health checks. Younger women are also susceptible to ovarian cancer and should undergo regular examinations as well to be aware of their health conditions.

Amid continued advancement in therapeutics, among which clinical trials on Poly (ADP-ribose) polymerase (PARP inhibitors) have produced promising outcomes for ovarian cancer patients with the BRCA1 and BRCA2 genetic mutations. Among the patients administered PARP inhibitors, 60 percent saw no recurrence of the cancer in the three years following treatment. In contrast, only 27 percent of patients in a control group were able to prevent recurrence successfully. While more time is still needed for further clinical trials, these findings are in no doubt encouraging for patients.

In facing the high cost of new cancer drugs, patient groups have advocated for the expense to be jointly shouldered by both patients and the government. Director General Lee has supported copayments in his individual capacity. “Abiding by the user-pays principle is the most practical solution, as people will really think about whether a treatment is essential when they need to pay a portion of the cost out of pocket,” Director General Lee was quoted as saying. “However, deciding the types of cancers and treatment options that should require copayments, as well as the details of how a copayment system should be set up remains a difficult topic for discussion.”

Director General Lee said that as the National Health Insurance (NHI) system’s annual drug expenditure continues to rise each year, the subsequent challenges of ensuring the system’s financial viability and debates on the allocation of resources would likely have to wait until the COVID-19 pandemic is under control. Currently, the NHIA is prioritizing cutting the squandering of resources on non-critical items and reallocating the savings to cancer patients.

For some precision medicine treatments for oncology, genetic testing is required to identify the most appropriate patients, which also brings the question on whether genetic testing should be reimbursed by the NHI.

Director General Lee said that if all patients undergo genetic testing, the amount of NHI expenditure would be immense. However, further calculations show that through comprehensive genetic testing, the patients who are most likely to respond to treatment can be identified and considered for reimbursement, resulting in significant cost savings through the cutting of unnecessary drug prescriptions and ultimately bring down overall NHI expenditure.

【2020-04-18 / United Daily News】