2026/10/07 12:05
National health insurance will expand immune globulin benefits and implement the national blood policy. (File photo)
[Reporter Luo Bi/Taipei Report] Immune disorders attack peripheral nerves, which may make children weak and have difficulty walking. Starting from October 1, the National Health Insurance Administration will expand the payment of high-unit immune globulin. The second-generation national blood preparation made from Chinese plasma will be included in the items that can be used by patients with chronic inflammatory demyelinating polyneuropathy (CIDP) over the age of 2 and under 18 years old, giving eligible sick children one more treatment option.
Ye Jianhong, deputy director of Shin Kong Hospital, said that this type of chronic neuritis is related to immune disorders. Standard treatments include immunomodulatory drugs such as steroids. Intravenous immunoglobulin (IVIG) is also a first-line treatment option. It can often quickly improve the course of the disease, and its episodic use can help to maintain a stable course of the disease. However, health insurance has payment conditions, and whether patients need to use it must still consider the severity of the disease.
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Ye Jianhong pointed out that immune globulin has clinical experience in treating CIDP, and adults are also covered by health insurance for its use. The focus of this adjustment is to allow children and adolescent patients to use this national blood preparation, which is obtained by blood donation from Taiwanese people and made in Australia, subject to compliance with regulations.
Hong Zhengsheng, a consultant physician at the Taiwan Blood Foundation, explained that the pathogenesis of CIDP is still unclear. The patient's immune system will attack the myelin sheath of peripheral nerves, resulting in damage to nerve conduction. Limb weakness, loss of leg sensation, and difficulty in walking may occur. In addition to steroids and immunoglobulins, plasmapheresis, commonly known as "blood washing", can also be used to separate and remove plasma containing autoantibodies or inflammatory factors, and then reinfuse healthy plasma.
Wang Zongxi, CEO of the Taiwan Blood Foundation, said that the second-generation national blood preparation Yikang will be launched in 2024, and the approved indications include CIDP. National Cheng Kung University Hospital, Chang Gung Memorial Hospital and other medical centers have also had precedents of using Privigen to treat patients under the age of 18 through health insurance projects or prior review.
Wang Zongxi pointed out that in the past, payment regulations did not specify that this national blood preparation could be used in this age group. Although there is clinical experience in using it, sick children may still face out-of-pocket expenses or limited medication choices. Therefore, the Blood Foundation wrote to the National Health Insurance Department in November last year, recommending that payment regulations be clearly stated. The National Health Insurance Department convened an expert meeting and completed the revision so that sick children who meet medical indications and review conditions can have clearer medication choices.
This revision also expands the qualifications of CIDP diagnostic and prescribing physicians to "neurologists or pediatric neurologists", so that sick children can be evaluated and treated by pediatric neurologists. Patients must still meet relevant diagnostic and treatment conditions and undergo prior review and approval before they can use high-unit immune globulin.
Regarding the number of patients, clinical estimates provided by the Blood Foundation indicate that there are dozens of new cases of CIDP in domestic children and adolescents every year, and the total number of patients does not exceed a hundred. However, Ye Jianhong has reservations about this estimate, believing that the number of cases in children may not be so large, and whether patients need immune globulin treatment cannot be determined based on diagnosis alone, but the severity of the condition must be considered.
Wang Zongxi emphasized that the two immune globulins used in CIDP, the original health insurance benefit, came from abroad. Once the supply is in short supply, it may affect the treatment of patients. Increasing the option of national blood preparations will not only implement "national blood for national use", but also help reduce the risk of imported supply fluctuations and enhance the autonomy of the supply of blood preparations.
