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Multiple breakthrough new drugs included under NHI coverage, providing critically ill patients with new medication options

  The National Health Insurance Administration (NHIA) convened a meeting of the "Pharmaceutical Benefit and Reimbursement Scheme Joint Committee" (hereinafter referred to as the "PBRS Joint Committee") on August 20. With the joint efforts of the pharmaceutical industry, consumer representatives, and patient support groups, a number of new drugs have been included under NHI coverage, including the inclusion of new chemical entities for the treatment of ovarian cancer and triple-negative breast cancer, follicular lymphoma, and medullary thyroid cancer, and the elaboration of biologic drugs for "moderate to severe pemphigus vulgaris". Following the completion of administrative procedures, the scope of coverage is expected to take effect on November 1 this year.

  According to the latest cancer registration information published by the Ministry of Health and Welfare, breast cancer leads the top ten cancers prevalent among women in Taiwan. According to clinical statistics, about 15% are diagnosed with triple-negative breast cancer. Because of their younger age of onset, higher metastasis, higher recurrence rate and lower survival rate, the cancer is referred to as "the most malignant type of breast cancer." This time, the PBRS Joint Committee agreed to include under NHI coverage the oral PARP inhibitor Olaparib, which is suitable for maintenance treatment of advanced ovarian cancer with BRCA1/2 gene mutations combined with first-line platinum-based chemotherapy, and patients with triple-negative breast cancer who have received failed prior systemic therapies. The drug is the first targeted drug for triple-negative breast cancer to be paid by National Health Insurance, and it is included under coverage at an earlier date than the three major reference countries for health technology assessment(HTA), the United Kingdom, Canada, and Australia. It is expected that approximately 150 patients will benefit from the inclusion and experience improved quality of life.

  In addition, another new mechanism drug for the treatment of follicular lymphoma, Copanlisib, has a response rate reaching 59% after treatment in adult patients with recurrent follicular lymphoma according to clinical trials, and its effect is shown to be better than traditional follicular lymphoma treatment. Based on clinical needs, the drug was also agreed to be included under coverage after discussion at the PBRS Joint Committee meeting; however, the NHI reimbursable prices and coverage regulations for this drug will be reviewed again in 2 years. Meanwhile, it is estimated that around 113 patients will benefit.

  Among patients with thyroid cancer, which ranks seventh among the top ten cancers in Taiwan, those diagnosed with papillary cancer and follicular cancer account for the majority. Medullary cancer is a tumor derived from parafollicular C cells, for which the current treatment is mainly surgical resection. When the patient has disease progression or symptomatic cancer metastasis, however, surgery or radiation therapy is not suitable, therefore the PBRS Joint Committee meeting convened this time discussed and agreed to the inclusion of the new drug component vandetanib under coverage, which will benefit future patients with local invasion or metastatic medullary thyroid cancer that cannot be surgically removed.

  • Date:2020-09-08