Jonathan Chan, M.MedSc.
Neil Grubert, M.A.
Michael Latwis, M.B.A.
Gilan Megeed, M.P.H.
Nikhil Mehta, M.Eng.
Lulu Pickering, Ph.D.
Andreia Ribeiro, Ph.D.
Michael Yeung, M.Sc.
Last Updated 18 December 2013
Taiwan has a universal health insurance program that ensures all citizens access to healthcare services. The healthcare system in Taiwan is well established and has a very high public satisfaction rate because its universal coverage keeps out-of-pocket payments low for its citizens, and exempts patients from all copayments for a variety of catastrophic illnesses. Spending on pharmaceuticals is relatively high in Taiwan, accounting for 24.1% of total healthcare expenditure, higher than neighboring countries such as Japan (20.8%) and South Korea (21.6%). This high level of pharmaceutical expenditure is partly due to the fact that health facilities and physicians in Taiwan generate a significant portion of their income from dispensing the medicines they prescribe. Several important changes were introduced as part of Taiwan’s healthcare reform in 2013: health technology assessment was officially introduced, an annual target was established for drug expenditure, and a two-stage drug review mechanism was set up to increase the transparency and public involvement in the pricing and reimbursement process. The pharmaceutical industry will be anxious to see the practical impact of these policies on market access and the pricing of new drugs in the near term.
Socioeconomic trends: Gross domestic product (GDP), nominal per capita gross national income (GNI).
Demographics: Overall population (projected to 2030); life expectancy at birth (projected to 2030); median age and number of senior citizens (projected to 2030); urban population (projected to 2030).
Healthcare system: Healthcare spending; public sector administrative framework, funding, and providers.
Regulatory affairs: Registration process for new drugs; fast-track applications; Cross-Strait Medical and Healthcare Cooperation Agreement with China.
Intellectual property protection: Patent and data protection; compulsory licensing; price setting for generics; guidelines for biosimilars.
Health technology assessment: Roles and responsibilities of the Center of Drug Evaluation (CDE) and the National Institute of Health Technology Assessment (NIHTA) within the National Health Insurance Administration (NHIA).
Pricing and reimbursement: Selection for pricing and reimbursement under public health insurance; price premiums for new drugs; role of Taiwan Food and Drug Administration.
Cost containment: Biennial price revisions under the NHIA; price volume survey; price adjustment for off-patent drugs, annual drug expenditure target.
Healthcare reform: Second generation healthcare reforms.
Commercialization Outlook for the pharmaceutical industry: Well-established health infrastructure and regulatory environment; universal healthcare coverage and low out-of-pocket costs; relatively high spending on pharmaceuticals with physician dispensing; second generation healthcare reforms, new HTA framework, drug expenditure target, and two-stage drug review process; biennial price revision; weak patent linkage system.
Exhibits: 30 data-rich tables and figures.