Taiwan’s healthcare system is widely recognized for its efficiency, accessibility, and quality. With near-universal coverage and strong patient outcomes, it has become a benchmark among advanced health technology assessment (HTA) markets. Compared with other developed economies, Taiwan has also demonstrated a notable ability to bring innovative medicines to patients with speed, achieving in some cases more rapid and broad reimbursement than other developed HTA markets.

Yet the conditions that enabled this success are beginning to shift.

“What got us here won’t get us there,” says Mark Little, general manager of AstraZeneca Taiwan. “Taiwan has been globally recognized for delivering the innovations of the future and making them broadly available. But the next wave of innovation is fundamentally different.”

This shift is driven by the increasing complexity of modern medicine. Advances in precision oncology, emerging cell therapies, bi-specifics and combination treatments that use multiple mechanisms of action to treat a single disease are redefining how diseases are diagnosed and managed across not only oncology but also metabolic, rare and immunologic diseases.  Many of these approaches depend on identifying specific biomarkers responsible for the disease, requiring not only new medicines but also access to diagnostics that can guide treatment decisions.

“Patients don’t benefit if they’re not diagnosed correctly,” Little notes.

That dependence on diagnostics marks a structural change. Treatment is no longer a single intervention, but part of a pathway that links testing, sequencing, and multiple therapies over time.

While these innovations offer the potential for significantly improved outcomes — and in some cases, cure — they also introduce new challenges for healthcare systems. The science behind them is more advanced, the development timelines can be longer, and the investment required substantially higher. At the same time, the frameworks used to assess and fund these treatments have changed far less.

The result is a growing disconnect between how innovation is developed and how it is evaluated. While therapies continue to advance in complexity, the existing value assessment and reimbursement frameworks have yet to fully adapt to these sophisticated new models of care, including combination therapies.

Taiwan’s position as a leading clinical trial hub illustrates both its strengths and its opportunities. AstraZeneca ranks Taiwan among its top global markets for clinical research, reflecting the country’s ability to run studies with both speed and quality. Clinical trials do more than advance science — they are often the first point of access to new treatments for patients.

“The first access that a patient can have to benefit from an innovative medicine is through a clinical study,” Little says.

Clinical trials also generate local data, which play a critical role in demonstrating value and real world outcomes among Taiwan’s local population. However, maintaining this position requires continued investment. Clinical trials are not only a marker of capability, but also a foundation for long-term competitiveness and system resilience.

Ensuring access to advanced therapies will require mechanisms that go beyond Taiwan’s existing reimbursement structures. Taiwan’s Cancer Drugs Fund offers one example of how earlier access to treatments can be supported, particularly when evidence is still emerging.

“And the trick will be how do we make it sustainable over time,” Little says, pointing to the need for clearer pathways from early access into long-term reimbursement.

Public-private collaboration will be central to that effort. In Taiwan, regular dialogue is already taking place among government, industry, and other stakeholders, creating space to address increasingly complex questions around funding and access.

“That dialogue is critical,” Little says, noting the role of platforms that bring together multiple stakeholders to evaluate how new treatments can be introduced responsibly.

But the next step often becomes more challenging.

“How we reimburse these new modalities — whether they’re combinations or whether they’re cures — is something that requires more innovation,” Little says.

That need for change extends beyond funding mechanisms. It also raises questions about how quickly new treatments can be made available. Taiwan has the opportunity to lead in compressing approval timelines and aligning more closely with major markets like the US, allowing patients to benefit from innovation sooner.

“Can we approve a drug within 30 days of US approval?” asks Little. “How do we align our standards internationally?” Rather than looking at how long it took in the past, we should start from what’s possible, he suggests.

For Little, the issue is not whether Taiwan’s healthcare system is strong — it clearly is — but whether it can adapt quickly enough to retain its place at the forefront.

“We need to be thinking together about how to ensure that we can have transparent and broad access to the next wave of innovations,” he says.