Last year, the medical expenditure for cancer treatment reached 139.9 billion NT dollars, with drug expenses accounting for 39.4 billion NT dollars. Chih-Liang Shih, Director of the National Health Insurance Administration, stated that the overall growth rate of the National Health Insurance budget is less than 4%, while the average growth rate of cancer drug expenses exceeds 9%. This indicates a significant burden of cancer drug costs, particularly as precision medicine has rapidly advanced in recent years. Many new drugs obtain approval during phase II clinical trials, but their efficacy evidence still requires clarification. To address this, the National Health Insurance Administration has established the "Health Policy and Medical Technology Evaluation Center" to conduct medical technology assessments and hopes to establish a precise medical ecosystem through the coverage of Next-Generation Sequencing (NGS).
At the 2024 Cancer Summit hosted by the United Daily News, Shih, speaking on "Cancer Health Insurance Policies Regarding New Drugs and Technologies," stated that the National Health Insurance has covered 162 cancer drugs, including 63 targeted therapies and cell therapies priced at 8.19 million NT dollars per dose. Targeted therapy accounts for the highest proportion of drug expenses. Evaluating their efficacy and identifying precise medication for patients will be crucial. To expedite cancer patients' access to the latest and best drugs, the National Health Insurance Administration has increased the budget for new drugs from 3 billion to 7 billion NT dollars from last year and is planning to establish a parallel review mechanism for cancer drug genetics to accelerate the operational process.
Starting from May 1st, the National Health Insurance will begin covering NGS, intending to cover 19 types of cancers. It will be divided into three modes based on the size of genetic segments: BRCA, small panel, and large panel, with reimbursements of 10,000, 20,000, and 30,000 points respectively. Shih mentioned that currently, the National Health Insurance only covers over 30 genetic loci for drug applications. The large panel coverage will include testing for over 100 genes, aiming to enable patients to receive new drugs early or participate in clinical trials when they become available. Additionally, NGS test results will be uploaded to the National Health Insurance database, facilitating cross-hospital treatments for cancer patients or referrals to new drugs in clinical trials, thus accelerating drug development and enabling early drug use for patients.
Furthermore, Shih emphasized that disease screening is an important way to prevent precancerous lesions. Through screenings and treatment plans for hepatitis B and C, as well as H. pylori screening, the Ministry of Health and Welfare aims to reduce the incidence of liver and gastric cancers. The National Health Insurance Administration will expand the qualification for H. pylori medication coverage in the second half of this year. People who test positive for H. pylori through breath carbon-13 or fecal antigen tests without undergoing gastroscopy will be eligible for coverage.
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