If regenerative medicine is included in the health insurance payment, it is expected to reduce the cost of cell therapy and benefit more patients.

(Information photo, provided by Xuanjie)

[Reporters Lin Huiqin, Wang Menglun, Wu Xintian/Report from Taipei] Regarding the inclusion of regenerative medicine into the health insurance and commercial insurance mechanisms, Shi Chongliang, Director of Health Insurance of the Ministry of Health and Welfare, said that the procedures for regenerative medicine to be included in health insurance are the same as other new drugs and new technologies, and commercial insurance is expected to make up for the burden of the public. part.

An official from the Insurance Bureau of the Financial Supervisory Commission pointed out that the insurance industry has been invited to conduct research. There are four main links. The most important thing is the acquisition of relevant "medical data". The Ministry of Health and Welfare will be asked to provide assistance.

Shi Chongliang pointed out that for regenerative medicine to be included in the health insurance process, first obtain the drug license and submit the relevant materials to the National Health Insurance Administration, then arrange an expert consultation meeting, conduct a medical technology assessment (HTA), and check the cost effect and the empirical basis of the patient's prognosis. If there is no problem , and then further included in the joint drafting meeting of health care drug payment items and payment standards for discussion, and can be included in the payment after approval.

For example, gene therapy for spinal muscular atrophy (SMA) and CAR-T therapy for leukemia have entered the HTA stage.

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Shi Chongliang further explained that the burden of public medical treatment can be divided into partial burden and differential burden. For example, the specialty of Da Vinci surgery is the differential burden. Commercial insurance can make up for the gap in health insurance benefits. In the future, regenerative medicine may also take this approach.

An official from the Insurance Bureau stated that the introduction of regenerative medicine into commercial insurance involves four links in the procedure: the first is the insurance company's "willingness to start"; the second is "data information", which is the most critical link, because if there is no relevant data, It is difficult to evaluate design products. If there is no domestic medical statistics, I hope to at least obtain international data; the third is "pricing", that is, to formulate rates and prices based on the aforementioned data; the fourth is reinsurance companies , so that the risk spread out.

At present, some life insurance companies have cooperated with the government to launch health insurance collaborative commercial insurance to provide more comprehensive medical protection; whether regenerative medicine will be included in the plan in the future, the industry said that it is inconvenient to comment further.