In a forum held by the Taiwan Society of Regulatory Affairs for Medical Products (TSRAP) and the Taiwan Total Cancer Care Foundation (TTCC), the panel pointed out that Taiwan is lagging behind other countries in access to new drugs, mainly due to insufficient investment in new drugs and the National Health Insurance (NHI) system’s resource allocation structure, which favours existing drugs. As a result, the listing of new drugs under Taiwan’s NHI is slower and the number is fewer than the international average. The stakeholders agreed that urgent reform is needed to improve access to new drugs and to achieve the government’s goal of a “Healthy Taiwan.”
At the forum, a study conducted by PwC Taiwan and the TSRAP was presented. It examined the current status of access to new drugs in Taiwan and the associated policy challenges. The study revealed that in some advanced countries, such as the United States, Germany, and Japan, spending on patented new drugs accounts for 60–80% of total drug expenditure, whereas in Taiwan this figure is only 40%. There is still room for improvement.
Dr. Kang Zhao-Zhou, President of the TSRAP, noted that Taiwan provides a high standard of healthcare; however, treatment outcomes will be affected without the support of new drugs. He emphasized that new drugs play a vital role in achieving the government’s target of reducing cancer mortality by one-third. He also pointed out that the current NHI drug fee structure is dominated by older drugs. Amid the ongoing reshaping of the global supply chain and fluctuations in drug prices, he warned that failure to adjust policies accordingly could affect patients’ access to new drugs and treatments. Therefore, Dr. Kang proposed four broad directions: optimizing the budgetary structure, reforming the pricing and payment system, improving drug review efficiency, and establishing a national new drug index - all aimed at ensuring timely access to new drugs.
Dr. Chen Shih-Chung, Minister without Portfolio of the Executive Yuan, stated that the government has finalized the direction of its new drug policy, which will build on the success of introducing new treatments for hepatitis C. He noted that the government will continue to allocate resources to disease screening and treatment. In the short term, there may be a surge in drug expenditures; however, in the long term, this approach will help improve public health and sustain the financial stability of the NHI system. In addition, the individual hospital global budget system implemented in 2025, the establishment of a human biobank, and the third generation of the long-term care system will collectively contribute to a comprehensive healthcare system covering disease prevention, treatment, and care.
From the patients’ perspective, Dr. Chang Wen-Chen, CEO of the TTCC, stated that the NT$10 billion cancer drug fund has set a milestone in Taiwan’s drug policy. He added that the government should accelerate the introduction of risk-sharing and outcome-based payment mechanisms so that effective new drugs can be made available more quickly under the NHI. Dr. Chang also suggested using real-world data (RWD) to support decisions on expanding drug indications and establishing a mechanism for withdrawing ineffective drugs.
Legislator Wang Cheng-Hsu (DPP) noted that as demand for new drugs for cancer and other serious diseases increases, the government needs to adopt a forward-looking approach to regulation and budgeting. He emphasized that the Legislative Yuan and the Executive Yuan should continue their constructive dialogue to strengthen the new drug review and reimbursement system, thereby facilitating the introduction of innovative drugs into Taiwan’s healthcare system.
Dr. Chen Lian-Yu, Director-General of the NHIA, pointed out that NHI drug expenditures increased from 130.1 billion points in 2009 to 167.7 billion points in 2025. In response to the financial strain posed by an ageing population, the government has allocated an annual budget of NT$10.438 billion for new health technologies this year, while also advancing the health technology assessment (HTA) system through the establishment of a national HTA center.
Dr. Yang Chi-Hsin pointed out the gap in actual access to new drugs. Taking lung cancer as an example, he noted several gaps in treatment, including the lack of targeted therapies or immunotherapies for early-stage lung cancer, as well as limited access to various new treatments for gene mutations. He stressed that spending on new drugs should be regarded as a long-term investment in national competitiveness.
Dr. Chen Fang-Min also pointed out that targeted therapies play a crucial role in reducing mortality. He suggested that Taiwan’s treatment policies should be aligned with international guidelines. Furthermore, financial and management systems should be made more flexible and dynamic to ensure patients have stable access to medications.
Prof. Ou Huang-Tz stated that Taiwan’s new drug launch time is not significantly different from the international average; however, the waiting time for inclusion in the NHI reimbursement scheme is considerably longer, particularly for cancer drugs and treatments for rare diseases. She noted that review efficiency could be improved by applying more scientific assessment methods and enhancing transparency in the review process.
Many experts have called for the establishment of key performance indicators (KPIs) for new drug policy. These KPIs should include the waiting time between drug approval and NHI listing, coverage rates, the proportion of spending on new drugs, and patient outcomes, among others. They also suggest a minimum annual growth of 3–5% in the new drug budget. A survey showed that about 70% of patients are willing to partially share drug costs in exchange for earlier access to innovative treatments. However, such a mechanism should be designed with careful consideration for financially vulnerable populations.
The panellists all agreed that access to new drugs is not just a healthcare issue; it also affects national health, the sustainability of the NHI system, and national competitiveness. The government has no choice but to accelerate reforms, improve resource allocation, and establish a long-term monitoring system in order to maintain its advantages in the global market and ensure timely access to the best available treatments for patients.
【2026-04-16 / Economic Daily】
