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Doctors urge government to revise NHI regulations

A recent study shows that among several Asian countries, Taiwan ranks last in cholesterol control and goal attainment, which could be attributed to inadequate funding by the National Health Insurance (NHI), doctors said in Taipei yesterday.

Doctors from several medical associations came together yesterday to urge the government to revise health insurance regulations to allow for early and continuous treatment of cholesterol control in an effort to lower the rate of cardiovascular disease.

Last year’s “Return on Expenditure Achieved for Lipid Therapy in Asia” study showed that the nation’s cholesterol goal attainment rate of 24 percent was the lowest among several Asian countries, including South Korea, Malaysia, Singapore, China and Thailand.

Those in high-risk groups, such as patients with diabetes or Coronary Artery Disease (CAD), achieved even lower rates of cholesterol goal attainment, with only about 16 percent of patients reaching their therapy goals, said Hwang Juey-jen (黃瑞仁), secretary-general of the Taiwan Society of Cardiology.

The American Heart Association says that a high cholesterol and fat diet is a leading cause of cardiovascular disease, which has ranked second to fourth in the leading causes of death in the nation in the past few years, Hwang said.

“Because of the current restrictions of the NHI system, Taiwan has a low goal attainment rate,” Taiwan Society of Lipids and Atherosclerosis president Chen Chao-wen (陳肇文) said.

The doctors urged government health officials to loosen the many restrictions on NHI coverage of cholesterol-controlling drugs, saying that it would decrease health expenditure and social costs in the long term if patients did not have to wait until the final stages of their disease to receive treatment.

Take for example patients in high-risk groups, such as CAD and myocardial infarction sufferers, Chen said. The low-density lipoprotein (LDL) goal is set at 100mg/dL, but NHI regulations stipulate that patients must wait until their LDL reaches 130mg/dL before they can receive treatment covered by the insurance, he said.

“By lowering the regulations by 20mg/dL, the risk of cardiovascular disease can be cut in half,” he said. “But if the NHI causes the patient to delay medication until the situation gets worse, it costs more for [the NHI] later to pay for the more expensive treatments involved in treating patients with cardiovascular disease.”
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