The National Health Insurance (NHI) is to include more medicines for cancer, osteoporosis, chronic kidney diseases and other diseases, the National Health Insurance Administration (NHIA) said yesterday, adding that the initiative would take effect on Feb. 1 next year at the earliest.
As the number of people with high blood pressure, diabetes and obesity in the nation rises and the onset age of kidney diseases decreases, increasingly more people are on dialysis.
About 100,000 Taiwanese are on kidney dialysis — the highest rate of kidney dialysis patients per capita in the world — and the treatment could cost the NHI system up to NT$50 billion (US$1.53 billion) per year, the agency said, citing data from the Health Promotion Administration.
Photo: Chiu Chih-jou, Taipei Times
NHIA Director-General Shih Chung-liang (石崇良) yesterday said that NT$5.95 billion would be allocated to the NHI fund for reimbursement of drugs for cancer, osteoporosis, chronic renal diseases and other diseases, and it is expected to benefit more than 310,000 people.
A medicine to be included in the NHI benefit catalogue is sodium–glucose cotransporter-2 inhibitors, which could delay deterioration of kidney diseases and reduce the risk of heart failure in clinical trials, he said.
It would be reimbursable for patients with a glomerular filtration rate of 25 to 60, expected to prevent their conditions from worsening to the extent that dialysis is inevitable, Shih said.
However, people would not be eligible for reimbursement without signing up for an early-stage chronic kidney disease integrated care program or a care and health counseling project for patients with renal disease, he said.
The agency would require people to change their lifestyle and track their renal function to qualify, he said.
The reimbursement is projected to benefit 153,000 patients with renal diseases, while the listing of medicine for chronic systolic heart failure would benefit 16,000 people, Shih said, adding that the annual total expenditure would be up to NT$1.6 billion.
In terms of cancer drugs, immune checkpoint inhibitors, or immuno-oncology (IO) therapies, were added to the catalogue, including durvalumab and tremelimumab, which are applicable to patients with liver or bile duct cancer, Shih said, adding that it would benefit 1,938 people with an annual expense of about NT$1.28 billion.
The combination of durvalumab and tremelimumab is a dual IO therapy applicable to liver cancer based on international standards, he said.
For the first time, IO therapies are to be approved for bile duct cancer, which is highly malignant and has few therapy options. They are to be used in small cell lung cancer as well, he added.
Trastuzumab deruxtecan would also be reimbursable for patients with human epidermal growth factor receptor 2-positive breast cancer, which is expected to benefit 1,172 people by saving NT$1.46 million of medicine expenditure per capita a year, Shih said.
The annual NHI reimbursement for the therapy would total NT$1.59 billion, he said.
Bevacizumab, a targeted therapy drug for colorectal cancer, would be listed as a second-line therapy and benefit 842 people, with an annual NHI reimbursement of about NT$202 million, he said.
As Taiwan ages, medicines for osteoporosis would be part of primary prevention for people with high-risk factors, he said, adding that secondary prevention would be expanded to cover people with radius or humerus fractures.
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