HEOR, RWE, HTA for Policy Support – Experience from Taiwan’s National Hepatitis C Program

Published May 5, 2022

Raoh-Fang Jasmine Pwu, PhD, Director, National Hepatitis C Program, Ministry of Health and Welfare, Taipei, Taiwan

Hepatitis C has been a public health threat to Taiwan for decades. Among the several thousands of liver cancer deaths each year, Hepatitis C may account for 25% to 40% of them. With this heavy disease burden, Taiwan has put in many years’ work on all kinds of measures to control Hepatitis C – including mass screening programs, peg-interferon/ribavirin treatment reimbursement since 2007, and various prevention programs.

The new direct-acting antiviral (DAA) medications offer shorter therapy courses, oral administration, fewer serious adverse events and higher cure rates, shedding a light on the path to Hepatitis C elimination in Taiwan. The Ministry of Health and Welfare (MOHW) assessed the importance to public health and later initiated the National Hepatitis C Program Office (TWNHCP office) under the Ministry in December 2016 to assist on the policy formulation, coordination, implementation, and communication.

Specifically, TWNHCP has applied the HEOR methods, RWE and HTA concepts to the following developments:

1. Develop a policy guideline: a group effort on collecting and summarizing the epidemiological, clinical, institutional characteristics to formulate a roadmap for policies and the strategies. For example, an HCV risk map down to county level was developed and revised using available datasets. This map is used by local governments as their guide to the prioritization of community screening efforts.

2. Set up a patient registry: a DAA-reimbursement patient registry was set up within National Health Insurance system, for the purposes of 1) quota control in the initial stage when there was limited all drug expenses NHI budget; 2) safety and short-term effectiveness (SVR12, adherence, etc.) monitoring; 3) national program completeness and long-term outcome assessment.

3. Economic evaluation: the TWNHCP involves all kinds of interventions (DAA treatments, screening programs, diagnosis tools) in various settings. Careful assessment of the cost-effectiveness and budget impact in each program is essential.

4. Projection of the expected benefit: communication materials, including the budgets spent and the long-term benefit due to the TWNHCP, is constantly provided to the stakeholders. This is important to every policy but especially crucial in TWNHCP since the allocated budget is high.

TWNHCP has been working for over 5 years now. It is estimated that we are over halfway to the WHO’s goal of elimination. More than 135,000 patients received DAA treatment under NHI reimbursement and 95% of them are cured (SVR12). A national screening targeting 45~79-year-old adults was installed, and more than 1.6 million received anti-HCV tests. Several special population screening and treatment programs have been planned and implemented as scheduled. It is with high chance that Taiwan achieves the goal of Hepatitis C elimination in the near future.
Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now