The National Health Insurance Administration’s (NHIA) capping of psychiatric patients’ prescription medication expenses at NT$55 per day violates both the spirit of the NHI and basic human rights, several civic groups said this week.
People who will be affected by the agency’s announcement include those with chronic mental illness, categorized as a major illness, and those who suffer from dementia, major depression, bipolar disorder, schizophrenia and autism, the groups said.
Several organizations, including the NHI Civic Surveillance Alliance, the Taiwan Association for Human Rights and Taiwan Alzheimer’s Disease, said that if the policy, now in place in central Taiwan, is to be implemented nationally, it would take a toll on more than 1 million people.
Each kind of disease needs a particular kind of treatment and medication, depending on how serious a condition the patient is in, which makes it almost impossible to standardize the amount according to a few hospitals’ averaged drug expenses, the groups’ statement said.
“The condition of some might be stabilized by a therapy that costs NT$38, but some would need one that requires thousands of dollars to achieve the same state,” NHI Civic Surveillance Alliance spokeswoman Eva Teng (滕西華) said.
“NT$55 for daily drug expenses is backtracking on human rights, and it would make a socially vulnerable group unable to benefit from new drugs. Patients would either have to pay out of pocket or suffer the onset of the diseases and be sent for long-term hospitalization,” she said.
Foundation for the Welfare of the Elderly secretary-general Wu Yu-chin (吳玉琴) said that the just-ended NHI global budget negotiations “championed the fair distribution of medical resources and care for vulnerable groups. And the vulnerable include those with major illnesses and injuries, of which the group of psychiatric patients is the second-largest in number.”
In response, the NHIA said that the policy was intended to curb some psychiatry departments that have been found to excessively prescribe expensive drugs, without appropriate and necessary records and documents to support their use.
Shen Mao-ting (沈茂庭), director of the agency’s Medical Review and Pharmaceutical Benefits Division, said that the cap, which for the medical centers is NT$69, is an averaged amount that has been carefully evaluated.
The agency stated that 90 percent of hospitals will not be affected by the policy, which is aimed at reining in unreasonable use of high-priced drugs or multiple prescriptions.