China News Service, February 27 (Xinhua) According to Taiwan media reports, Taiwan has experienced recent inflation, but there are more and more "candy pills" worth more than 2 yuan (NT$, the same below) each.

The National Health Insurance Administration, the health and welfare department of the Taiwan authorities, recently announced the latest drug price adjustment this year, slashing drug prices by more than 5.5 billion yuan. However, it has been criticized as just "letting old drugs fall again and again" and "it may cause a shortage of drugs as soon as the end of the year." It seems like it’s saving money for health insurance, but in the end it’s the patients who suffer.”

  The National Health Insurance Administration, the health and welfare department of the Taiwan authorities, recently announced drug price adjustments for April, slashing the prices of 4,551 drugs by NT$5.53 billion.

The top three products with the largest reductions this time are colorectal cancer treatment drugs, breast cancer drugs, and gastric drugs for the treatment of gastric and duodenal ulcers.

  Huang Jinshun, chairman of the National Federation of Taiwan Pharmacists Association, pointed out that among the drugs that were bargained, new drugs accounted for 7%, and more than 90% were "old drugs". 93% of the drugs were older than patented for 15 years, and some were still in the hands of manufacturers. Nine of the 13 medicines are planned not to be produced.

  Huang Huangshun believes that as the elderly population increases, more medicines will be used for medical treatment. In the next six months or so, some pharmaceutical factories may suspend production, which may lead to a shortage of medicines as soon as the end of the year. It is estimated that 6 million patients with chronic diseases will be affected. .

Old medicines have become "candy prices" and "Taiwan is in a dilemma of drug shortage"?

  According to the latest statistics from Taiwan’s National Health Insurance Administration, among the more than 14,000 drugs covered by the National Health Insurance, there are as many as 3,879 drugs that cost less than 3 yuan a pill, accounting for nearly 28%.

Among the 3,879 kinds of health insurance "candy drugs", the top three declared items are the diabetes drug metformin, the antipyretic and analgesic drug aspirin, and the anti-anxiety drug alprazolam. They are all old drugs with a long history and have already expired. .

  Shen Caiying, a senior pharmacist in Taiwan, said that many old drugs have expired and become "candy prices" at 1 or 2 yuan each. For hospitals, the price difference is too small and there is no profit at all, so they are not willing to purchase drugs; as for hospitals, Pharmaceutical companies are even more unprofitable and will not be willing to manufacture drugs when their drug licenses expire. Import agents may no longer extend drug licenses and stop importing, which will of course affect patients' use of drugs.

  According to statistics from Taiwan’s National Health Insurance Administration, there are currently nearly 4,000 kinds of “candy drugs”.

Photo from Taiwan's United Daily News

  Chen Wenqian, a senior media person on the island, recently posted on Facebook that Taiwan is facing a shortage of medicines. The oral steroid Hydrocortisone, which costs less than NT$1 a pill, cannot be purchased through health insurance, so she needs someone to purchase it from the United States.

  The related "drug shortage" has also triggered heated discussions among Taiwanese netizens: "Medicines are cheaper than candy", "Health insurance profits are constantly shrinking, there are more and more elderly people, and there are fewer and fewer young labor force paying premiums", "Drug manufacturers cannot make money, "Nurses have no salary, and doctors cry too little." "Just don't get sick." "Without medicine and without nursing staff, how long can the beautiful bubble of health insurance last?"

“The sound of “lack of medicine” keeps coming, what’s the reason?

  Shen Lijuan, a professor at the School of Pharmacy at National Taiwan University, pointed out that the National Health Insurance Administration adjusts drug prices on April 1 every year, and "drug shortages" often begin in March. She suggested that the National Health Insurance Administration re-examine the "Drug Expenditure Target System (DET)" )", only by truly clarifying the amount of the drug price difference can drug price adjustments be made.

  Kang Zhaozhou, chairman of the Taiwan Pharmaceutical Association, also believes that the National Health Insurance Administration cannot find a good tool to adjust drug prices and uses drug price surveys. However, the price of drugs sold by pharmaceutical companies to hospitals includes the drug price difference. National Health Insurance refers to drug sales. It is impossible to know the true drug prices through invoices. The DET, which has been in operation for more than ten years, should indeed review and improve and come up with a truly suitable drug price adjustment plan.

  Xiao Meiling, director of the Taiwan Pharmaceutical Regulatory Society and former "Deputy Director of the Department of Health," pointed out that drug price adjustments involve market economics. As to why some pharmaceutical companies in Taiwan no longer produce pharmaceuticals, the "Health Insurance Agency" needs to convene an expert meeting to study and plan adjustments to DET. related mechanisms.

  Regarding related discussions, "Director of National Health Insurance" Shi Chongliang said that due to their sophisticated manufacturing technology, large variety of products, and large sales volume of off-patent drugs, manufacturing costs can be significantly reduced, allowing National Health Insurance to pay for more new drugs.

In addition, the pharmaceutical industry hopes to continue to implement DET, but the implementation content and details do need to be adjusted, and revisions are expected to begin in the first half of this year.

  It is reported that the National Health Insurance Administration has implemented DET since 2013 and adjusts drug prices every year. The savings will be used to invest in new drugs.

Lin Yahui, CEO of the Medical Reform Commission, pointed out that annual adjustment of drug prices is necessary, but it is not the main way to help save health insurance. The "National Health Insurance Administration" should focus on and respond to people's concerns on where the saved expenditures are used and what should be done in detail. After further discussion, it would be futile to just announce the items and amounts of drug price adjustments. Instead, it would only increase worries and doubts.

  According to industry insiders on the island, the "Drug Expenditure Target System (DET)" plan that is being piloted should be reviewed again.

Photo from Taiwan's United Daily News

Will the drug price adjustment affect the willingness of pharmaceutical companies to produce and import drugs?

  The pharmaceutical industry has different views on whether this drug price adjustment will cause a "drug shortage".

Su Dongmao, chairman of the Taiwan Pharmaceutical Industry Association, pointed out that if there is a shortage of drugs due to the Ministry of Health and Welfare cutting drug prices this year, it is expected that only smaller pharmaceutical companies will be affected, and listed drug manufacturers will be able to respond in a more flexible way.

  Shi Chongliang said that after the National Health Insurance Administration announced the drug price adjustment, it has not yet received any information that pharmaceutical companies have stopped producing drugs. Based on past experience, drug shortages are mostly caused by shortages of raw materials and unstable supply. very few".

  Kang Zhaozhou said that after the drug price adjustment is announced, if manufacturers have insufficient costs, they can check the cost analysis data on March 8 and propose price adjustment suggestions to the National Health Insurance Administration.

As profits are getting lower and lower, there are indeed problems with the current drug pricing plan. However, if the National Health Insurance increases drug prices to a higher level than before the price reduction, the "National Health Insurance Department" will often pay more costs, and this must be reviewed.

  Huang Huangshun believes that drugs below the "floor price" should be purchased uniformly by the "National Health Insurance Administration".

Kang Zhaozhou pointed out that the advantage of unified procurement is that the drug price differences between hospitals will disappear, which can alleviate drug shortages. However, pharmaceutical companies may also lower drug prices and give more discounts in order to seize the hospital market. There are even situations such as "Guan Shuo (intercession)", which is another problem.