To ensure the continuous improvement of the quality of cancer treatments, the National Health Insurance Administration (NHIA) has included biliary stent placement for patients with malignant biliary obstruction in the payment package starting this June, as an addition to the already-covered colon stents and duodenal stents. The new measure is expected to benefit over 4,000 cancer patients each year, utilizing approximately 170 million points from the NHI budget.
The NHIA explained that malignant biliary obstruction can occur due to biliary stricture caused by the growth of a malignant tumor or bile duct compression due to the metastasis of a malignant tumor. Patients with malignant biliary obstruction may exhibit symptoms such as jaundice, itchy skin, abdominal pain, fever, and loss of appetite. Clinical treatment for biliary obstruction often involves surgical removal of the tumor. Other treatment options include placing a drainage tube to remove bile from the body or inserting a stent to facilitate bile flow into the intestine, thus alleviating discomfort for the patients.
Biliary stents can be constructed from either plastic or metal. To enhance the standard of care for cancer patients, the Center for Drug Evaluation was tasked with conducting a health technology assessment on these materials. The assessment revealed that, for patients with inoperable or borderline resectable malignant bile duct stenosis, metal biliary stents offer superior outcomes. Compared to the plastic biliary stents already covered by the NHI, metal stents demonstrate higher patency rates, longer patency times, and require fewer reinterventions, thereby showing the potential to elevate the quality and efficacy of clinical treatments.
Starting from June 1, 2024, metal biliary stents have been included in the NHI package, as determined by the NHI Pharmaceutical Benefit and Reimbursement Scheme Joint Committee Meeting (for special materials) convened in March 2024. The NHIA expresses its gratitude to the Gastroenterological Society of Taiwan, the Digestive Endoscopy Society of Taiwan, and the Taiwan Radiological Society for their professional opinions and efforts to improve safety and healthcare quality for patients. Their contributions enable doctors to choose the optimal medical material based on each patient's situation and expand treatment options. Additionally, the NHIA extends its thanks to the manufacturers and suppliers who are willing to collaborate to enhance healthcare quality in Taiwan.
Director General Chung-Liang Shih of the NHIA pointed out that, to ensure people's basic medical requirements and health interests, the NHIA will continue advocating for an increased NHI budget. This will allow for the inclusion of new medical materials that have empirical evidence of their benefits and substantial clinical demand, thereby constructing a better payment package for cancer treatments. These improvements are expected to relieve the financial burden on patients, enhance medical value, and improve public health.