Several National Health Insurance (NHI) drug reimbursement measures took effect on June 1, 2026, covering treatments for cancer, rare diseases, and pediatric conditions. According to Director General Lian-Yu Chen of the National Health Insurance Administration (NHIA), these measures reflect the agency's commitment to expanding patient access to innovative therapies based on scientific evidence.

The NHIA continues to align with international standards in cancer treatment by broadening access to precision therapies. This expansion includes coverage for capivasertib for adult patients with HR-positive and HER2-negative locally advanced or metastatic breast cancer harboring a PIK3CA, AKT1, or PTEN genetic variant. When used in combination with fulvestrant, this regimen is recommended as a Category 1 preferred regimen in the NCCN Clinical Practice Guidelines. Additionally, fruquintinib is now included as an alternative treatment option for patients with metastatic colorectal cancer who have undergone multiple lines of therapy, helping to improve disease control and survival outcomes. Furthermore, reimbursement criteria for taxane and pyrimidine analogue chemotherapy drugs have been expanded to align with their approved indications. This measure ensures alignment between reimbursement policies and clinical needs, thereby improving treatment outcomes and the overall quality of care. The expansion is expected to benefit approximately 8,200 cancer patients.

For the treatment of rare diseases, including idiopathic or heritable pulmonary arterial hypertension, sotatercept have been included under reimbursement. Unlike existing NHI-covered therapies, which primarily delay disease progression by reducing pulmonary vascular resistance and controlling symptoms, the newly included medication has a novel mechanism of action that targets upstream pathways involved in disease onset and progression. It may be used as escalation therapy for patients with World Health Organization Functional Class (WHO-FC) III and IV pulmonary arterial hypertension. Clinical evidence has shown that the medication significantly improves the six-minute walk distance (6MWD), a key indicator of treatment effectiveness, while enhancing patients' exercise capacity and reducing pulmonary vascular resistance. The inclusion is expected to benefit approximately 140 patients.

In pediatric care, the NHIA has included a new injectable formulation of baclofen under the reimbursement scheme, listed among the Pediatric Essential Medicines and Medical Devices of Difficult Availability. This medication is used to treat severe spasticity of cerebral or spinal origin in pediatric patients aged four years and above as well as adult patients. It is highly effective in improving functional performance and reducing severe spasticity and pain is particularly significant in pediatric patients. The inclusion is expected to benefit around 126 children, with the NHIA allocating approximately NT$18.6 million in medication expenses.

In addition, the NHIA has expanded reimbursement coverage for dexamethasone intravitreal implants in patients with non-infectious posterior uveitis. Recognizing the clinical necessity for some patients to receive repeated injections to maintain treatment efficacy and prevent further vision deterioration, the reimbursement limit has been extended to up to six injections per eye. This measure helps reduce the risk of eye inflammation and vision impairment, while improving patients' visual function and overall quality of life.

Director General Chen emphasized that all the above-mentioned adjustments were carefully planned based on a comprehensive assessment of clinical needs, health technology assessment, and the NHI's financial sustainability. Looking ahead, the NHIA will continue to refine the drug reimbursement scheme and introduce new therapies with proven clinical benefits. The aim is to ensure patients receive the most appropriate and effective care during the critical periods of treatment, while advancing health equity and safeguarding public health.