On June 30, the media reported that "continuous haggling of prices and the rise of raw material prices resulted in a shortage of medical supplies for severe illnesses… clinical doctors are being stripped of weapons." In response, National Health Insurance Administration (NHIA) would like to make the following clarifications:

1. NHIA established stop-loss principles for pricing adjustments of special materials in 2018 and has not modified since then. The principles include the following items: 1) considering the market share of each supplier; 2) items with payment points reduced by 50% or more; 3) items included in NHI package for more than 15 years and have undergone price volume surveys multiple times. That is, NHIA does not just haggle the prices regardless of any situation as the media questioned. In response to the rise of raw material price due to the pandemic and the Russo-Ukrainian War, the NHIA has conducted a price volume survey in 2022 on the actual sales on the market and raised the special material payment points of 283 items of 129 categories. If the payment is not enough to cover the cost, suppliers are welcome to propose to raise the payment points. In 2023, the NHIA has proceeded to process and announce the raise of payment points for a total of 40 special materials with an estimated total of 76,500,000 points upon receiving such propositions made by relevant suppliers.

2. Explanation on the shortage of medical supplies for severe illnesses:

(1) Extracorporeal Membrane Oxygenation (ECMO): ECMO has been included in NHI package since 2002. Depending on whether or not heparin is included, the ECMO coverage is divided into two categories with payment points of 16,771 and 18,230, respectively; payment regulations for both categories are the same. Main suppliers with relevant medical device license specified that the one in shortage is the ECMO without heparin and the shortage is caused by a global supply shortage of raw materials. Because the ECMO with heparin is still available, NHIA has not received any report from the clinical end regarding a shortage of ECMO.
(2) Intra-Aortic Balloon Pump (IABP): IABP has been included in NHI package since 1999 and the payment point is 25,364. Due to a global shortage on raw materials, the supply of IABP has been unstable. However, the suppliers with relevant medical device license reported a gradual recovery from unstable supply and should be able to satisfy the minimum demand of all hospitals in Taiwan. The NHIA has loosened the payment regulations on May 25, 2023 to allow contracted hospitals to adopt a higher-level IABP with fiberoptic sensor (payment points: 41,110) during the shortage of regular IABPs until December 31, 2023.
(3) Embolectomy catheter: There is no shortage of this material, but the shortage of relevant raw materials resulted in a rise of its cost. Consequently, the NHIA followed relevant procedure to adjust its payment points and the adjustment shall be in effective on August 1, 2023. According to our survey, main suppliers on the market reported no shortage for such catheters.

In summary, according to the understanding of the NHIA, the current medical supply shortage is a result of the global shortage of raw materials. Fortunately, replacements for such materials are available on the clinical end. The NHIA shall continue to closely monitor the supply of medical devices for severe cases to ensure the right to medical treatments for the people.