Affordable health technology assessment in Taiwan: A model for middle-income countries.

Abstract

Taiwan achieved the goal of providing universal health care coverage by launching the National Health Insurance (NHI) program in 1995. Covering 99.9% of the population, including prison inmates, the NHI provides patients access to health care ranging from Western drugs and procedures to traditional Chinese medicine. The initiative was ahead of its time, with the World Health Assembly (WHA), the decision-making body of the World Health Organization, passing resolution WHA58.33, which urges states to develop health financing systems as part of efforts to provide universal health coverage, in 2005. Among other things, WHA58.33 calls for universal health care systems to provide equal access to health resources. Treatment must be affordable to all, and this puts pressure on health care systems to control costs. Taiwan began conducting health technology assessments (HTAs) to determine the suitability of new drugs within the financial context of the NHI program in 2007 by launching an HTA working group in the Center for Drug Evaluation. HTAs were extended to medical devices in 2011 and to medical services in 2014. All these assessments are used to support the NHI Administration (NHIA) for reimbursement decisions.