NHI to Benefit 1.05 Million from September: Expanded Coverage for Lipid-Lowering and Rare Disease 'Bleeding Control' Medications

The National Health Insurance Administration (NHIA) will implement new drug reimbursement measures starting September 1, 2024, including expanded coverage for lipid-lowering medications aligned with clinical treatment consensus, as well as newly added treatments for rare diseases such as paroxysmal nocturnal hemoglobinuria (PNH) and cholestatic pruritus.

The expansion of lipid-lowering drug coverage alone is expected to benefit approximately 1.05 million patients, with an estimated drug expenditure of NT$2.28 billion.

The NHIA stated that these measures support the 'Healthy Taiwan – Three Highs Prevention 888' policy goal, aiming to strengthen cardiovascular disease prevention and chronic disease care. Based on the '2025 Taiwan Lipid Management Clinical Pathway Consensus' jointly developed by nine medical societies, the NHIA has revised LDL-C initiation and treatment targets according to atherosclerotic cardiovascular disease (ASCVD) risk levels, expanding reimbursement for statin-class drugs, ezetimibe, and combination drugs containing both ezetimibe and statins.

The NHIA explained that the expanded coverage will align Taiwan's lipid treatment standards with the latest clinical guidelines, enabling hyperlipidemia patients to receive appropriate drug therapy earlier and effectively reduce cardiovascular risks, thereby providing stable and comprehensive medical care.

Additionally, to improve the quality of life for patients with rare cholestatic diseases, the NHIA will begin reimbursing medications containing maralixibat chloride from September 2024, for treating cholestatic pruritus in patients aged one year and older with Alagille syndrome (ALGS) and progressive familial intrahepatic cholestasis (PFIC).

The NHIA noted that cholestasis can cause severe itching, leading patients to scratch repeatedly, resulting in skin damage, bleeding, infections, and even sepsis. The new drug reduces serum bile acid concentration and alleviates bile acid accumulation, effectively improving difficult-to-control pruritus symptoms, enhancing patients' daily quality of life and care outcomes. Approximately 18 to 28 patients are expected to benefit, with an estimated drug expenditure of NT$0.85 billion.

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