The National Health Insurance Administration (NHIA) on Aug. 20 held a Pharmaceutical Benefit and Reimbursement Scheme Joint Committee (PBRS) meeting, where with the joint efforts by medical service providers, payer and patient group representatives there was agreement to expand reimbursement standards and to reimburse a number of new drugs under the National Health Insurance (NHI) system. The newly approved new drugs include those treating ovarian cancer, triple negative breast cancer, follicular lymphoma and medullary thyroid cancer. Reimbursement standards have also been expanded for a biologic to treat moderate to severe pemphigus vulgaris. Pending administrative process, the new reimbursement terms are expected to take effect on Nov. 1, 2020.
According to the latest Ministry of Health and Welfare data, breast cancer is the most prevalent cancer among women in Taiwan. Clinical statistics show that around 15 percent of breast cancer patients are diagnosed with triple-negative breast cancer. As the disease has higher prevalence among younger women, high metastatic potential, high recurrence rates and lower survival rates, triple-negative breast cancer has earned the moniker of the “most deadly kind of breast cancer.” As a result, the PBRS agreed to provide NHI reimbursement for Olaparib, a PARP inhibitor, for late-stage breast cancer patients with the BRCA1/2 gene mutations who are undergoing first-line treatment alongside maintenance therapy with platinum-based doublet chemotherapy, as well as triple-negative breast cancer patients who have not responded to chemotherapy. Olaparib is the first targeted therapy drug to be included under NHI reimbursement, making Taiwan the first to provide reimbursement for Olaparib, earlier than the health technology assessment reference countries of England, Canada and Australia, benefiting an estimated 150 patients who are expected to see quality of life improvements.
In addition, clinical data show that Copanlisib brings improved treatment outcomes for follicular lymphoma, with a 59-percent response rate among adult patients with relapsed follicular lymphoma, superior to conventional treatments. To address clinical needs, the PBRS agreed to provide NHI reimbursement for Copanlisib. Around 113 patients are expected to benefit from the change, while a follow-up review on the reimbursement pricing for Copanlisib is due in two years’ time.
The PBRS also approved vandetanib for the benefit of patients with metastatic medullary thyroid cancer with regional lymph node involvement who cannot undergo surgery.
The NHIA said that apart from the three aforementioned new drugs, the PBRS also expanded reimbursement for rituximab, a biologic, to cover treatment of moderate to severe pemphigus vulgaris, which can help patients avoid side effects stemming from a reliance on prolonged treatment with high dosage steroids. Clinical studies show that patients administered rituximab for 24 months have an 89 percent chance of seeing their symptoms subside enough to halt treatments. An estimated 600 patients will benefit from the decision.
The NHIA said that it will continue to ensure the interest of disadvantaged groups and allocate limited medical resources reasonably towards the most effective treatments.
[2020-09-08 / NHIA]
