Chang Po-sheng (張博勝), Chief Honorary President of the Taiwan Pharmaceutical Marketing and Management Association, has expressed strong support for Minister of Health and Welfare Shih Chung-liang’s recent proposal to consider legislative amendments introducing differential copayments for medicines. Under the proposed system, patients could pay the difference between the amount covered by National Health Insurance (NHI) and the price of a medicine from their preferred brand.

Chang emphasized that differential copayments do not imply that originator drugs are superior to generic drugs. Rather, price differentiation would give generics a genuine price advantage while restoring patients’ freedom to choose among brands. Under the current system, originator and generic drugs containing the same active ingredient are often priced at the same or similar levels, leaving patients with little financial incentive to choose generics. If clear price differences existed among brands, patients could consult their physicians and pharmacists and select an appropriate medicine based on efficacy, adverse effects, and affordability.

Chang further noted that, if the system genuinely ensures patients’ freedom to choose among brands, healthcare institutions may need to move away from purchasing a single brand and instead stock multiple brands containing the same active ingredient. This would not only facilitate shared decision-making between patients and healthcare professionals, but also allow other brands to fill supply gaps when an individual manufacturer experiences a shortage, thereby reducing dependence on a single source and strengthening pharmaceutical supply resilience.

The system could also change healthcare institutions’ longstanding emphasis on the profit margins generated by differences between procurement prices and NHI reimbursement rates. Procurement decisions could instead take into account quality, supply reliability, patient acceptance, and trust in particular brands, encouraging the market to shift from price-based competition toward value-based competition.

Nevertheless, supporting measures would be essential. Healthcare institutions should be required to offer at least one medicine for which no additional payment is necessary, disclose the prices of different brands and the corresponding patient-paid differences, and protect disadvantaged groups to prevent the creation of a tiered healthcare system. Chang views the proposed legislative amendments as an important opportunity to reform the NHI pharmaceutical system while balancing patient rights, pharmaceutical supply resilience, industry development, and the long-term sustainability of the NHI system.

【2026-09-08/The Liberty Times】