Acute Myeloid Leukemia Strikes Fiercely; Medical Community Calls for Breaking Payment Restrictions
Dr. Hou Hsin-an of Taiwan called for easing National Health Insurance payment restrictions for acute myeloid leukemia (AML) treatment. Despite new drugs improving patient survival rates, payment conditions deviate from international guidelines, posing challenges for early precision medicine and treatment continuity.
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- 📰 Published: April 19, 2026 at 14:12
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Hou Hsin-an, convener of the Acute Myeloid Leukemia Working Group of the Hematology Society of the Republic of China and attending physician in the Department of Internal Medicine at National Taiwan University Hospital, pointed out today at the World Acute Myeloid Leukemia Day event that acute myeloid leukemia (AML) develops rapidly with aggressive symptoms. AML is the most common and most malignant acute blood cancer in adults, accounting for 32.2% of all leukemias.
According to statistics, nearly a thousand new cases of acute myeloid leukemia are diagnosed in Taiwan each year, with over 50% being elderly individuals aged 65 or older, and the rest mostly middle-aged adults. Hou Hsin-an stated that in the past, with only standard chemotherapy or bone marrow stem cell transplantation, the average survival for those aged 65 and above was only about 3 to 5 months. Even for younger groups under 65, the 5-year survival rate was less than half.
Hou Hsin-an said that with the advent of new drugs, the survival period for acute myeloid leukemia patients aged 65 and above can be extended to 10 to 12 months, and the 5-year survival rate for younger groups can be increased to 60% to 70%. Because healthy bone marrow cells are occupied by cancer cells in a very short time, if not discovered and treated promptly, patients may die from severe infection or massive bleeding within a few weeks to months.
The Central National Health Insurance Administration has included new therapies for acute myeloid leukemia in its payments in recent years. Hou Hsin-an pointed out that compared to international treatment guidelines, there is still room for optimization in NHI payment conditions. "This is a disease racing against time," he said, proposing three major directions: early precise medication, seamless integration of patient eligibility and treatment courses, and comprehensive care.
He explained that there is often only one chance to treat acute myeloid leukemia. Next-generation sequencing (NGS) is expected to expand its payment coverage to different cancer types in the second half of the year. He hopes that AML can be included, and that restrictions on the use and course of precise targeted new drugs can be further relaxed, reducing or eliminating cumbersome prior reviews, allowing patients to seize the first opportunity for cure.
Hou Hsin-an stated that due to budget constraints, many targeted drugs have strict "treatment course and payment period limits." He hopes that the scope of application can continue to be expanded in the future, benefiting young, elderly, and frail individuals alike; while also ensuring the completeness and continuity of the treatment course, preventing patients from being "forced to discontinue medication" due to NHI payment restrictions, even if the medication is effective, leading to changes in their condition.
He also believes that Taiwan's NHI currently has some "mutually exclusive payment" clauses, putting doctors and patients in a dilemma regarding treatment choices. He hopes that by referring to international systems, a complete treatment map can be provided to ensure patients receive comprehensive care at all stages of cancer fighting, such as targeted therapy, low-intensity treatment, infection prevention during treatment, and long-term maintenance medication after remission, to prevent recurrence.
Hou Hsin-an said that many patients often ignore their body's warning signs and delay seeking medical attention. If people find unexplained recurrent fever, or accompanied by extreme fatigue, shortness of breath during activity, unexplained bleeding or bruising, and bone pain—these four major warning signs, especially when two or more symptoms appear simultaneously, they must not be taken lightly and should seek blood tests at a hematology-oncology department or family medicine department as soon as possible. (Editor: Chen Ching-fang) 1150419
According to statistics, nearly a thousand new cases of acute myeloid leukemia are diagnosed in Taiwan each year, with over 50% being elderly individuals aged 65 or older, and the rest mostly middle-aged adults. Hou Hsin-an stated that in the past, with only standard chemotherapy or bone marrow stem cell transplantation, the average survival for those aged 65 and above was only about 3 to 5 months. Even for younger groups under 65, the 5-year survival rate was less than half.
Hou Hsin-an said that with the advent of new drugs, the survival period for acute myeloid leukemia patients aged 65 and above can be extended to 10 to 12 months, and the 5-year survival rate for younger groups can be increased to 60% to 70%. Because healthy bone marrow cells are occupied by cancer cells in a very short time, if not discovered and treated promptly, patients may die from severe infection or massive bleeding within a few weeks to months.
The Central National Health Insurance Administration has included new therapies for acute myeloid leukemia in its payments in recent years. Hou Hsin-an pointed out that compared to international treatment guidelines, there is still room for optimization in NHI payment conditions. "This is a disease racing against time," he said, proposing three major directions: early precise medication, seamless integration of patient eligibility and treatment courses, and comprehensive care.
He explained that there is often only one chance to treat acute myeloid leukemia. Next-generation sequencing (NGS) is expected to expand its payment coverage to different cancer types in the second half of the year. He hopes that AML can be included, and that restrictions on the use and course of precise targeted new drugs can be further relaxed, reducing or eliminating cumbersome prior reviews, allowing patients to seize the first opportunity for cure.
Hou Hsin-an stated that due to budget constraints, many targeted drugs have strict "treatment course and payment period limits." He hopes that the scope of application can continue to be expanded in the future, benefiting young, elderly, and frail individuals alike; while also ensuring the completeness and continuity of the treatment course, preventing patients from being "forced to discontinue medication" due to NHI payment restrictions, even if the medication is effective, leading to changes in their condition.
He also believes that Taiwan's NHI currently has some "mutually exclusive payment" clauses, putting doctors and patients in a dilemma regarding treatment choices. He hopes that by referring to international systems, a complete treatment map can be provided to ensure patients receive comprehensive care at all stages of cancer fighting, such as targeted therapy, low-intensity treatment, infection prevention during treatment, and long-term maintenance medication after remission, to prevent recurrence.
Hou Hsin-an said that many patients often ignore their body's warning signs and delay seeking medical attention. If people find unexplained recurrent fever, or accompanied by extreme fatigue, shortness of breath during activity, unexplained bleeding or bruising, and bone pain—these four major warning signs, especially when two or more symptoms appear simultaneously, they must not be taken lightly and should seek blood tests at a hematology-oncology department or family medicine department as soon as possible. (Editor: Chen Ching-fang) 1150419