How to promote patient support programs in Taiwan's hospitals to help patients

Taiwan's National Health Insurance system provides extensive medical coverage, but as medical costs rise, some patients still face financial difficulty with self-paid drug treatment. Promoting a Patient Assistance Program (PAP) can further ease these patients' financial pressure and improve access to new medical treatments. However, hospitals' understanding of and assistance with patient support programs are crucial for patients. From clinical treatment to simplifying the application process and proactively providing patient support information, only then can better medical and financial-assistance outcomes be achieved.

1. The importance of medication support programs

Although Taiwan's National Health Insurance (NHI) already covers most medical costs, some newly launched high-price drugs and treatments still require patients to pay high out-of-pocket costs. A Patient Assistance Program (PAP) can provide the necessary financial support for patients who cannot bear the full cost, easing their burden in obtaining needed treatment, which is crucial for improving the accessibility and fairness of new medical treatments.

2. The challenges hospitals face

In Taiwan's hospitals, because NHI support covers most standard treatments, cases in which patients cannot receive treatment due to poverty are relatively rare, and hospitals' bad-debt rates are usually low. However, for items requiring self-paid care, because they involve the patient's ability to pay, patients need to sign a self-pay consent form with the physician to clearly understand the financial burden before proceeding with self-paid treatment. Patients with different financial capacity bear different levels of financial stress, which in clinical treatment prompts physicians and patients to make treatment recommendations and choose options together, ensuring the best shared decision-making process.

3. Raising awareness and reducing misunderstanding

In promoting patient support programs, there are indeed some obstacles, including patients' insufficient understanding of the program or inability to obtain related information, or mistakenly assuming that because they are not low-income households they are not eligible. In the past, patient support programs mostly came from charity or compassionate-use programs, but as the market has evolved, today's programs are more oriented toward the concept of continuous financial support, especially providing drug support solutions in situations the NHI cannot reimburse.

To overcome these obstacles, it is recommended that hospitals increase patients' understanding of support programs through promotion and education. This includes proactively providing information about the programs, so patients understand that they may be eligible and the importance of applying. This ensures that patients can obtain more comprehensive information in treatment decisions and choose the treatment option best suited to their needs.

4. Simplifying the application process

When a patient wants to apply for a support program, they must follow the hospital's clinical process, including obtaining the physician's prescription consent and the necessary medical-record and medication information. Given the authorization requirements for medical personal data and compliance management, the application process is usually quite cumbersome, especially the need to fill out application forms and attach documents, so patients usually need help to complete the application, which becomes another kind of medical barrier.

Simplifying and digitizing application forms, so that the information needed for program review can be verified digitally, is the best patient-centered practice. This not only makes the hospital's clinical work and program applications smoother but also helps reduce the impact on the timeliness of care.

5. Proactively screening patient eligibility

If hospitals can collaborate through system integration with patient support programs, comparing and screening drug-cost financial plans against prescription content so that eligible patients can have their physician proactively apply for a PAP, this can ensure that patients' treatment rights are protected. However, this approach requires adjusting the integration of the medical information system and the patient support program system, so that program drugs can be incorporated into the patient's treatment plan.

6. Legislative trends and policy application

It is recommended that Taiwan draw on the practices of other countries and, while considering the limits of NHI subsidies, incorporate patient support program applications into policy considerations and provide clear administrative guidance to help the market operate more efficiently. A public-private new-drug policy can let hospitals more effectively manage self-paid drug situations while providing patients with better treatment and care during the wait for NHI applications.

7. The hospital's social responsibility and mission

Providing inclusive healthcare is an important part of a hospital fulfilling its social responsibility! In addition to caring for the community and for low-income households or special populations, combining patient support programs to reduce patients' financial burden not only helps improve patient health outcomes but also enhances the hospital's reputation and satisfaction.

─ PatientForce Media-WIND Health Group General Manager Sean Chang