National Health Insurance Administration (Taiwan)

The National Health Insurance Act, in force from 1 March 1995, makes health insurance compulsory and social. Patients normally pay 20% of outpatient costs (30% to 50% at hospitals visited without a referral) and 5% to 30% of inpatient costs, depending on the ward and the length of stay, but Article 48 exempts people with a catastrophic illness (重大傷病) from these co-payments. Cancer needing active or long-term treatment is one such illness. Certificates for cancer were permanent when the scheme began; since 2002 they last five years and are renewed if the cancer still needs active or long-term treatment, as the administration explained in December 2013. At the end of 2013, 923,396 people held a catastrophic illness certificate, and cancer accounted for 482,949 of the 986,287 certificates in force (49.0%).

Medicines are listed through a joint committee of the insurer, experts, the insured, employers and providers under Article 41, with patient groups able to give their view, and the insurer may commission a health technology assessment under Article 42; the Center for Drug Evaluation writes those assessments. In 2023 the administration started temporary payment for medicines given accelerated approval and, from January 2024, parallel submission, letting a company apply for reimbursement while the TFDA is still reviewing its licence. From 1 January 2025 NT$5 billion of public budget was put into the insurance fund for a temporary payment fund for new cancer medicines, under rules published on 25 February 2025. Next-generation sequencing for cancer has been reimbursed since May 2024: by February 2026, 62 hospitals had claimed for it and the administration counted 5,700 people who had benefited.