CONCERNS THAT WAVE OF CHEAPER PHARMAS MAY AFFECT PATIENT CARE|健保調降7千項藥品給付 醫改會憂引發換藥潮

The National Health Insurance Administration has adjusted prices for pharmaceuticals. 7,000 pharmaceuticals currently subsidsied by the NHIA will be cut by approximately NT$5.7 billion. The new regulations will apply from April 1. However, reform groups worry that some hospitals will try to make money from the shortfall and use other cheaper medicines. Then there will be a wave of changing medications which may affect patients' rights. Over 5 million Taiwanese with high blood pressure, diabetes and high cholesterol levels represent a considerable annual outlay for the national health insurance scheme. To cut the cost of medications and treatment for such conditions, the NHIA announced that from April 1, the subsidies for 7,331 types of medication will be cut by 3.5 percent, cutting costs by around NT$5.7 billion. ==SHIH JU-LIANG Head, NHIA Medical Review and Pharma Benefits Division== Adjustments to the top five for rises and cuts were mostly chemotherapy agents, as there are many chemotherapy agents and brands, so they are very competitive. The NHIA said that the five with lowered prices were all cancer-related drugs and the reasons were because exclusive licences from the original manufacturers were due to expire and so generic drugs could be introduced. According to pharmaceutical market survey statistics, these include the frequently-used blood pressure control medication Norvasc, cholesterol-lowering Rosuvastatin, and diabetes control drug Januvia. However, some reform groups worry that when the price of medication is dropped some hospitals will try to earn the shortfall and will use even cheaper pharmaceuticals which may lead to a whole wave of change of medication, which could well affect patients. ==CHU HSIEN-KUANG CEO, Taiwan Healthcare Reform Foundation== The reasons for changing medication are not very clear, there was no communication with doctors or patients as though they don't consider that after changing to a new medication there will be all sorts of effects on patients which have not been taken into consideration. The NHIA said that it would monitor hospitals change of medication and the money saved by the change of pharmaceuticals would be allocated as subsidies to the new medication. TRANSLATED BY：CLARE LEAR 健保署昨天公告最新藥價調整方案，將調降7千多項藥品的健保給付，預估可減少約57億元的藥費，新規定將從4月1號上路，但醫改團體擔心，部分醫院可能為了賺取藥價差，改用其他更便宜的藥，到時恐怕出現換藥潮，間接影響病患用藥權益。 國內罹患高血壓、高血糖、高血脂等三高慢性病患者，多達五百萬人，每年健保藥費支出相當可觀，為了減少藥價差與節省醫療支出，健保署公告，從4月1號起，將調降7331項藥品的健保給付，平均降幅3.5%，預估將可減少健保藥費57.1億元。 ==健保署醫材組長 施如亮== 調升前五名跟調降前五名 都大概是一些化療的藥品 因為化療的藥品 現在用得蠻多的 廠牌也很多 所以它的競爭也比較大 健保署表示，這次調降單價前五名、主要是癌症用藥，調降原因包括原廠藥專利期滿，有學名藥推出，並根據藥價市場調查而來，其中包括民眾常用的降血壓藥「脈優錠」、降血脂藥「冠脂妥膜衣錠」，以及治療糖尿病的「佳糖維膜衣錠」。不過有醫改團體擔心，藥價調降後，部分醫院可能為了賺取藥價差，改用其他更便宜藥物，到時可能出現換藥潮，間接影響病患的用藥權益。 ==醫改會副執行長 朱顯光== 換藥的理由 其實也都沒有很明確的 跟醫師溝通或跟病人溝通 甚至有的大剌剌就直接講說 不需要考慮換藥以後 這個新的藥品 對病人產生各種不適的影響 都不列入評估 對此健保署強調，會持續監測醫院換藥的情況，而節省下來的藥費，將用於擴大給付及引進新藥等。 記者 賴淑敏 彭耀祖 台北報導