Taiwan NHI rules for common dermatology drugs — complete reference
Coverage criteria, dosing, treatment duration, PASS pre-authorization

Taiwan NHI Coverage for Common Dermatology Drugs

This article summarizes Taiwan National Health Insurance (NHI) coverage rules, dosing, treatment duration, and pre-authorization (PASS — Pre-Authorization Submission System) requirements for common dermatology prescriptions. Note: NHI conditions are revised several times a year; this reflects the rules as updated 2026-09-22 (115/9/22). Actual coverage subject to NHI Administration's most recent announcement at time of prescription.

Coverage Badge Definitions

• ✓ NHI covered: Prescribable under NHI within the licensed indication (General Principle 7) and any applicable NHI clause; listing follows the NHI drug list at the time of prescribing
• ▲ Conditional: Covered only when specific diagnosis / severity / prior treatment criteria met; some require pre-authorization (PASS)
• ✗ Out-of-pocket: Not NHI-covered, or off-label use

Topical Drugs

• Topical corticosteroids (all classes): ✓ NHI covered. Standard for inflammatory dermatoses.
• Topical retinoids (Adapalene 0.1%, Tretinoin 0.025-0.05%): ✓ NHI covered for acne. Out-of-pocket for cosmetic use.
• Tacrolimus 0.03/0.1% (Protopic), Pimecrolimus 1% (Elidel): ▲ Conditional — second-line for AD ≥ 2 yo with moderate-severe disease over > 30% body surface area (pimecrolimus also for sensitive sites such as face, eyelids and skin folds); not combined with UV therapy.
• Crisaborole 2% (Staquis): ✗ Out-of-pocket (not covered by NHI). For mild-to-moderate AD (age per product label).
• Topical Ivermectin 1% (Soolantra): ✗ Out-of-pocket. Effective for papulopustular rosacea.
• Hydroquinone, Tri-Luma, Ruxolitinib cream: ✗ Out-of-pocket.

Oral Isotretinoin (NHI Section 13.4)

• NHI conditions (Section 13.4): dermatologist prescription only; signed patient consent form plus records of failed conventional therapy or pre-treatment photos; prior authorization required.
• Dose: 0.5-1.0 mg/kg/day; NHI maximum 100–120 mg/kg per course, completed within 4–6 months (a further course needs new prior authorization)
• Pre-screen: pregnancy test (women), CBC, AST/ALT, lipid panel
• Monitoring: monthly initially, then every 2-3 months
• Pregnancy ban: throughout treatment + 1 month after; 2 contraceptive methods required

Oral Antibiotics for Acne / Rosacea

• Doxycycline 100 mg, Minocycline 100 mg: ✓ NHI covered. Use 8-12 weeks for acne; sub-antibiotic dose 40 mg modified-release for rosacea (when available).
• Sarecycline: ✗ Not available in Taiwan (US-only).

Atopic Dermatitis Biologics & JAK

• Dupilumab (Dupixent): ▲ NHI conditional for ≥ 6 years of age (Section 13.17.2 for ages 6–11, Section 13.17.1 for ≥ 12), chronic moderate-severe AD failing a full course of standard therapy, with PASS pre-authorization.
• Upadacitinib (Rinvoq), Abrocitinib (Cibinqo): ▲ NHI conditional for ≥ 12 yo failing standard therapy. PASS required.
• Lebrikizumab (Ebglyss): ▲ NHI conditional from 2026-06-01 (115/6/1) for ≥ 12 yo weighing ≥ 40 kg, same criteria as dupilumab; PASS required, EASI 50 needed at week 16. Dupilumab, upadacitinib, abrocitinib and lebrikizumab may not be combined.
• Tralokinumab: ✗ Out-of-pocket if available.

Psoriasis Biologics

NHI key criteria: PASI ≥ 10 (or ≥ 10% body surface area where PASI does not apply) + adequate phototherapy + failure of at least 2 of MTX / acitretin / cyclosporin / apremilast / deucravacitinib, each for ≥ 3 months. DLQI is not an NHI requirement.

• Adalimumab, Secukinumab, Ixekizumab, Bimekizumab, Guselkumab, Risankizumab, Ustekinumab: all ▲ NHI conditional with PASS
• Apremilast (Otezla), Deucravacitinib (Sotyktu): ▲ Conditional for adults with moderate-to-severe plaque psoriasis after adequate phototherapy plus MTX or cyclosporine (or contraindication); PASS required; not combined with biologics, tofacitinib or cyclosporine.

Alopecia Areata JAK

• Baricitinib, Ritlecitinib: ✗ Not covered by NHI for alopecia areata (NHI baricitinib coverage is limited to rheumatoid arthritis and hospitalized COVID-19); self-pay.

Chronic Spontaneous Urticaria

• Omalizumab (Xolair): ✗ Not covered by NHI for CSU — Section 6.2.6 covers severe persistent asthma only (2026-09-22 rules), so CSU use is self-pay. Clinically used when UAS7 ≥ 28 despite up to 4× antihistamine for ≥ 4 weeks; 300 mg q4w; up to 600 mg q2w off-label.

Hidradenitis Suppurativa

• Secukinumab (Cosentyx): ▲ NHI conditional from 2025-07-01 for adults with moderate-severe HS (Hurley 2–3, ≥ 5 inflammatory lesions in ≥ 2 areas) after ≥ 3 months of at least two conventional systemic regimens; PASS required; 300 mg at weeks 0–4, then every 2 weeks.
• Adalimumab: ✗ Not NHI-covered for HS (self-pay).

PASS Pre-Authorization 7-Step Process

1. Confirm diagnosis with appropriate ICD-10 code
2. Document severity (PASI / EASI / SALT / UAS7 / Hurley score)
3. Document failed prior treatments with dates and dosages
4. Pre-treatment screening complete (TB, hepatitis, pregnancy test, etc.)
5. Submit PASS application via NHI online system
6. Review time is not specified in the NHI drug rules; it depends on NHIA processing
7. Receive approval; prescribe; reauthorize per coverage period (usually 6-12 months)

Major Out-of-Pocket Drug List

• Hydroquinone, Tri-Luma: melasma / hyperpigmentation
• Ruxolitinib cream (Opzelura): vitiligo, AD
• Soolantra (Ivermectin 1%): rosacea
• Brimonidine 0.33% gel (Mirvaso): rosacea erythema
• Finasteride / Dutasteride: AGA (hair loss)
• Shingrix vaccine: shingles prevention
• Newer biologics not yet in NHI coverage

Summary

Taiwan NHI provides excellent coverage for common dermatologic prescriptions including topicals, oral antibiotics, isotretinoin, and increasingly biologics with conditional approval. Patients should discuss with dermatologists about whether their disease severity meets NHI criteria, what documentation is needed for PASS, and which out-of-pocket options may offer better outcomes for specific conditions.