The National Health Insurance Administration of the Ministry of Health and Welfare announced that starting in December, a new drug for treating the rare disease “AADC deficiency” will be covered under National Health Insurance (NHI). With each dose costing up to NT$100 million, approximately 13 patients are expected to benefit in the first year, with drug costs totaling approximately NT$1.3 billion. This decision has sparked public debate over whether high-cost rare disease medications should be included in NHI coverage.
Hsien-Ming Lien, President of the Chung-Hua Institution for Economic Research (CIER), explained that the NHI system inherently combines both insurance and social welfare functions. Its primary purpose goes beyond simply providing medical services. The goal is to prevent citizens from falling into poverty due to illness, thereby preserving the social safety net as an essential institution. The global healthcare industry is universally subject to high levels of regulation and subsidization, making it inappropriate to evaluate expensive drug coverage decisions solely on commercial grounds.
In the past, the high cost of dialysis treatment placed a heavy financial burden on patients, often forcing families into debt or even leading to tragedies. The NHI intervention has successfully alleviated pressure on many families and reduced the broader societal impact. While substantial, NHI expenditures play a crucial role in safeguarding vulnerable populations from the financial burden of medical expenses. By covering everything from rare disease medications to treatments for major illnesses, the NHI not only shields families from financial collapse but also represents society’s collective commitment to supporting those in need.
President Hsien-Ming Lien indicated his willingness to support NHI premium adjustments, noting that the existence of NHI enables society’s members to share risks. Even if individuals do not necessarily use these services themselves, they feel the expenditure is worthwhile. The society should view NHI financing and major drug coverage decisions from the perspective of long-term public interest.
Author: CIER Editorial Team
Date: December 4, 2025