Abstract
Since Taiwan launched its mandatory National Health Insurance (NHI) on March 1 1995, the growth of pharmaceutical expenditures has far exceeded that of other NHI benefit expenditures. It remained around 25% of total medical expenditures until 2002. The Bureau of NHI has adopted several strategies to contain the escalating pharmaceutical expenditures over the past couple of years. This article describes the background of Taiwan’s NHI, its current status, pharmaceutical benefit scheme, pricing control and cost containment measures. It also delineates in detail the strategies taken, including co-payment of prescription medicines, price volume survey, generic grouping, restrictive guidance on new drug indications, and payment reforms so far. Regardless of measures taken by the Bureau of NHI, there are issues 133 134that remain unsolved. The scope of the pharmaceutical benefits scheme remained to be clearly defined. There is no consensus whether reimbursement should be based only on active pharmaceutical ingredients. Other unsolved issues include the payment gap between the reimbursement price and acquisition cost, strategies of co-payment, transparency of the price setting mechanism, and rewards for innovations. It is advocated that any issues on pharmaceutical cost containment should be subject to more transparency and public scrutiny in order to be accountable to all stakeholders. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com> Ó 2003 by The Haworth Press, Inc. All rights reserved.]
Published Version
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