To enhance treatment access for cancer patients, the National Health Insurance Administration (NHIA) approved the reimbursement of two PARP inhibitors during the Joint Committee Meetings on March 28 and April 17, 2025. These medications are indicated for the maintenance treatment of advanced high-grade epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer, adjuvant therapy for early-stage breast cancer, and first-line treatment of metastatic castration-resistant prostate cancer. The policy is expected to benefit approximately 775 cancer patients with an annual drug expenditure of around NT$979 million. The reimbursement will take effect on June 1, 2025.

Ovarian cancer, fallopian tube cancer, primary peritoneal cancer, and breast cancer ranked among the top ten most common cancers among women in Taiwan in 2022, while prostate cancer ranked among the top three for men. In response, the NHIA has recently prioritized the inclusion of high-evidence-level drugs aligned with international treatment guidelines to provide more comprehensive care.

Currently, PARP inhibitors under the NHI are reimbursed for patients with advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who have germline or somatic BRCA1/2 pathogenic mutations. The latest expansion extends coverage to patients with HRD-positive status, including those with pathogenic BRCA mutations or genomic instability. Two PARP inhibitors—olaparib and niraparib—have been approved under this expanded indication:

1. Olaparib in combination with bevacizumab has been shown to prolong median overall survival by 17.9 months (75.2 months vs. 57.3 months).
2. Niraparib extends progression-free survival by 11.4 months (19.6 months vs. 8.2 months).

In addition, for adjuvant treatment of early breast cancer with germline BRCA1/2 mutations and HER2-negative status with high recurrence risk, olaparib significantly reduces the risk of invasive disease by 42% and distant disease by 43%.

For first-line treatment of metastatic castration-resistant prostate cancer (mCRPC) in patients with germline or somatic BRCA1/2 pathogenic or suspected pathogenic mutations, olaparib combined with abiraterone has been shown to delay progression-free survival (median not reached vs. 8.4 months) and overall survival (median not reached vs. 23 months), thereby providing cancer patients with more therapeutic options.

For breast cancer, the covered therapy is classified as Category 1 and a preferred treatment, with all three major Health Technology Assessment (HTA) organizations recommending reimbursement. For prostate cancer, the treatment is also Category 1, with consistent reimbursement recommendations from all three major HTA bodies. In the case of ovarian cancer, fallopian tube cancer, or primary peritoneal cancer, the olaparib–bevacizumab combination is classified as Category 1, while niraparib is also recommended by all three major HTA organizations.

The NHIA remains committed to including effective cancer treatments in the reimbursement benefits and aligning with international clinical guidelines. The goal is to ensure comprehensive medication coverage for cancer patients at every stage of treatment, ultimately improving their quality of life and sustaining hope.