Next-generation sequencing tests for precision cancer therapy might be covered by the National Health Insurance (NHI) from May, National Health Insurance Administration Director-General Shih Chung-liang (石崇良) said yesterday.
About 830,000 people sought medical treatment for cancer in 2022, and the total NHI drug expense was about NT$39.2 billion (US$1.25 billion), of which 61.7 percent was spent on targeted therapy, Shih said while attending a conference on next-generation sequencing held by Taiwan Precision Medicine Society in Taipei.
The NHI covers 26 types of targeted therapy, aimed at 11 gene loci (fixed positions on a chromosome) and for the treatment of 10 types of cancer, he said.
Photo: CNA
Coverage for next-generation sequencing would mainly be for gene locus testing, he added.
The technology can examine multiple gene loci at once for 19 types of cancer, including non-small cell lung cancer, triple-negative breast cancer, ovarian cancer, fallopian tube cancer, intrahepatic cholangiocarcinoma (bile duct cancer of the liver), primary peritoneal cancer and prostate cancer.
The NHI plan would include three types of payment models: an independent payment for longer gene segments of the breast cancer 1 and breast cancer 2 genes, payment for a small set of fewer than 100 genes based on the most basic gene loci of each type of cancer, and payment for a large set of more than 100 gene loci, Shih said, adding that people can pay the difference in cost out of pocket according to their personal needs.
To be covered, the test results must be uploaded to the National Health Research Institutes’ database, he said.
Issues concerning the NHI-covered tests would be discussed in a specialists meeting on Feb. 6, and hopefully the policy can take effect in May or June, he said, adding that it is expected to cost about NT$600 million to NT$1 billion, and the budget might be expanded next year if possible.
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