While the National Health Insurance Administration (NHIA) has expanded coverage for a third-generation targeted drug for late-stage lung cancer patients with the epidermal growth factor receptor (EGFR) from October, approximately 500 patients are ineligible, Taiwan Society of Pulmonary and Critical Care Medicine president Chen Yu-min (陳育民) said today.
The drug would be offered to about one-quarter of all lung cancer sufferers, or over 4,000 patients, costing the NHIA NT$8 billion (US$247 million) in one year which would be its highest annual spending for one drug.
Lung cancer is the most common type of cancer in Taiwan and has the highest mortality rate.
Photo: Chiu Chih-jou, Taipei Times
President William Lai (賴清德), formerly a physician himself, implemented the “Healthy Taiwan” plan earlier this year, aiming to reduce lung cancer deaths by 30 percent by 2030.
Among Taiwan’s non-small cell lung cancer cases, approximately 55 percent involve an EGFR mutation, with deletion of exon 19 and exon 21 the most common mutations, treatable with first to third-generation targeted drugs and covered by the National Health Insurance (NHI), he said.
However, about 500 EGFR-mutated cancer patients with a deletion of exon 20, who comprise four percent of cases, remain ineligible under the NHI scheme and must undergo chemotherapy or foot the bill themselves for the expensive new drug, Chen said.
International medical research recommends first-line targeted therapy alongside chemotherapy, which can double the remission period and reduce the risk of cancer worsening or leading to death by over 60 percent when compared to chemotherapy alone, Taipei Tzu Chi Hospital’s Thoracic Department physician Huang Chun-yao (黃俊耀) said.
“It’s not affordable for regular families,” said 60-year-old Ms. Lu, recalling her son, an engineer, exhausting himself from bearing the costs of her treatments. After developing symptoms such as headaches and blurred vision, she went into a coma which led her to seek treatment as she was diagnosed with Exon 20 EGFR-mutated lung cancer that then quickly spread to the brain.
They had no family history of lung cancer and she did not smoke, she said.
After undergoing treatment using the targeted drug, her tumor noticeably shrank and she was able to exercise for three hours per day, but the medical bills were a huge burden on her family, she said.
However, Huang also described another patient with exon 20 deletion who could not access the new drug due to its cost. The patient underwent long-term chemotherapy treatment but their condition worsened, leaving them with no option except palliative care, Huang said.
He hopes that the NHI can get on board with international cancer treatment norms and improve accessibility to life-saving cancer drugs as soon as possible, he added.
Thirty-five earthquakes have exceeded 5.5 on the Richter scale so far this year, the most in 14 years, the Central Weather Administration (CWA) said on Facebook on Thursday. A large earthquake in Hualien County on April 3 released five times as much the energy as the 921 Earthquake on Sept. 21, 1999, the agency said in its latest earthquake report for this year. Hualien County has had the most national earthquake alerts so far this year at 64, with Yilan County second with 23 and Changhua County third with nine, the agency said. The April 3 earthquake was what caused the increase in
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