Managed Entry Agreements in Taiwan: An Overview
Managed Entry Agreement (MEA) is a negotiated agreement between the pharmaceutical company and the health authority of a country to provide access to a high-cost drug that is not yet reimbursed by the country`s public health insurance system. It is a way to balance the needs of patients who require the drug with the financial limitations of the healthcare system. In Taiwan, the government has been implementing MEAs to help address the increasing demand for expensive drugs while keeping healthcare expenditures under control.
Taiwan`s National Health Insurance (NHI) system covers over 99% of the population and reimburses an extensive list of drugs, medical procedures, and services. However, the system faces the challenge of providing access to high-cost drugs that are not yet covered by the NHI. The government has been using MEAs to handle this challenge. Under an MEA, the pharmaceutical company agrees to provide the drug at a discounted price or on a cost-sharing basis, and the government agrees to cover the drug under the NHI for a limited time.
One example of an MEA in Taiwan is the agreement for the use of a drug called Spinraza, which is used to treat spinal muscular atrophy (SMA). SMA is a rare genetic disease that affects infants and children, causing muscle weakness and wasting. Spinraza is an expensive drug, and the cost of treatment can run up to millions of dollars per patient over their lifetime. The high cost of the drug has limited access for many SMA patients in Taiwan. In 2019, the government signed an MEA with the pharmaceutical company, allowing access to the drug for SMA patients at a significantly reduced cost.
MEAs are beneficial in providing access to high-cost drugs for patients who need them and addressing the financial challenges faced by healthcare systems. However, the use of MEAs needs to be managed carefully to ensure that patients receive necessary treatments while maintaining the financial sustainability of the healthcare system. In Taiwan, the government has implemented a rigorous process to evaluate and approve MEAs. Before a drug can be included in an MEA, it must undergo a comprehensive review by the National Health Insurance Administration (NHIA) and the Drug Benefit Committee (DBC). The review process considers the drug`s clinical efficacy, safety, cost-effectiveness, and other factors to determine its suitability for an MEA.
In conclusion, MEAs are an important tool for providing access to high-cost drugs for patients while balancing the financial limitations of healthcare systems. The use of MEAs in Taiwan has helped address the challenges of providing access to expensive drugs and has enabled patients to receive needed treatments. The government`s rigorous evaluation and approval process for MEAs ensures that patients receive high-quality care while maintaining the financial sustainability of the healthcare system.