Centers for Disease Control strict controls on the payment for HAART

-Pharmacists shall assist to check

Reporter/Taitung County Wang Chung-jen

Source:http://www.taiwan-pharma.org.tw/weekly/1760/1760-3-2.htm

Reporter/Taitung County Wang Chung-jen

Translator：Liu TingYi

Our country is one of the few countries first provide HIV infectors with Highly Active Anti-Retroviral Therapy (HARRT) for free in the world at present. Since 1997 provides free HARRT, the lethality rates for AIDS cases have declined year by year. Forty-five designated hospitals in Taiwan provide those infectors with free medical therapy that caused the accessibility of medical care improved for the infectors.

However, the free supply of HARRT results in huge increasing in drug expenditure, and the average medical expenses for each infector is about three hundred and fifty thousand dollars per year. Because of the decline in mortality rates and the increment in survival rates, number of the infected persons has been increased and medical expenses/drug expenditure also augmented, which has been confronted by the plight of a serious shortage of the public affairs‘ budget of the government.

According to article fifth of “Regulations on Expense payment for Human Immunodeficiency Virus (HIV) inspection, prevention and treatment”, the designated medical institution can apply for the expense payment items are as below:

1. The medical expense for the relative treatment of HIV outpatient and hospital costs by diagnosis.

2. Drug charge for HIV.

3. Dispensing service fees for HIV medicines.

4. Inspection fees for HIV-1 viral load examination and lymphocyte subset analysis (infectious disease).

5. Other items specified by the central competent authority.

The payment benchmark for the preceding expense payment items is as below:

1. The items and prices of payment which set by central competent authority.

2. The payment standard of medical expense by National Health Insurance.

3. The items and prices of medicines and special materials which enclosed by National Health Insurance.

The anti-HIV medicines in the regulation of item 2, paragraph 1 has mentioned the usage regulation shall follow the regulation by central competent authority.
Therefore, in accordance with the payment benchmark in “Regulations on Expense payment for Human Immunodeficiency Virus (HIV) inspection, prevention and treatment”, the Centers for Disease Control has been set the newest payment regulation. And they decide to announce three implemented policy in March of the following, which provide the HARRT prescription for reviewing reference for pharmacists in the future.

1. The regulation of prescription: for all patients who need the prescription of anti-HIV, the prescription with same efficiency and lower prices has priority (the charges for medicine lower than twenty thousands and five hundred dollars per month).

2. To take the system of prior examination: if use the prescription which exceeds the limited amount of the charges for medicine per month, the prescription shall submit an application for prior examination.

3. To strengthen the random examination execution for the anamnesis: if use the prescription which exceeds the limited amount of the charges for medicine per month, the anamnesis shall mark the reason and strengthen the random examination. And pharmacists shall inform the hospital if the prescription is irregularity or unreasonable. The hospital shall not pay the case for the prescription after receiving the inform next month.

Anyway, health units of government have been adopted the necessary measure on the payment of anti-AIDS treatment. Therefore, pharmacists shall act as keepers on prescription examination, and assist the government to control the improper payment of medicine expense to avoid the medical resources waste and save the social resources.