Patient Involvement in the Health Technology Assessment Process in Taiwan.

Kuei An Chen,Li Ying Huang,Churn Shiouh Gau

doi:10.3389/fmedt.2021.732160

Abstract

The COVID-19 pandemic initially had a smaller impact on Taiwan than on most other industrialized countries. However, an outbreak in late April 2021 led to a sharp surge in cases from mid-May 2021. Patient involvement in the health technology assessment (HTA) process, however, was not much affected by this; virtual meetings were implemented. This descriptive paper presents an overview of patient involvement in the HTA process in Taiwan via the National Health Insurance Administration (NHIA) online submission platform, participation in appraisal committees, education programs, and cooperation with patients' organizations, and outlines its progress and challenges. The National Health Insurance Act, amended in 2013, protects patients' rights and invites them to voice their opinions, which are then presented to the relevant authority. Based on this act, various mechanisms have been developed to involve patients, caregivers, and patient organizations in both the HTA and the reimbursement process. Prior to the Pharmaceutical Benefit and Reimbursement Scheme (PBRS) Joint Committee meeting, the NHIA built an online platform that allows patients to submit their opinions, which are then incorporated into the HTA reports. The results are also discussed with patient representatives, following which the related documents are published on the NHIA website. From May 2015 to December 2020, 30 patients' insights were published before the PBRS Joint Committee meetings. Of these, 19 (63%) were related to oncology cases. In Taiwan, approaches to fostering patient engagement include the use of a platform for patients' and patients groups' input, among others. Although patient engagement is important for understanding the needs of the target patient population, challenges in ensuring timely patient engagement and provision of relevant resources remain. In addition, further efforts are needed to implement and improve the visibility of patient input in the HTA process.

Highlights

In 1995, the single-payer National Health Insurance (NHI) program was established in Taiwan
In 2013, Taiwan implemented the second-generation National Health Insurance Act 2, with the health technology assessment (HTA) process, the composition of the Pharmaceutical Benefits and Reimbursement Scheme (PBRS) Committee, and transparency being written into the law
In Taiwan, patients participating in HTA and the reimbursement decision-making process are fully supported by the National Health Insurance Administration (NHIA)

Summary

INTRODUCTION

In 1995, the single-payer National Health Insurance (NHI) program was established in Taiwan. The CDE/HTA team holds a pre-meeting for patient representatives, beneficiary representatives (consumers) and case-related patient organizations, who have provided input on the platform to discuss patients’ perspectives before the PBRS Joint Committee meeting. In a resubmission case, the NHIA can invite patient organization representatives and listen to their opinions in the PBRS Joint Committee meeting for 10 min [7]. It set up an advisory committee with experts—which included patient representatives of the PBRS—and conducted six interviews with patient organizations Through such cooperation, the CDE/HTA hoped that the patient involvement mechanism could become more structured and adaptable to local conditions. The CDE/HTA has conducted more than 15 training courses for patients, caregivers, hospital volunteers, and patient organizations focused on various disease types, like systemic lupus erythematosus, rheumatoid arthritis, cancer, psoriasis, development disability, and end-stage renal disease These training courses were held across Taiwan, from Taipei to Kaohsiung, and even on the island of Penghu.

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DATA AVAILABILITY STATEMENT