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Advancing health technology assessment in Taiwan: over 15 years of evidence-based reform; innovation; and patient partnership
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DOI：10.1017/S0266462326103766.png)
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Abstract
En 中文
ObjectiveSince 2007; the Taiwan Health Technology Assessment (HTA) system has developed from a review process for new drug reimbursement into a core element of National Health Insurance (NHI) decision-making. This study examines Taiwan’s development of a sustainable; learning-oriented HTA ecosystem.MethodsThis article synthesizes more than 15 years of HTA development in Taiwan; highlighting recent advancements; including parallel reviews; temporary reimbursement pathways; managed entry agreements (MEAs); real-world evidence (RWE) guidelines; precision medicine frameworks; and structured health technology reassessment. Drawing on national policy sources; administrative datasets; and published evaluations; four interrelated domains were analyzed: institutional development and governance; access pathways for high cost and high clinical impact; infrastructure for evidence generation; and mechanisms to strengthen patient and patient organization involvement (PPI).ResultsIn 2024; 196 rapid HTA assessments were completed; reflecting increased system capacity and methodological sophistication. This evolution builds on earlier HTA-driven policy experiences; including immune checkpoint inhibitors supported by HTA; MEA design; and national RWD collection. These developments formed the groundwork for managing uncertainty; assessing high-cost therapies; and supporting life cycle evidence. Parallel review improved timely access to novel medicines without compromising assessment rigor. The Taiwan Cancer Drugs Fund provided a structured model for temporary reimbursement and RWD collection. Formal PPI processes expanded the integration of patient voices.ConclusionsTaiwan’s HTA system is transitioning into a learning health system that supports adaptive coverage; continuous reassessment; and sustainable access to new medical technologies. Developments offer guidance to health systems seeking to balance access; evidence development; and financial sustainability.
Keywords:
health technology assessment (HTA)
managed entry agreements (MEAs)
real-world evidence (RWE)
patient and patient organization involvement (PPI)
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