The ECCT arranged a Premium Event lunch with Dr Lin Ching-Yi, Deputy Minister of the Ministry of Health and Welfare (MOHW). Deputy Minister Lin gave a presentation which covered recent and ongoing health and welfare developments in Taiwan and related policies and reforms.

She began by summarising the main challenges facing National Health Insurance Administration's (NHIA) drug coverage. A limited budget and the rising costs of drugs are the principal challenges. Another challenge is ensuring a stable supply of essential drugs, which requires strengthening the supply chain and enhancing local production. The problem of limited and uncertain evidence of the efficacy of new drugs makes it difficult to make decisions on them. Finally, Taiwan's ageing population and advances in health technology are both increasing demand for medical care.

The government's key strategies to accelerate the inclusion of new drugs under the NHIA are to: 1) Increase the budget for new drugs and special funds for provisional listing of drugs; 2) Implement a parallel review process in the Taiwan Food and Drug Administration (FDA). In this regard, a process for specific items has been in place since 1 January 2024, allowing market authorisation (MA) holders to apply for proposed reimbursement to the NHIA simultaneously while applying for new drug registrations. This is aimed at shortening the waiting time for NHI reimbursement to within six months after market authority is issued; 3) Reforming the Health Technology Assessment (HTA) organisation: In this regard, the Center for Health Policy and Technology Assessment (CHPTA) was established on 1 January 2024; 4) Establish a Provisional Listing Fund for New Drugs, another dedicated fund to alleviate the financial burden on cancer patients and serve as a financial buffer for the NHIA and 5) Promote Provisional Listing: Through risk-sharing agreements with pharmaceutical companies, the NHIA will provide conditional listing within the NHI global budget. After collecting real-world data, the clinical benefits will be re-evaluated through Health Technology Reassessments (HTR) to determine whether the drugs should be fully covered by the NHI.

Following the establishment at the beginning of the year of the CHPTA as a dedicated office, in the future, authorities plan to establish the "National Health Technology Assessment Center" as an administrative agency to strengthen HTAs. This is aimed at accelerating the review of new drugs for NHIA inclusion and facilitating collaboration with international organisations, such as the UK's National Institute for Health and Care Excellence (NICE), to align with global clinical guidelines.

With the rapid advancement of health technology, advanced services such as robotic-assisted surgery and AI applications are emerging. These technologies need to be assessed through HTAs before being incorporated into the NHI. For health services that are expensive, have a significant impact on NHI funding, or have unclear effectiveness compared to current treatments, or require further information, a comprehensive HTA must be conducted. The assessment criteria include efficacy, safety, cost-effectiveness, cost adjustment, and financial impact.

Regarding cancer drugs, starting in 2025, the NHIA will reallocate NT$5 billion from the government budget to the NHI fund specifically for a provisional listing fund for new cancer drugs. This fund will serve as a buffer for cancer drugs or new indications that address significant unmet medical needs and have therapeutic potential, but for which clinical benefits or financial impacts remain uncertain.

The speaker went on to talk about the challenges related to Taiwan's ageing society and low birth rate and policies to address this. To address the increasing need for long-term care services, authorities are working to integrate medical care and long-term care services in communities in a seamless manner to allow individuals to receive timely and continuous care. For individuals with disabilities or dementia, services can be obtained from medical, long-term care, and care institutions based on their needs. To facilitate the integration of medical and long-term care services, the MOHW is implementing a discharge planning programme that transitions patients from hospitals to long-term care services and provides patients with care in their homes.

The deputy minister made the point that 80% of these diseases can be prevented through lifestyle changes such as giving up smoking, proper nutrition and exercise. In response, the MOHW is promoting the so-called "8-Year 888 Program," which aims to enrol 80% of patients with the three "high conditions" (high blood pressure, high cholesterol, and high blood sugar) into the care network over eight years. Within this network, 80% will receive lifestyle consultations. Of those who receive lifestyle consultations, it is hoped that 80% will be able to effectively control their three high conditions.

To increase the prevention of cancer, the MOHW has identified several key cancers, and is strengthening related screening and prevention and control efforts. This includes lowering the screening criteria for these cancers, introducing HPV testing services for women aged 35, 45 and 65 and adjusting some screening fees to encourage healthcare institutions to proactively identify potential cases early.

A number of programmes have also been introduced to improve maternity and infant care, especially subsidies to cover healthcare costs for children up until the age of six.

In the Q&A session, Deputy Minister Lin expressed support for including a wider range of stakeholders, including industry representatives, in discussions about healthcare policies. She also stressed the importance of international cooperation and data sharing.