癌症為國人十大死因之首且發生率仍持續攀升，近年因癌症治療方式日新月異，明顯衝擊健保有限資源。為加速取得先進癌症藥品，並兼顧健保永續發展，衛生福利部健保署石崇良署長、國民健康署吳昭軍署長及財團法人醫藥品查驗中心(CDE)林時宜執行長等人，於本屆世界衛生大會(WHA)會前赴英國，拜訪英國國家健康暨照護卓越研究院 (National Institute for Health and Care Excellence, NICE)及英國國民健康服務署 (National Health Service, NHS)官員，就創新藥品基金(Innovative Medicines Fund, IMF)及癌藥基金(Cancer Drugs Fund, CDF)運作模式、醫療科技評估(HTA)、多元財務管控機制等議題進行交流，並由健保署署長石崇良、CDE執行長林時宜和英國NICE於今(112)年5月18日共同簽署合作協定，未來將深化雙方資訊交流及人員訓練，以提升健保新藥給付評估及財務管理機制。
NICE是英國負責改善並追求健康及社會照護體系卓越發展的獨立機構，負責制定高品質健康照護治療指引與標準，亦就促進健康的生活方式和預防疾病提供建議。NICE的目標係基於最新的實證基礎下，幫助 NHS、地方政府、慈善團體及醫療、公共衛生與社會服務人員，善用有限資源提供最佳照護及具成本效益及價值的治療，以減少醫療不平等。
此次衛福部前往考察，主要是希望瞭解如何在有限資源下，運用HTA技巧，讓病人及早取得突破性新藥，並透過真實世界數據的收集與評估，讓缺乏成本效益的藥品退場，將資源用在刀口上，為具醫療不確定性之昂貴新藥問題提供解方。
石崇良署長於會談中表示：「今天非常榮幸帶領台灣衛福部代表團拜訪有24 年悠久歷史的NICE，學習享譽全球的癌藥基金制度。而能夠代表衛福部健保署與NICE 簽訂合作協定，對於實施了28 年的台灣健保發展史而言，更是重要的里程碑」。 NICE亦與加拿大的CADTH及澳洲PBAC簽訂合作協定，兩機構均為國際HTA頂尖機構，顯示健保署大數據管理與CDE在HTA之表現受到NICE肯定。
NICE國際合作部副主任 Pilar Pinilla-Dominguez會中提到：「我們非常樂意支持台灣精進HTA評估系統的強烈企圖，也熱切希望可以分享NICE在英國的經驗，這項協定為我們提供極好的機會，可以交流想法、找到解決HTA相關挑戰的共同方法，進而造福我們兩個國家的病人」。
健保署表示，此次簽署合作協定，雙方聚焦在HTA之人員訓練及技術研討，未來可透過與NICE的深入合作，第一手接觸國際HTA的最新趨勢、評估流程和方法，及真實世界資料的應用、創新藥品基金和癌藥基金的財務運作等方面進行充分交流；而健保署也非常樂意與NICE分享在大數據管理及人工智慧運用的最新進展，讓合作協定更加落實與互惠。
健保署與國健署拜會英國國家健康暨照護卓越研究院(NICE)。國健署吳昭軍署長(右三)、健保署石崇良署長(右五); NICE國際合作部 Pilar Pinilla-Dominguez 副主任 (左五)及商業聯繫組David Thomson 副組長(右四)、英國國民健康服務署(NHS)商業運作組Nina Pinwill組長(左四)及藥品政策分析組John Spoors組長(左三)。
合作協定由健保署石崇良署長(右二)、醫藥品查驗中心林時宜執行長(右一)與英國國家健康暨照護卓越研究院國際合作部Pilar Pinilla-Dominguez副主任(左二)共同簽署，國健署吳昭軍署長(左一)共同見證。
健保署石崇良署長致贈英國國家健康暨照護卓越研究院禮物，期待未來雙方合作順利。
健保署、國健署及醫藥品查驗中心人員於會後與英國國家健康暨照護卓越研究院主管合影留念。
Taiwan's NHIA and UK's NICE Sign Partnership Agreement to Advance Health Technology Assessment, Optimize Resource Allocation
Taiwan's National Health Insurance Administration (NHIA) and the United Kingdom's
National Institute for Health and Care Excellence (NICE) have signed a partnership
agreement on 18th May 2023.
Cancer remains the leading cause of death in Taiwan, and its incidence continues to rise. The rapidly evolving treatment methods for cancer have put a significant strain on the limited resources of the National Health Insurance system. To expedite access to advanced cancer drugs while also considering the sustainability of the health insurance system, Director-General Chung-Liang Shih of the NHIA, Director-General Chao-Chun Wu of the Health Promotion Administration, and CEO Shyr-Yi Lin of the Center for Drug Evaluation (CDE) visited NICE and officials from the National Health Service (NHS) in the UK.
During the visit, discussions were held on various topics, including the operation of the Innovative Medicines Fund (IMF) and the Cancer Drugs Fund (CDF), HTA
methodology, and diverse financial management mechanisms. On May 18, NHIA Director-General Chung-Liang Shih, CDE CEO Shyr-Yi Lin, and NICE signed a partnership agreement, solidifying their commitment to deepen information exchange and personnel training. The collaboration aims to enhance the evaluation and inclusion of new drugs in the health insurance system, providing a more comprehensive cancer treatment guarantee to the population.
The NICE is the independent body responsible for driving improvement and excellence in the health and social care system. It develops guidance, standards and information on high-quality health and social care. NICE also advises on ways to promote healthy living and prevents ill health.
NICE’s aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.
NICE’s products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services. This visit aimed to learn how to effectively utilize HTA techniques within the constraints of limited resources, ensuring timely access to
breakthrough new drugs. Additionally, the collection and assessment of real-world data will aid in phasing out drugs that lack proof of cost-effectiveness at the time of initial assessment, ensuring that resources are focused where they are most needed. This partnership agreement provides a solution to the challenges posed by expensive new drugs with uncertain outcomes.
Director-General Chung-Liang Shih expressed during the meeting, "Today, it is my great honor to lead the Taiwan delegation from the Ministry of Health and Welfare to visit NICE, which has a 24-year-long history, and learn about the renowned Cancer Drugs Fund system. Signing a partnership agreement on behalf of the NHIA with NICE is an important milestone in the 28-year history of Taiwan's National Health Insurance development." NICE also have MOUs with Canada's CADTH and Australia's PBAC, both being top international HTA institutions, which demonstrates the recognition of the NHIA's big data management and the impact of the CDE in HTA.
“We are delighted to support Taiwan's ambitions to advance their HTA system and are keen to share our experience in the UK with them. This agreement provides us with an excellent opportunity to exchange ideas and find common solutions to HTA-related challenges that will translate into benefits for patients in both our countries.” Pilar Pinilla-Dominguez, NICE International Associate Director.
Through this agreement, the NHIA and NICE will focus on personnel training and technical discussions in HTA. The collaboration will provide an opportunity to learn about the latest trends and methods in cutting edge HTA skills. This will include comprehensive exchanges on processes and methods for developing HTA evaluations of new drugs, the application of real-world data, and the financial operation of the innovative medicines funds and cancer drugs funds. The NHIA is eager to share its advancements in big data management and the utilization of artificial intelligence with NICE, fostering a mutually beneficial partnership and promoting the effective implementation of the partnership agreement.
The National Health Insurance Administration (NHIA) and the Health Promotion Administration (HPA) visited the National Institute for Health and Care Excellence (NICE) in the UK. Director General Chao-Chun Wu (third from the right) of the HPA, Director General Chung-Liang Shih (fifth from the right) of the NHIA, the NICE International Associate Director Pilar Pinilla-Dominguez (fifth from the left), NICE Commercial Liaison Associate Director David Thomson (fourth from the right), and Head of Commercial Operations Nina Pinwill (fourth from the left) and Head of Commercial Medicines Policy Analysis John Spoors (third from the left) from the National Health Service in England (NHS England) .
The partnership agreement was jointly signed by Director General Chung-Liang Shih (second from the right) of the NHIA, the CDE CEO Shyr-Yi Lin (first from the right), and the NICE International Associate Director Pilar Pinilla-Dominguez (second from the left). Director General Chao-Chun Wu (first from the left) of the HPA served as a witness to the signing.
Director General Chung-Liang Shih of the NHIA presented a gift to the NICE, expressing the anticipation for successful future collaboration between the two parties.
Delegations of the NHIA, HPA and CDE took a group photo with the NICE International Associate Director.