To seize the golden window for the treatment of acute ischaemic stroke (AIS), the National Health Insurance Administration (NHIA) has loosened the payment conditions for the injection of thrombolytic agent recombinant tissue plasminogen activator (rt-PA) and AIS treatment fee from October 1, 2023. This payment was previously only applicable for treatments administered within 3 hours of AIS onset and is now applicable for treatments within 4.5 hours of the onset. It is estimated to benefit an additional 1,600 patients each year. The budget for the new measure is approximately 69 million points.

The Director General of NHIA Shih Chung-Liang stated that there are three different types of strokes, namely, ischaemic stroke (e.g., cerebral infarction and cerebral ischemia), haemorrhagic stroke (e.g., cerebral hemorrhage), and transient ischemic attack. Of these, ischaemic stroke refers to cerebral embolism caused by intracranial stenosis or blood clots formed in the heart or other parts of the body that resulting in cerebral tissue necrosis and dysfunction. According to NHI statistics, from 2020 to 2022, the number of patients hospitalized due to AIS was approximately 40,000 each year. Some of the patients who suffered a stroke are unable to return to their jobs or have to rely on wheelchairs for mobility. In more severe cases, patients may become bedridden and require care from others, which imposes significant economic burdens and tremendous pressure on the patients and their families . However, timely interventions in the early stage of stroke onset greatly improve a patient's prognosis,  reduces the family's pressure due to the patient's disability and increases the chance of the patient returning to the society.

NHIA stated that, according to the current guidelines, the rt-PA drugs (e.g., Actilyse) used to treat patients with AIS must be administered within 3 hours of the onset. However, Taiwan Stroke Society, after considering evidence and clinical guidelines worldwide, proposed to NHIA to loosen the restrictions on relevant payments to seize the golden window for cerebral reperfusion and improve patient prognosis. In August and September of 2023, NHIA convened a Pharmaceutical Benefit and Reimbursement Scheme Joint Committee Meeting and a Medical Service Benefit and Reimbursement Scheme Joint Committee Meeting, respectively, and amended for the NHI payment to cover the administration of rt-PA drugs and relevant treatments within 4.5 hours of a stroke onset instead of 3 hours. The amendment is effective from October 1, 2023 and expected to effectively reduce the mortality rate and minimize the disability level of patients with stroke onset, as well as improving their recovery.

Director General Shih further expressed his appreciation to Taiwan Stroke Society and their associated societies for providing their professional opinion and assistance. To achieve the goal of improving the health of all citizens, NHIA expects to introduce various policies to improve the care for chronic illnesses, reduce the incidence of stroke and stroke-induced disabilities, minimize the load and cost of care for the families, and enhance the health and welfare for everyone.