Taiwan's health authority announced plans to significantly expand the National Health Insurance (NHI) coverage to include both cancer immunotherapies and targeted drugs, marking a major advancement in cancer care accessibility for Taiwanese patients.
Immunotherapy Coverage Expansion
Starting as early as June 2025, the NHI will cover three types of cancer immunotherapies as first-line treatments for non-squamous non-small cell lung cancer (NSCLC), metastatic colorectal cancer, and early-stage triple-negative breast cancer (TNBC).
According to the National Health Insurance Administration (NHIA), between 2,700 and 3,400 patients are expected to immediately benefit from this expansion. The government has allocated approximately NT$3.295 billion (US$101.28 million) from a dedicated cancer fund to subsidize these treatments annually.
Huang Yu-wen, director of the NHIA's Medical Review and Pharmaceutical Benefits Division, highlighted the financial impact for patients: "Cancer patients can expect to save about NT$1.71 million (US$52,564) to NT$2.47 million in medical expenses each year."
The distribution of beneficiaries across cancer types shows NSCLC patients forming the largest group (1,581-1,930 patients), followed by those with TNBC (826-897) and metastatic colorectal cancer (265-587).
The NHIA stated that this decision aligns with international treatment guidelines, specifically citing the United States' National Comprehensive Cancer Network (NCCN) as a reference. The immunotherapy drugs pembrolizumab and atezolizumab, which have shown effectiveness in treating NSCLC, will be covered under the expanded plan.
PARP Inhibitor Coverage Extension
In a parallel development, the NHIA announced that starting June 1, the NHI will also expand coverage to include two types of poly (ADP-ribose) polymerase (PARP) inhibitors—olaparib and niraparib—for the treatment of five types of cancers.
This expansion follows decisions made by the Pharmaceutical Benefit and Reimbursement Scheme Joint Committee in March and April meetings. The coverage will now include:
- Maintenance therapy for advanced high-grade epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal carcinoma
- Postoperative adjuvant therapy for early-stage breast cancer
- First-line treatment for metastatic castration-resistant prostate cancer
Currently, NHI payment covers PARP inhibitors only for advanced-stage epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal carcinoma with specific gene mutations (germline or somatic BRCA1/2). The expanded criteria will include patients with homologous recombination deficiency positive status, pathogenic BRCA gene mutation, or genomic instability.
Clinical Benefits and Economic Impact
The clinical benefits of these targeted therapies are substantial. According to the NHIA, olaparib plus bevacizumab as maintenance therapy has demonstrated "a clinically meaningful improvement in median overall survival by 17.9 months," while treatment with niraparib can extend progression-free survival by approximately 11.4 months.
Huang Yu-wen noted that the expanded PARP inhibitor criteria are expected to benefit about 775 additional patients and might cost up to NT$979 million (US$32.41 million) per year.
Addressing High-Burden Cancers
The expansion targets some of Taiwan's most prevalent cancers. According to 2022 cancer registry data released by the Ministry of Health and Welfare, breast cancer is the most common cancer among women, while ovarian and fallopian tube cancers rank among the top 10. For men, prostate cancer is the third most common malignancy.
The NHIA emphasized that these coverage expansions were decided after extensive consultations with local medical communities and patient advocacy groups, reflecting a collaborative approach to improving cancer care in Taiwan.
