Taiwan's health and welfare minister, Shih Chung-liang, raised the question of drug supply resilience and said the National Health Insurance system would examine opening original-brand drugs to a patient top-up arrangement.

Under such an arrangement, insurance covers up to a set benchmark and the patient pays the difference when choosing a more expensive product. Taiwan already applies the model to some medical devices, including artificial joints.

The proposal arises from the interaction of price cuts and supply interruptions. When insurance sets a drug price low, manufacturers sometimes withdraw from the market, leaving patients unable to obtain a particular medicine.

The counter-argument is equally clear. Introducing top-ups makes the range of accessible medicines depend on ability to pay, which critics say conflicts with the universality the system has claimed.

Taiwan's National Health Insurance is frequently cited internationally for very high enrolment and low out-of-pocket costs. That is precisely why balancing fiscal pressure against drug pricing remains a standing problem.

Korea's health insurance carries a similar structure of debate, through selective benefits and tiered co-payments. That the two systems address the same problem by different routes leaves room for comparison.