An estimated 4,000 people with lung cancer would benefit from last month’s expansion of eligibility for a third-generation targeted drug covered by the National Health Insurance (NHI), while the government is planning to expand eligibility for publicly funded low-dose computed tomography (LDCT) scanning next year.
A 42-year-old woman nicknamed Hsiao Ning (小寧) talked about her lung cancer experience in a letter presented at a Formosa Cancer Foundation news conference in Taipei yesterday.
Hsiao Ning said she and her husband do not smoke, drink alcohol or stay up late, although they are often busy running their creative business, which leaves them with little time to cook.
Photo: CNA
After experiencing involuntary mouth twitches and drooling in May, she sought medical treatment and was found to have a brain tumor larger than 3cm. In late August, it was diagnosed as stage 4 lung cancer with an epidermal growth factor receptor (EGFR) mutation, which metastasized to the brain, she said.
She initially paid out of pocket to receive a third-generation targeted drug, which reduced the size of her brain tumor, but after the eligibility was expanded last month, she was able to receive the drug through her NHI coverage and steadily control the tumor’s progression, which Hsiao Ning said she is very grateful for.
NHI Administration Director-General Shih Chung-liang (石崇良) said that lung cancer is the most common cancer and the leading cause of cancer-related deaths, with about 18,000 people diagnosed in Taiwan every year, but many of them are diagnosed at later stages.
A third-generation targeted drug for treating late-stage lung cancer with EGFR mutation was included in NHI coverage from Oct. 1 this year, benefiting about 4,000 more people, he said.
Taiwan Society of Pulmonary and Critical Care Medicine president Chen Yu-min (陳育民) said the eligibility was expanded from only stage 4 to “stages 3B, 3C and 4.”
It also no longer limited coverage to those with brain metastasis, with coverage expanding from those with “EGFR exon 19 deletion (E19del) mutation and brain metastasis” to those with “EGFR E19del or EGFR Exon 21 L858R mutations,” Chen said.
The eligibility changes allow nearly 90 percent of people who have late-stage lung cancer with EGFR mutation to receive the drug covered by the NHI, he said.
Allowing people to receive the third-generation drug earlier is expected to increase their survival rates, as drug resistance occurs in about half the people who received the first or second-generation targeted drugs, National Taiwan University Hospital’s Hsinchu branch superintendent Yu Chong-Jen (余忠仁) said.
While the third-generation targeted drug costs about NT$1 million (US$31,007) per person per year, the expansion of NHI-covered drug eligibility from only about one-eighth to nearly 90 percent of people with late-stage lung cancer with EGFR mutation would greatly benefit them, he said.
Early detection and treatment are crucial to reducing lung cancer mortality, as the five-year survival rate of people with lung cancer at stage 1 or earlier is about 90 percent, but when diagnosed at stage 3 or 4, survival rates drop significantly, to only about 13 percent in stage 4, Shih said.
The Ministry of Health and Welfare is also planning to expand the eligibility for publicly funded LDCT next year to encourage more people to undergo lung cancer screening, he said.
The plan would loosen the definition for “chain-smokers,” which is currently included in the eligibility, he added.
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