The National Health Insurance Administration (NHIA) convened a meeting of the Pharmaceutical Benefit and Reimbursement Scheme Joint Committee (PBRS Joint Committee) on April 16 under the concerted efforts of the NHIA, the pharmaceutical industry, and consumer representatives, multiple Class 1 new drugs have been covered by the National Health Insurance, and the coverage for several covered items were expanded, including the expansion of the coverage for antiviral drugs for premature infants, the expansion of the coverage for anti-angiogenic agents treating macular degeneration, and new coverage for targeted therapies treating ovarian cancer and cervical cancer.
The new coverage for Class 1 new drugs and expansion of the coverage for several covered items approved in this meeting are summarized as follows:
1.Ceftazidime/avibactam is a new-generation β-lactamase inhibitor and an antibiotic against gram-negative bacteria. It can effectively treat infections caused by carbapenem-resistant bacteria, such as Klebsiella spp., and decrease the use of carbapenem antibiotics and the increasing resistance. It is approved as a Class 1 new drug covered by the NHI, and it will benefit nearly 4,179 infected people within 5 years.
2.Letermovir is a non-nucleoside cytomegalovirus inhibitor. It is the first drug whose approved indication is prevention against cytomegalovirus infections and other conditions associated with allogeneic stem cell transplants. It can decrease the prevalence of cytomegalovirus infections in Taiwan by up to 80% to 90%. It is approved as a Class 1 new drug covered by the NHI, and it is expected to benefit more than 200 patients with allogeneic stem cell transplants.
3.Icatibant is a synthetic decapeptide and a rescue medication for acute episodes of a rare disease, hereditary angioedema (HAE). It is approved as a Class 1 new drug covered by the NHI, and it will benefit 34 patients with HAE and satisfy urgent medical needs faced presently.
4.Palivizumab is a human IgG1 monoclonal antibody that helps prevent against respiratory syncytial virus infection in premature infants, and clinically speaking, premature infants born before 32 weeks of gestation are a high-risk group of such infection. Current approval will extend coverage from premature infants born before 30 weeks to those born before 32 weeks of gestation. The NHIA will negotiate with pharmaceutical companies over the price and the volume involved.
5.Aflibercept and ranibizumab are two anti-angiogenic agents treating macular degeneration. Wet age-related macular degeneration (wAMD) and polypoidal choroidal vasculopathy (PCV) in people over 50 are choroidal disorders, and visual acuity of patients will hardly be restored if eye bleeding or edema is present. In order to maintain clinically-proven treatment efficacy, it has been approved to include wAMD and PCV as indications initially, as to reduce financial impact on NHI. The number of vials will be expanded from a maximum of 7 to that of 14. The NHIA will negotiate with pharmaceutical companies over the price and the volume involved to facilitate effective utilization of NHI resources.
6.Bevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) monoclonal antibody and the first NHI-covered targeted drug for use in patients with recurrent ovarian carcinoma, fallopian tube cancer, or primary peritoneal carcinoma susceptible to platinum-based drugs, and persistent, recurrent, or metastatic cervical cancer. Besides prolonging overall survival of patients, it can also lengthen progression-free survival when used in patients with persistent, recurrent, or metastatic cervical cancer. Once covered by the NHI, it will serve as a new treatment for patients with these conditions.
In recent years, the NHIA has been devoted to reasonable distribution of limited medical resources, hoping to extend NHI coverage to the most beneficial treatments. In the future, the NHIA will continue to join forces with representatives in the PBRS Joint Committee, including experts, medical groups, consumer representatives, patient groups, and pharmaceutical companies, to promote precision medicine on the foundation of evidence-based medicine, so that each drug covered may render optimal benefits.