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Early diagnosis and early treatment of rare diseases can prevent severe disabilities and reduce social and medical costs. However, patients face a significant hardship due to the slow and challenging process for obtaining National Health Insurance (NHI) coverage for orphan drugs, as it delays access to lifesaving medications and creates financial burdens. This article outlines the process for listing in the NHI Pharmaceutical Benefits and presents two cases that illustrate the issues with the existing procedures. It concludes by proposing seven reform suggestions for the National Health Insurance Administration to consider. [ABSTRACT FROM AUTHOR]