Page 10 - 中華民國112年版 全民健康保險會年報

2023 ANNUAL REPORT 摘要

中華民國112 年
全民健康保險會年報

Abstract

The National Health Insurance Committee (NHIC) functions as a consultation and public
communication platform for National Health Insurance (NHI) policies. It is mandated by NHI
regulations to deliberate insurance rates, negotiate and allocate the total amount of medical benefits
payments, and oversee NHI operations. Comprised of 39 members serving a two-year term, the
6th term committee, inaugurated in 2023, saw a turnover rate of 43.6% from the previous term.
Committee members endeavor to consolidate consensus from diverse perspectives and proactively
propose various suggestions to fulfill their statutory obligations. To mark its 10th anniversary, the
committee hosted a seminar and consensus camp in 2023, dedicated to reviewing the achievements of
the past decade and outlining future prospects. This event provided a platform for committee members
to exchange and pass on their experiences, offering valuable insights for enhancing operational
efficiency.

In 2023,the overall budget of NT$3,274 million was allocated for the introduction of new
medical technologies, while NT$1,283 million was earmarked to relax the reimbursement regulations
for pharmaceuticals and medical devices. This adjustment aimed to align insurance coverage more
closely with the actual healthcare needs of the public, thereby offering more comprehensive care.
The National Health Insurance Administration (NHIA) expanded the scope of coverage by adding 22
new medical procedures, 87 new medical devices, and 31 new pharmaceuticals, including 8 cancer
drugs and 10 drugs for rare diseases. Significantly, for the first time, the reimbursement scheme
included gene therapy drugs for rare diseases, particularly for the treatment of spinal muscular
atrophy (SMA). This breakthrough innovation requires only one injection for a lifetime, greatly
enhancing convenience for patients. Moreover, in 2023, insurance coverage for "cochlear implants"
was expanded from unilateral to bilateral implants, extending benefits to approximately 168 severely
hearing-impaired children. Additionally, reimbursement criteria for various medications and medical
devices for conditions such as cancer and rare diseases were broadened. Notably, the criteria for
oral hepatitis B antiviral drugs were eased, benefiting over 210,000 individuals and contributing to
Taiwan's objective of eliminating viral hepatitis ahead of schedule.

To diligently fulfill its statutory duty of supervising health insurance operations, in 2023, the
NHIC completed a report on the results monitoring of the 2022-year supervisory indicators in 2023.
Among the 5 major dimensions and 23 indicators monitored, 10 showed improvement and should
be maintained. However, trends in 13 indicators showed slight regression, particularly in the areas of
efficiency and resource allocation, which deserves special attention. The NHIC will keep supervising
the indicators and request the NHIA to conduct a comprehensive review of concerning indicators from
the standpoint of insurer management, examining the underlying reasons for regression. Improvement

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