TAIPEI (Taiwan News) — Starting March 1, Taiwan will broaden coverage for sodium-glucose cotransporter-2 inhibitors to include chronic kidney disease and heart failure, in addition to diabetes.
These oral prescription medicines can lower blood sugar by helping with glucose reabsorption in the kidneys and promoting its excretion in urine. SGLC2 inhibitors are now recognized by international guidelines as a crucial treatment for chronic kidney disease or CKD, per CNA and Far Eastern Memorial Hospital.
CKD affects approximately one in eight people in Taiwan, totaling 2.73 million individuals. Over 80% of early-stage CKD cases go unnoticed due to a lack of noticeable symptoms.
Without treatment, these patients face a high risk of kidney function deterioration. It could potentially lead to dialysis within 15 years.
For individuals with diabetes, where high blood sugar can overwhelm the kidneys' reabsorption capacity and contribute to CKD development, SGLT2 inhibitors offer a dual benefit. They manage blood glucose and protect kidney function, potentially delaying the need for dialysis by up to 26.6 years.
Under the expanded insurance policy, patients must participate in a chronic disease co-management program, which promotes early medication use, lifestyle modifications, and health education. Officials expect the initiative to strengthen kidney disease prevention and reduce the likelihood of patients progressing to dialysis.
The latest expansion of coverage is projected to annually benefit between 150,000 and 200,000 people in the country. Taiwan Society of Nephrology Supervisor Chiu Yi-wen (邱怡文) said chronic illnesses such as diabetes and high blood pressure, combined with a diet high in salt and protein, have significantly impacted kidney health in Taiwan.
Taiwan Society of Cardiology Secretary-General Hsieh I-Chang (謝宜璋) highlighted the strong link between diabetes, heart disease, and kidney disease. He stated that SGLT2 inhibitors can help ease heart failure symptoms while lowering the risks of hospitalization and death.
Research has demonstrated that SGLT2 inhibitors can slow kidney function decline up to fourfold, even when administered for heart failure. This is why, Hsieh explained, the NHI is broadening coverage this year to include heart failure, aiming to improve blood sugar management, protect kidney health, and minimize cardiovascular risks.
Chiu noted that kidney function naturally declines by about 1 ml per minute each year after age 40. Asians, Chiu said, are more susceptible to CKD.
CKD not only affects a single organ but also doubles the risk of cardiovascular-related death and increases the likelihood of heart failure by 1.5 times. Those with the condition experience a decline in kidney function five times faster than the general population.
National Health Insurance Administration Director General Shih Chung-liang (石崇良) said Taiwan was once known as the “dialysis kingdom” due to its high per capita rate of dialysis patients. Since 2001, the National health insurance program has worked to detect kidney disease earlier, provide routine monitoring, and encourage lifestyle changes.
These efforts have led to a decline in the incidence of new dialysis patients, Shih said. Currently, about 90,000 individuals undergo dialysis annually in Taiwan.
