Taiwan's NHI Strengthens Controls on Sleeping Pills, Targeting Polypharmacy in Seniors

(CNA, Taipei, June 8, by reporter Chen Chi-ling) As Taiwan enters a super-aged society, the prescription rate of sleeping pills has increased. Starting last December, the National Health Insurance Administration (NHIA) under the Ministry of Health and Welfare has strengthened its review process to implement better management of sleeping pills. It is conducting professional reviews for seniors over 65 who are on multiple hypnotic medications, with fewer than 100 cases having their prescriptions rejected for being unreasonable in the first quarter of this year.

According to NHIA statistics, from 2021 to 2025, approximately 1.9 million people used sleeping pills annually, with the elderly population aged 65 and above accounting for about 40%, or 760,000 people. Data from the International Narcotics Control Board (INCB) in 2024 shows that the daily dosage of some BZD and Z-drug sleeping medications in Taiwan is twice that of South Korea and three times that of Australia.

Last year, the NHIA convened professional communication meetings with major medical associations and the Taiwan Medical Association.

Chang Hui-ping, a senior specialist at the NHIA's Medical Review and Pharmaceutical Benefits Division, told the media today that the enhanced management targets elderly individuals who have been using large amounts of sleeping pills long-term. The focus is on patients over 65 who are simultaneously using three or more types of long-acting or short-acting hypnotic drugs and have accumulated more than six months of use within a year.

Chang said that by strengthening the management of sleeping pills and polypharmacy, the NHIA regularly monitors patients' medication use on a monthly basis. If polypharmacy of sleeping pills is found in seniors over 65, feedback is provided to the original medical institution and attending physician for guidance. The physician must explain the reason for the prescription, and clinical experts will review the rationality of the patient's medication use and re-evaluate the prescription.

NHIA Director-General Chen Liang-yu stated that the enhanced monitoring of sleeping pill use has been in effect since last December. In the first quarter, fewer than 100 cases were rejected, with no concentration in urban or rural areas, indicating that the proportion of inappropriate prescriptions is not high. Polypharmacy of sleeping pills in seniors over 65 can easily lead to risks of falls and fractures, and long-term use may also cause cognitive decline. It is necessary to raise the medical community's alertness to high-risk medication use and strengthen case management, health education, and referrals. For the public, the NHIA has integrated sleep health-related assessments and lifestyle counseling into the "Triple High Chronic Disease 888 Project." People can fill out the "Lifestyle Assessment Scale" through the "National Health Insurance Express" mobile app. The results will be imported into the family medicine platform, allowing physicians to provide consultation, advice, and referrals during visits. (Editor: Kuan Chung-wei) 20260608