The eligibility for National Health Insurance (NHI)-covered spinal muscular atrophy (SMA) treatment would be expanded starting today, and is expected to cover about 90 percent of people with SMA, the Ministry of Health and Welfare said yesterday.
About 400 people in Taiwan have SMA, a rare genetic disease affecting motor neurons, nerve cells mainly in the spinal cord that control voluntary muscle movement. The disease causes progressive weakness and atrophying of muscles.
People with SMA, their families and pharmaceutical companies had urged the National Health Insurance Administration (NHIA) to expand the eligibility of the NHI’s coverage of SMA treatments to all affected.
Photo: Lin Chih-yi, Taipei Times
The health ministry in early March announced that it would ease restrictions for receiving NHI-covered SMA treatments this year, adding that the policy would commemorate the late human rights lawyer Chen Chun-han (陳俊翰), who had SMA and advocated for SMA patients’ right to affordable treatment. He died in February.
Three types of medicines are primarily used to treat SMA, including an intrathecal injection into the spine every few months, a daily oral medication and a one-time gene therapy treatment.
NHIA Medical Review and Pharmaceutical Benefits Division head Huang Yu-wen (黃育文) yesterday said the change in eligibility is for the spinal injection and the oral medication, which had similar eligibility criteria.
The eligibility has been expanded to include people who experienced the onset of symptoms at age 18 or younger, removes the requirement of Revised Upper Limb Module assessment score of 15 or higher and allows people to change their medication once if they have an intolerance to a drug, Huang said.
People with SMA can choose between a spinal injection or oral medication covered by the NHI, but considering the possibility of drug intolerance, they can switch to the other type once in their lifetime, she said.
Under the previous eligibility, only about 140 of the affected people in Taiwan met the criteria for NHI-covered spinal injection or oral medication, but the expanded eligibility is expected to cover treatment for about 250 more people.
The estimated medical expense for the policy in the first year would be about NT$2 billion (US$60.91 million) — an average of NT$6.6 million per patient per year.
Meanwhile, the health ministry earlier this month announced that it would expand a government-funded mental health counseling program, offering three free counseling sessions to people aged 15 to 30.
The program, launched in August last year, would be from today available to people aged 15 to 45.
In addition, starting today, a prescription drug refill limit would be expanded for crew members of long-distance fishing or international shipping vessels, whose chronic disease condition is stable, receive the same prescription drugs each refill and are also scheduled to leave within a month for maritime work for 90 days or longer, the ministry said.
The crew members would be allowed to refill their prescription drug for chronic disease for up to 180 days, and refills of prescription drugs for more than 180 days would also be allowed for special circumstances approved by the NHIA.
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