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Lessons learned from the reimbursement policy for immune checkpoint inhibitors and real-world data collection in Taiwan

Published online by Cambridge University Press:  21 December 2020

Li Ying Huang Open the ORCID record for Li Ying Huang [Opens in a new window]  and
Churn-Shiouh Gau
Li Ying Huang
Affiliation:
Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
Churn-Shiouh Gau*
Affiliation:
School of Pharmacy, National Taiwan University/Former Chief Executive Director, Center for Drug Evaluation, Rm. 402, No. 33, Linsen S. Rd., Taipei10050, Taiwan
*
Author for correspondence: Churn-Shiouh Gau, E-mail: csg@ntu.edu.tw
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Abstract

This paper describes the reimbursement policy for immune checkpoint inhibitors in Taiwan and provides a perspective to improve the quality, consistency, and transparency of decision making. Global trends for cancer treatment have shifted from chemotherapies to targeted therapies and immuno-oncology (IO) medicine, leading to significant increases in treatment costs. To enhance the accessibility of advanced therapy, the Taiwan National Health Insurance Administration announced two pathways for high-cost medicine: the managed entry agreement and a set of general rules of reimbursement submission for high-cost drugs. To further manage the financial burden on Taiwan's national health insurance system, the policy makers introduced novel inhibitory drugs for cancer immune checkpoints, subject to a maximum annual budget of NT$800 million (≈US$26.7 million). In April 2019, a national registry was established for patients undergoing cancer immunotherapy. Clinical characteristics, treatment duration, toxicity, and the outcome of the postcheckpoint inhibitor treatments were recorded. By analyzing real-world data, we assess the therapeutic effect of IO treatment in Taiwanese patients, thereby enabling payers to adjust payment regulations and rules for reimbursement. The Health Technology Assessment Team plays an important role in drawing upon the evidence to support policy making. Under an implemented cost-management mechanism, Taiwan's high-cost drug policy has enabled patients to access new medicines and maximized patient benefits.

Keywords

Immune checkpoint inhibitorsNational health insuranceHealth technology assessmentReal-world data
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 37 , Issue 1 , 2021 , e26
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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