To lift the burden for patients, the National Health Insurance Administration (NHIA) constantly carries out reforms of the NHI payment system for relevant drugs. Center for Health Policy and Technology Assessment was founded to reinforce the NHI payment policy based on scientific evidence and values and provisional listing was introduced to accelerate the inclusion of new drugs and new technologies in the NHI package. New drugs for breast cancer and lymphoma that have been included recently in the NHI package are as follows:
The targeted therapy drug Verzenio, used as adjuvant therapy for adult patients with early-stage breast cancer at high recurrence risk, has been included in the NHI package since March 1, 2024. Studies have shown that Verzenio can effectively decrease the risk of recurrence by at least 30% and reduce the risk of metastasis. The annual cost of this drug per patient is approximately NT$750,000. It is estimated that the inclusion of Verzenio will benefit around 2,150 patients, with a total fund of around NT$1,594 million.
The targeted therapy drug Trodelvy injection, used for adult patients with inoperable locally advanced or metastatic triple-negative breast cancer who have undergone at least two ineffective systemic therapies, has been included in the NHI package since February 1, 2024. Trodelvy injection is shown to prolong the overall survival of patients with triple-negative breast cancer by approximately 5.4 months, compared to standard treatments. The annual cost of this drug per patient is approximately NT$1.21 million. It is estimated that the inclusion of Trodelvy injection will benefit 472 patients, with a total fund of about NT$570 million.
Polivy injection, used as the third-line therapy for adult patients with relapsed or refractory diffuse large B cell lymphomas (DLBCL) who have never undergone or are ineligible for hematopoietic stem cell transplants, has been included in the NHI package since February 1, 2024. It is shown to prolong overall survival by approximately 7.7 months compared to current treatment methods, serving as an alternative for patients ineligible for CAR T-cell therapy. The annual cost of this drug per patient is about NT$1.97 million. Provisional listing is applied, and the treatment effectiveness is continuously tracked to serve as a reference for future evaluations of the payment policy. The inclusion of Polivy injection is estimated to benefit around 180 patients, with a total fund of about NT$301 million.
Via@NHI Website