1. National Health Account in Taiwan: An update Chung-Fu Lan National Yang-Ming University Pi - Joen Lee Department of Health, ROC (Taiwan) Seoul, 5th SHA Meeting June 16, 2009

3. Financial Flows in Taiwan’s Health Care System

4. Health Financing Overview, Taiwan 2005 Population (million) 23 Gross domestic products (GDP) per capita US$ 15,714 Total Expenditure on Health (TEH) per capita US$ 957 Public US$ 562 general gov’t (excl. social security) US$ 52 social security fund US$ 511 Private US$ 395 General government spending on health as a share of total government spending 11.50% Pharmaceuticals as a share of TEH 26.50% TEH as a share of GDP 6.09%

5. TEH Per Capita & GDP Per Capita in OECD Member Countries and Taiwan, 2005

6. Total Expenditure on Health by Financing Source, 2005

7. Out-of-pocket Health Expenditure

8. Out-of-pocket Expenditure by Provider, 2005

9. Out-of-pocket Expenditure by Function, 2005

10. Out-of-pocket Payments for Medical Care in Two Months VariableMeanSD% of total NHI cost-sharing: inpatient and outpatient1136426.9 NHI cost-sharing: prescription drugs14630.9 Over-the-counter drugs483212.9 Extra-billing for inpatient hospital bed356637821.6 Extra-billing for laboratory and diagnostic177244910.8 Extra-billing for surgery224217313.6 Extra-billing for medical equipments or supplies 11823057.2 Extra-billing for anesthesiology688204.1 All others527-32.0 Total out-of-pocket payments164519 264100 Note: All monetary values are in NT Yuan Reference: Chi C., Lee J-L., Tsai S-L., and Chen W-Y. Out-of-pocket payment for medical care under Taiwan’s National Health Insurance system. Health Econ, 2008; 17: 961-75.

11. Preliminary Analyses on Disease & Pharmaceutical Accounts

12. Personal Health Care Expenditure, Disease Specific, 2005

13. ATC Drug Expenditure, 2008 _____________ ATC____________________________________NT$(M)____Growth rate C Cardiovascular system 26,317 7.8% A Alimentary tract & metabolism 14,125 6.7% N Nervous system 14,097 6.0% J Antiinfectives for systemic use 13,961 6.6% L Antineoplastic & immunomodulating agents 13,306 17.9% B Blood & blood forming organs 9,549 9.0% M Musculo-skeletal system 4,713 0.7% R Respiratory system 4,622 -2.4% G Genitourinary system & sex hormones 2,589 7.2% H Systemic hormonal preparations (excl. sex hormon & insulin) 1,797 12.8% S Sensory organs 1,201 3.3% D Dermatologicals 1,167 -1.0% V Various 585 52.5% P Antiparasitic products, insecticides & repellents 160 3.0% ___________Total 108,187 7.8% * Growth rates are compared with drug expenditure year 2007

14. On-going Works To refine data & information on OOP expenditures –A National Household Health Care Expenditure Survey To complete Taiwan’s SHA-based Health Accounts, Year 1999 to 2004 & 2006 to 2008 To adjust with Consumer Price Index (CPI) & Medical Consumer Price Index (MCPI); or at constant year 2000 prices To interpretate the NHA’s policy implications

15. Thank You