Taiwan expands NHI drug coverage, IVF subsidies and children’s dental care

台灣擴大健保藥物給付、試管嬰兒補助及兒童牙科照護

TAIPEI (Taiwan News) — The National Health Insurance Administration will expand coverage for cholesterol-lowering drugs and add treatments for rare diseases beginning Sept. 1, while the government will also increase subsidies for in vitro fertilization and expand dental fluoride treatment for children, per UDN.

The NHIA said the changes to reimbursement rules for cholesterol-lowering drugs are intended to bring coverage in line with the “2025 Taiwan Lipid Management Clinical Pathway Consensus.” The expanded coverage will apply to statins, ezetimibe, and combination drugs with eligibility determined according to patients' cardiovascular risk levels and LDL-C treatment thresholds.

The agency estimates the changes will benefit about 1.05 million additional patients and increase annual drug spending by approximately NT$2.28 billion. The agency said the changes are intended to allow patients with high cholesterol to receive appropriate medication earlier and reduce their risk of cardiovascular disease.

The NHIA will also add two drugs for rare diseases to its reimbursement program. Fabhalta 200mg hard capsules, containing iptacopan, will be covered for eligible adult patients with paroxysmal nocturnal hemoglobinuria, or PNH. As an oral treatment, the drug provides another treatment option for patients with the rare blood disorder.

Livmarli oral solution, containing maralixibat chloride, will also receive temporary NHI coverage for eligible patients aged 1 and older with progressive familial intrahepatic cholestasis and Alagille syndrome (ALGS) who experience severe itching. The agency formally announced the temporary reimbursement of Livmarli on Aug. 14.

The government will also expand free fluoride treatment for children. Under the revised program, children will be eligible for subsidized fluoride treatment from birth through Aug. 31 of the year they enter elementary school. The change addresses a gap under the previous age rules that left some children who were already six but had not yet entered elementary school ineligible for the service.

The service includes professional fluoride treatment by dentists, oral examinations, and oral health education covering proper tooth cleaning, healthy eating, and other preventive measures.

Before entering elementary school, children can receive subsidized treatment every six months. Disadvantaged children younger than 12 from low-income households, as well as children with disabilities and those living in Indigenous, remote, or outlying island areas, can receive treatment every three months. The government estimates the expanded eligibility will benefit about 128,000 additional children, per UDN.

The Health Ministry said the prevalence of cavities in baby teeth among 5-year-olds fell from 65.4% in 2018 to 46.3%, while the average number of decayed, missing, or filled permanent teeth among 12-year-old students declined from 3.31 in 2000 to 2.01 in 2020.

The government will also increase subsidies for IVF treatment beginning Sept. 1. Under the revised IVF 3.0 program, the maximum subsidy for the second and third treatment cycles for each pregnancy will increase from NT$100,000 to NT$150,000 for women younger than 40.

For women aged 40 to under 45, the maximum subsidy for the second and third cycles will increase from NT$80,000 to NT$130,000. The Health Promotion Administration said the higher subsidies apply to applications submitted beginning Sept. 1.

The HPA estimates that about 20,000 people currently receive IVF subsidies each year and that the expanded program will provide higher subsidies to nearly 5,000 women.