As Taiwan confronts high heart disease rates, a mix of innovative technologies, strategic funding, and public-private collaboration stands to transform the landscape of cardiovascular healthcare.

In June this year, President Lai Ching-te launched the “Healthy Taiwan” initiative, aiming to enhance healthcare access and improve overall health outcomes by specifically focusing on tackling Taiwan’s top causes of death. The initiative included the establishment of a Healthy Taiwan Promotion Committee, chaired by the president himself.

At the committee’s inaugural meeting in August, Lai announced plans for an increased Ministry of Health and Welfare budget in 2024, emphasizing the importance of expanded investment in medical care and treatment.

“Going forward, Taiwan must actively address critical health-related challenges, including cancer, transnational communicable diseases of unknown origin, antibiotic-resistant superbugs, a low birth rate, and an aging society,” Lai said in his opening remarks.

Notably absent from his listed highlights was cardiovascular disease, the second leading cause of death in Taiwan, responsible for over 23,000 fatalities in 2023. This omission should not be interpreted as a complete lack of government effort, however.

In late October, the National Health Insurance Administration (NHIA) announced collaborations with nine major heart-focused associations to enhance the prevention and treatment effectiveness of cardiovascular diseases.

To raise awareness of cardiovascular diseases, the NHIA is rolling out the 888 Plan for the prevention of hypertension, hyperglycemia, and hyperlipidemia. The initiative aims to enroll 80% of patients with these conditions in shared care networks, provide lifestyle consultations to 80% of participants, and achieve an 80% control rate for each condition.

While these plans are ambitious, broader and faster access to innovative treatments is crucial to effectively tackle cardiovascular health challenges. Such advancements often come with substantial costs, significantly straining an already burdened NHIA budget.

“Long term, we would love to see something for cardiovascular treatment similar to the New Cancer Drugs Fund and engage in the same type of dialogue that others were able to do,” says Erik Ramp, Taiwan director of commercial management at Edwards Lifesciences, an American multinational medical technology company. 

In July this year, Taiwan’s Executive Yuan approved the establishment of a NT$10 billion (nearly US$307 million) fund dedicated to new cancer medicines. The goal of the fund is to enhance access to innovative cancer treatments and reduce cancer mortality by one-third by 2030, aligning with the “Healthy Taiwan” initiative.

The rationale behind setting up a heart-care fund is simple: heart disease is a close runner-up to cancer as Taiwan’s leading cause of death, and like cancer, effective treatment options often come with a hefty price tag. Creating a dedicated fund, modeled after the New Cancer Drugs Fund, would allocate resources specifically to cardiovascular care, improving patient access to innovative therapies.

“I think those in the cardiovascular space face some of the same burdens as those in oncology – that there’s so much technology that’s not in Taiwan yet, or if it is, it’s not reimbursed [included among the treatments available for NHIA subsidies to hospitals], with a very broad indication that we could be bringing in,” says Ramp. He adds that he’s confident the industry would be “willing to sign up for more real-world evidence generation once we’re in Taiwan, to really prove how effective it is. The NHIA has a great system for doing that.”

At present, many of Taiwan’s most advanced cardiovascular interventions are limited by the NHIA’s narrow reimbursement policies. “Reimbursement in Taiwan often restricts innovative treatments to the most severely ill patients, leaving a significant gap in care for those with moderate to early-stage disease,” Ramp says.

He stresses the importance of broader reimbursement criteria, which would allow younger patients and those in earlier disease stages to benefit from new therapies such as Transcatheter Aortic Valve Implantation (TAVI), a minimally invasive procedure to replace damaged aortic valves, currently primarily applicable for elderly or high-risk patients. Benefits of such procedures include quicker recovery, reduced infection risk, and shorter hospital stays compared to open-heart surgery.

Ramp’s emphasis on early-stage treatment aligns with Taiwan’s broader strategy of investing in preventive care. For Taiwan to succeed, he argues, a heart treatment fund must not only finance late-stage interventions like TAVI but also support early diagnostics and lifestyle modification programs. The potential benefits of early intervention extend beyond financial savings for the healthcare system to societal costs.

“Right now, a lot of people are diagnosed but the financial burden of more aggressive intervention may cause patients to delay treatment until they are at the life-threatening stage,” he says. “Treating heart disease at its earlier stages can prevent heart failure and renal complications later, which are among the most significant costs for our healthcare system.”

Bringing heart care home

In Taiwan, advanced telehealth solutions are becoming an integral part of the fight against and prevention of heart disease. Companies like Taiwanese HealthTech startup iXensor have pioneered the use of smartphone cameras to monitor cardiovascular biomarkers, making heart-health management more accessible than ever.

Dr. Carson Chen, CEO of iXensor, describes this shift as a step toward democratizing healthcare. “Our goal is to allow patients to take a ‘health selfie’ that tracks their critical biomarkers, such as cholesterol levels, glucose, and other indicators of cardiovascular risk,” he says.

iXensor’s technology has received clearance from the U.S. Food and Drug Administration for its smartphone-based blood testing, the first approval for such technology in the world, Chen notes.

By enabling patients to conduct at-home tests with clinical-grade accuracy, iXensor offers a glimpse of what the future of healthcare could look like – one where patients can track health trends over time and adjust their behaviors accordingly. Dr. Chen emphasizes that this approach is about more than just convenience; it’s about changing behavior.

“Frequent, at-home assessments make people more aware of how their lifestyle choices – like diet and exercise – affect their cardiovascular health,” he says. “The more patients understand the real-time impact of their habits, the more motivated they become to make lasting changes.”

This vision of accessible, patient-driven care is in line with global shifts toward telehealth, accelerated by the Covid-19 pandemic. During the pandemic, at-home testing became not only possible but necessary, transforming telemedicine into an everyday reality. For cardiovascular patients in Taiwan, this development has the potential to significantly improve outcomes.

“The annual health checkups offered to employees in Taiwan are beneficial, but they often lack follow-up, and the data is scattered because you might go to a different clinic every year,” Chen says.

Recognizing these challenges, the NHIA will also do its part by establishing a Family Physician Platform by the end of 2024. The platform will compile health data from hospitals for individuals, providing automated health risk forecasts and alerts.

The administration further aims to empower the public through My Health Bank, a tool that encourages users to take an active role in managing their health. However, for those at higher risk, the frequency of hospital visits could be lowered with the help of companies like iXensor. “Our technology fills the gap by enabling continuous monitoring, leading to more informed decision-making by both patients and doctors,” Chen says.

Beyond iXensor, international biotech companies like Amgen are also driving innovation through preventive approaches. Amgen’s efforts focus on managing cholesterol and reducing risks associated with high lipoprotein(a) levels, a significant contributor to heart attacks and strokes. Amgen’s work with RNA-based therapies and gene treatments represents a new frontier in heart-disease management, targeting genetic risk factors to offer more precise, patient-tailored interventions.

Working together with the cardiovascular disease community and local medical societies, Amgen also aims to improve the treatment landscape by increasing education, access, and screening, improving overall lipid management, and accelerating evidence-based care. As part of its global mission to halve heart attacks and strokes by 2030, the company is working on expanding education and access to lipid management treatments in Taiwan. 

“There needs to be a sense of urgency when it comes to addressing cardiovascular disease,” says Daniel Villegas, general manager of Amgen Taiwan. “By focusing on education and broadening access to innovative treatments, we hope to support patients in managing their risk factors before they become critical. This proactive approach aligns perfectly with Taiwan’s preventive healthcare goals.”

Bridging the gaps

One of the defining elements of Taiwan’s push for cardiovascular innovation is its commitment to public-private collaboration. Nonprofits like Taiwan Heart Foundation, in partnership with government entities, hospitals, and companies, play a pivotal role in raising awareness and improving heart disease prevention.

These collaborative efforts often take the form of community events that offer free cardiovascular screenings, educational campaigns, and early diagnostic tools. Edwards Lifesciences has been at the forefront of such initiatives, co-sponsoring events that bring healthcare services directly to elderly communities.

A recent event offering free screenings discovered that around 10% of those who participated needed further evaluation, ultimately leading to early and potentially lifesaving diagnoses for around 10% of the evaluated group. Ramp highlights the broader societal benefits of such programs, explaining that healthier seniors contribute significantly to family structures and economic stability.

“In Taiwan, grandparents play an active role in raising children and supporting working parents,” he says. “By keeping seniors healthier for longer, we’re not just helping individuals – we’re supporting entire families.”

This focus on early detection and intervention extends to Edwards’ research and development efforts. The company has invested heavily in improving the durability of heart valves, which could extend the lifespan of replacement valves by several years. Such developments are particularly crucial in an aging society like Taiwan, where reducing the need for multiple surgeries can significantly enhance patients’ quality of life.

Amgen’s global initiatives also include the LATTICE Consortium, which aims to close the gap between clinical evidence and the adoption of best care practices. By collaborating with a network of experts and organizations, Amgen is helping to improve cardiovascular disease treatment at scale, bringing cutting-edge therapies to underserved communities. The company’s efforts also focus on updating treatment guidelines to align with global standards, promoting broader access to innovative therapies.

The role of these partnerships cannot be overstated. By pooling resources, expertise, and outreach efforts, public and private entities are accelerating Taiwan’s cardiovascular health transformation. “To make real progress, we need a collective effort that includes policymakers, medical professionals, and the private sector working together,” says Ramp.

Amgen’s Villegas echoes this sentiment, emphasizing that addressing cardiovascular disease requires a unified approach. “The complexity of cardiovascular disease demands collaboration across sectors, from government to healthcare providers to biotech companies,” he says. “By working together, we can achieve meaningful change.”

As Taiwan looks ahead, the road to improved heart health will require sustained investment, innovation, and collaboration. For iXensor’s Chen, the future of cardiovascular care is both personal and professional.

“The ultimate goal is to empower individuals to take control of their heart health, making sure that access to lifesaving information and treatments is not a privilege, but a right,” he says.