《TAIPEI TIMES》Partial coverage for cancer drug begins

ALLAYMENT: The NHI on Wednesday began partial coverage of a leukemia and lymphoma therapy, lowering patients’ yearly drug costs by about NT$5 million

By Lin Hui-chin and Jonathan Chin / Staff reporter, with staff writer

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The National Health Insurance Administration has begun to partially cover chimeric antigen receptor T-cell （CAR-T） therapy, benefiting 100 people diagnosed with certain types of leukemia or lymphoma every year, it said yesterday.

The provisional expansion, which is set to increase National Health Insurance （NHI） costs by NT$800 million （US$24.71 million） annually, took effect on Wednesday, agency Director-General Shih Chung-liang （石崇良） said.

The policy marked CAR-T therapy as the first cellular therapy to be covered by the NHI, he said.

CAR-T therapy utilizes the transplantation of genetically modified T-cells to treat some types of cancer, including acute lymphoblastic leukemia and diffuse large B-cell lymphoma.

Drugs utilized for the therapy were formerly a self-paid medication that cost patients up to NT$13 million per year, a sum NHI coverage has reduced to NT$8.19 million per year, Shih said, adding that drugs cost NT$15 million per year for patients in the US.

Coverage for the drugs is tentative and its continuation would depend on CAR-T therapy’s observed effectiveness in the real world, the agency said, adding that a total of four types of cancer drugs currently fall under provisional insurance coverage.

The NHI currently covers the use of Kymriah in patients with acute lymphoblastic leukemia and diffuse large B-cell lymphoma, said Lee Chih-cheng （李啟誠）, an oncologist at Hualien Tzu Chi Hospital.

This type of cancer drug is being prescribed at National Taiwan University Hospital and its cancer center; Linkou Chang Gung Memorial Hospital; China Medical University Hospital and its cancer center; Taichung Veterans General Hospital; and Hualien Tzu Chi Hospital, he said.

Acute lymphoblastic leukemia mainly affects children between three and five years of age, with recurrence in 15 percent to 20 percent of patients, said Huang Wei-han （黃威翰）, another oncologist at Hualien Tzu Chi Hospital.

Patients with a recurrence of this type of cancer report a survival rate of 30 percent to 50 percent after five years, he said.

Diffuse large B-cell lymphoma is a cancer mainly affecting elderly people, and the disease has a 50 percent recurrence rate in adults, Huang said, adding that patients with a recurrence report a 10 percent survival rate after five years.

CAR-T therapy achieves complete response in 62 percent of acute lymphoblastic leukemia patients and 40 percent of diffuse large B-cell lymphoma patients, said Hematology Society of Taiwan secretary-general Huang Tai-chung （黃泰中）.

The therapy could sometimes achieve these results with just one round of treatment, he added.

新聞來源：TAIPEI TIMES