The Ministry of Health and Welfare (MOHW) has announced a draft amendment to increase the maximum reduction rate for drugs under the volume-based pricing negotiation system, raising it from 10% to 15%. An interim reduction rate of 12.5% will apply until December 31, 2025, with the full 15% discount cap set to take effect from 2026.

The volume-based pricing system adjusts drug prices through negotiation when expenditures on specific high-cost drugs surpass a set threshold, primarily targeting those with an average annual claim amount near $21.7 million. Currently, the cap on reduction rates is 10%, but under the new guidelines, this will rise to 15%, effective immediately upon official notification. The Ministry is open to public feedback on the proposal until December 16.

In April, the National Health Insurance Service (NHIS) revised operational guidelines for volume-based pricing, introducing a differential adjustment formula based on claim amounts rather than solely on usage increases. This includes raising the minimum claim amount for negotiation eligibility from $1.4 million to $2.2 million.

Additional adjustments aim to foster a more innovative pharmaceutical and biotech environment. Discounts are now available for companies investing over 10% in R&D. For drugs negotiated under this system more than three times within five years, the discount on the third negotiation will be reduced by 30%.

Furthermore, a "one-time reimbursement contract system" has been established for cases of unexpected surges in drug use, such as those caused by infectious disease outbreaks. This system provides reimbursement based on a reference formula discount rate, supplementing standard reduction measures.