The Committee commends the Ministry of Health and Welfare (MOHW) for its impressive achievements with regard to hepatitis C (HCV) treatment. Not only were around 10,000 patients helped in 2017, with the figure estimated to rise to over 17,000 this year, but even more importantly the potential risk of liver cancer is being reduced substantially.
Considering Taiwan’s outstanding history with regard to liver health management, Taiwan is well positioned to become the Liver Health Center of Excellence in Asia. The Committee and its members offer their cooperation to MOHW in working together toward that goal.
The Committee notes with appreciation that the government has increased the Vaccine Fund budget from NT$2.2 billion in 2017 to NT$3.1 billion in 2018, as part of ongoing efforts to enhance the standard of Taiwan’s national immunization programs. We urge MOHW to continue to strive to improve Taiwan’s vaccination policies and to allocate sufficient funding to make Taiwan a leading country in the region in this field.
Suggestion 1: Build Taiwan into a Liver Health Center of Excellence in Asia.
Liver health is always the one of the primary healthcare issues in Taiwan. According to the Ministry of Health and Welfare (MOHW), around 13,000 people died due to chronic liver disease, liver cirrhosis, and liver cancer in 2016. Chronic liver disease and cirrhosis is the ninth biggest cause of death in Taiwan, and liver cancer is the second leading cancer in terms of mortality. Hepatitis B (HBV) and Hepatitis C (HCV) are the key risk factors for chronic liver disease, liver cirrhosis, and liver cancer.
Taiwan implemented an HBV vaccination program for newborn babies as early as 1986, which received wide international recognition. Establishing HCV reimbursement in 2017 was another critical milestone, as it will lead to the eradication of HCV in Taiwan. As a result of these measures and in view of Taiwan’s world-class healthcare system and strong R&D expertise, the Public Health Committee believes Taiwan has the ability and opportunity to become the “Liver Health Center of Excellence in Asia.”
The biotechnology industry has been identified by President Tsai as one of Taiwan’s strategic growth drivers, mainly because biotechnology development will improve Taiwan’s healthcare technology. In the “Asia Pacific Bio-Pharma R&D Center White Paper,” President Tsai described bio-pharma as a capital-intensive, technology- intensive, and professional-intensive industry.
Based on the experience of advanced countries, the key success factors for bio-pharma industry development are people, IPR, regulations, and markets. The Committee sincerely hopes to partner with the Taiwanese government to enhance international cooperation, increase liver disease-related new drug development and clinical trials, and accelerate patients’ access to innovative medicines in order to improve Taiwan’s disease management and treatment of chronic liver disease, liver cirrhosis, and liver cancer.
Set up a cross-department agency to integrate the resources of screening, prevention, and treatment for all liver-related diseases. The agency would be tasked with reviewing and prioritizing the needs and resource allocations of medical services, medicines, vaccines, and devices.
Provide sufficient healthcare expenditure, especially increasing the public sector’s share, for development of an overall liver health-related disease prevention and treatment plan, so as to solve this important public health issue and reduce the death rate due to liver disease.
Develop comprehensive liver disease prevention and treatment related regulations, i.e. accelerating the reimbursement process and increasing the budget for new drugs, in order to accelerate patients’ access to innovative medical technology.
AmCham Taipei’s member companies stand ready to help facilitate Taiwan’s development as a Liver Health Center of Excellence in Asia, for example by encouraging the conducting of more liver disease new-drug clinical trials in Taiwan.
Suggestion 2: Improve Taiwan’s vaccination practices, restoring Taiwan’s leading position in the region for vaccination policy.
Vaccination is one of the most powerful and cost-effective measures for fighting disease. Besides preventing illness and death, it also brings the social and economic benefit of reducing the amount of lost work and lowered productivity. The Committee commends the government for having increased the Vaccine Fund budget from NT$2.2 billion in 2017 to NT$3.1 billion in 2018, and for announcing the introduction of human papillomavirus (HPV) vaccines for girls in 2018 as part of ongoing efforts to enhance the standards of Taiwan’s national immunization programs.
Taiwan used to be a pioneer in vaccination efforts such as the hepatitis B vaccination program it initiated for newborns. However, recently Taiwan’s budget for vaccination and the introduction of new vaccines has fallen behind our neighboring countries. The Taiwan Immunization Vision and Strategy, an association formed by medical experts, published a policy recommendation paper in 2017, advocating more government budget for vaccination so that Taiwan can catch up with the many countries in the world that have adopted more extensive national immunization programs.
The report indicates that the value of lost productivity due to seasonal influenza came to around NT$30 billion in 2010-2011, far more than the procurement cost of flu vaccines. UK researchers also estimate that a severe influenza pandemic could result in a decrease in Gross Domestic Product (GDP) of between 0.5% and 4.3%. As U.S. Centers for Disease Control and Prevention has reported, on average each US$1 in investment on vaccination brings US$10 in reduced medical and social expenses. Vaccination should therefore be seen as an investment, not a cost.
Based on the recommendations by the Advisory Committee on Immunization Practices (ACIP), several new vaccines will be introduced into Taiwan’s national program in the Phase III five-year plan starting 2019. The Committee urges the government to come up with a robust financial plan to ensure sufficient budget to implement this policy. In addition, the Committee would be happy to introduce analytic models such as the “Optimization Model” to help maximize desired healthcare objectives while also respecting budgetary and other limitations.
Introducing new vaccination programs will not only help protect the Taiwanese people’s health in line with international standards, but also rebuild Taiwan’s leading position in vaccination policy in the Asia Pacific. It will support the government’s New Southbound Policy by enabling Taiwan to showcase its successful healthcare practices to regional partners.