The public is once more debating whether the National Health Insurance (NHI) should cover the expenses of pharmacy-only medicine. Benefit payments provided by the NHI for pharmacy-only drugs last year totaled NT$2 billion (US$65.2 million), Ministry of Health and Welfare figures show. The amount is based on a population of about 18.5 million people. If each person was charged NT$200 for the minimum medical service fee, the amount of diagnostic fees would be about NT$3.7 billion, medical and pharmaceutical expenses about NT$1 billion, and self-bearing medical fees about NT$2.7 billion. Altogether, the NHI provided about NT$9.4 billion last year. If the amount could be reduced, the nation would be able to introduce more up-to-date drugs and implement other insurance plans.
Drugs are generally classified into three categories: drugs with higher risk, stronger efficacy and greater side effects are designated as prescription drugs; milder ones are classified as pharmacy-only drugs; and the rest are over-the-counter drugs.
Some say that if the NHI stops covering pharmacy-only medicine, it would infringe on people’s right to pharmaceutical services and the probability of treatment delays would increase.
That is an arbitrary judgement, as all pharmacy-only drugs must go through three stages of clinical trials; their safety is guaranteed by every country.
Moreover, pharmacists in local drugstores remind their customers to see a doctor immediately if the medicine does not work well. This is how levels of healthcare and responsible self-medication are practiced, and is a standard process in most advanced countries.
However, the nation should consider public opinion before changing the NHI policy. To avoid negative reactions, the NHI should modify insurance plans incrementally.
Furthermore, rather than referring to medical specialty and number of patients as the major criteria, other factors must be taken into account, including the drugs’ safety, indications, timing of use, side effects and clinical necessity. For pharmacy-only medicine that would continue to be covered by the NHI, the government should also help pharmaceutical companies apply for certificates.
Carbomix, for example, is classified as a pharmacy-only drug due to its relative safety, yet it is also used as an emergency treatment. Therefore, Carbomix must be certified as both a prescription and pharmacy-only drug, so that people can purchase it at pharmacies, while its clinical use is covered by the NHI.
The NHI covers 841 items classified as pharmacy-only drugs. The government should remove the outdated ones from the list. Officials should consult academics and medical experts to review those items based on empirical data and accurate statistics.
Meanwhile, as pediatricians have pointed out, drugs for children under the age of 12 should be prescribed by doctors. The issue must be further discussed by officials and experts. If pharmacy-only drugs are covered by the NHI, would that make parents more willing to take their children to a doctor?
Each year, a budget is allocated to the NHI. Taiwan should not go against the international trend by allowing more benefit payments for pharmacy-only drugs. For now, reform should be implemented gradually, but ultimately, Taiwan should follow the example of advanced countries, where pharmacy-only drugs are paid at one’s own expense.
Huang Jin-shun is national policy adviser to the president and president of the Federation of Taiwan Pharmacists’ Associations.
Translated by Emma Liu
Concerns that the US might abandon Taiwan are often overstated. While US President Donald Trump’s handling of Ukraine raised unease in Taiwan, it is crucial to recognize that Taiwan is not Ukraine. Under Trump, the US views Ukraine largely as a European problem, whereas the Indo-Pacific region remains its primary geopolitical focus. Taipei holds immense strategic value for Washington and is unlikely to be treated as a bargaining chip in US-China relations. Trump’s vision of “making America great again” would be directly undermined by any move to abandon Taiwan. Despite the rhetoric of “America First,” the Trump administration understands the necessity of
US President Donald Trump’s challenge to domestic American economic-political priorities, and abroad to the global balance of power, are not a threat to the security of Taiwan. Trump’s success can go far to contain the real threat — the Chinese Communist Party’s (CCP) surge to hegemony — while offering expanded defensive opportunities for Taiwan. In a stunning affirmation of the CCP policy of “forceful reunification,” an obscene euphemism for the invasion of Taiwan and the destruction of its democracy, on March 13, 2024, the People’s Liberation Army’s (PLA) used Chinese social media platforms to show the first-time linkage of three new
If you had a vision of the future where China did not dominate the global car industry, you can kiss those dreams goodbye. That is because US President Donald Trump’s promised 25 percent tariff on auto imports takes an ax to the only bits of the emerging electric vehicle (EV) supply chain that are not already dominated by Beijing. The biggest losers when the levies take effect this week would be Japan and South Korea. They account for one-third of the cars imported into the US, and as much as two-thirds of those imported from outside North America. (Mexico and Canada, while
The military is conducting its annual Han Kuang exercises in phases. The minister of national defense recently said that this year’s scenarios would simulate defending the nation against possible actions the Chinese People’s Liberation Army (PLA) might take in an invasion of Taiwan, making the threat of a speculated Chinese invasion in 2027 a heated agenda item again. That year, also referred to as the “Davidson window,” is named after then-US Indo-Pacific Command Admiral Philip Davidson, who in 2021 warned that Chinese President Xi Jinping (習近平) had instructed the PLA to be ready to invade Taiwan by 2027. Xi in 2017
RSS