//大腸直腸_Pembrolizumab給付規定
library CRCPembrolizumabRule1 version '1.0.0'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers

include CRCCodeConcept version '1.0.0' called CodeConcept

include Reusable version '1.0.0' called Reusable
 
context Patient

//============================================
// 申請類型判斷
//============================================

define "初次申請":
  "申請類型" = '初次使用'

define "續用申請":
  "申請類型" = '續用'

define "申請類型未知":
  "申請類型" = '無法判斷申請類型'

define "申請類型":
  case
    when Reusable."續用註記為1" then '初次使用'
    when Reusable."續用註記為2" then '續用'
    else '無法判斷申請類型'
  end


//============================================
// 主要規定一：初次使用條件
//============================================

/*規則1*/
//條件1-1
//Reusable."ICD-10使用C18、C19、C20、C21"
define "ICD代碼檢核_布林值": Reusable."ICD-10使用C18、C19、C20、C21"

//條件1-2
define "規則1-1-2=三個月內有影像檢查報告":
  exists (
    [DiagnosticReport] O
    where exists (
      O.code.coding Cdg
      where Cdg.system in CodeConcept.NHIMedication
      and Cdg.code in CodeConcept.ImageReportTumorCode
    )
    and O.effective is not null
    and FHIRHelpers.ToDateTime(O.effective) >= Today() - 90 days
    and FHIRHelpers.ToDateTime(O.effective) <= Today()
  )

//條件1-3
define "規則1-1-3=申請項目":
  exists (
    [MedicationRequest] MRPlan
    where MRPlan.intent = 'plan'
    and exists (
      MRPlan.medication.coding Cdg
      where Cdg.system in CodeConcept.NHIMedication
      and Cdg.code in CodeConcept.L01FF02
    )
  )
  and exists (
    [Claim] C
    where exists (
      C.item I
      where exists (
        I.programCode PC
        where exists (
          PC.coding Coding
          where Coding.code in CodeConcept."P141大腸直腸癌給付適應症"
        )
      )
    )
  )
  and  exists (
    [Claim] C
      where exists (
        C.item I
          where exists (
            I.modifier M
              where exists (
                M.coding Cdg
                  where Cdg.system in CodeConcept.NHILOT
                    and Cdg.code = '1'
            )
        )
    )
  )

define "條件1":
  (Reusable."ICD-10使用C18、C19、C20、C21" 
  and "規則1-1-3=申請項目")
  or "規則1-1-2=三個月內有影像檢查報告" 

//條件3
define "規則1-3=做為無法切除":
  exists (
    [Claim] C
    where exists (
      C.diagnosis Diag
      where Diag.type.text is not null
        and exists (
          Diag.type.text T
          where Matches(T, '(?i).*無法切除.*')
        )
    )
  )

//條件4
define "規則1-4=或轉移性高微衛星不穩定性(MSI-H)":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.inspectCodeMSI
    )
  )

//條件5
define "規則1-5=或錯誤配對修復功能不足性(dMMR)":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.inspectCodedMMR
    )
  )

//條件6
define "規則1-6=成年病人第一線治療":
  exists (
    [Claim] C
    where C.created is not null
    and AgeInDaysAt(C.created) >= 18
  )
  and  exists (
    [Claim] C
      where exists (
        C.item I
          where exists (
            I.modifier M
              where exists (
                M.coding Cdg
                  where Cdg.system in CodeConcept.NHILOT
                    and Cdg.code = '1'
            )
        )
    )
  )

define "規則1":
  ("條件1" and "規則1-6=成年病人第一線治療" and "規則1-3=做為無法切除")
  or "規則1-4=或轉移性高微衛星不穩定性(MSI-H)" 
  or "規則1-5=或錯誤配對修復功能不足性(dMMR)"

/*規則2*/
//條件1
define "規則2-1=病人身體狀況良好(ECOG≦1)":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'patientAssessment'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code = '89247-1'
    )
    and OBs.value is Integer
    and OBs.value <= 1
  )

//條件2
define "規則2-2=NYHA(the New York Heart Association) Functional Class I或II":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'patientAssessment'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code = '88020-3'
    )
    and OBs.value is String
    and (OBs.value = 'Class I' or OBs.value= 'Class II')
  )

//條件3-1
define "規則2-3-1=GOT<60U/L及GPT<60U/L":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.GOT
        or Cdg.code in CodeConcept.GPT
    )
     and OBs.value is Quantity
    and OBs.value < 60
  )

//條件3-2
define "規則2-3-2=T-bilirubin<1.5mg/dL":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.Tbilirubin
    )
     and OBs.value is Quantity
    and OBs.value < 1.5
  )

define "條件3":
  "規則2-3-1=GOT<60U/L及GPT<60U/L" and "規則2-3-2=T-bilirubin<1.5mg/dL"

//條件4-1
define "規則2-4-1=Creatinine<1.5mg/dL":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.Creatinine
    )
     and OBs.value is Quantity
    and OBs.value < 1.5
  )

//條件4-2
define "規則2-4-2=eGFR>60mL/min/1.73m2":
  exists (
    [Observation] OBs
    where exists (
      OBs.code.coding Cdg
      where Cdg.system in CodeConcept.NHIPASSupportingInfoType
        and Cdg.code = 'tests'
    )
    and exists (
      OBs.code.coding Cdg
      where Cdg in CodeConcept.LOINC
        and Cdg.code in CodeConcept.eGFR
    )
     and OBs.value is Quantity
    and OBs.value > 60
  )

define "條件4":
  "規則2-4-1=Creatinine<1.5mg/dL" and "規則2-4-2=eGFR>60mL/min/1.73m2"

define "規則2":
  "規則2-1=病人身體狀況良好(ECOG≦1)" 
  and "規則2-2=NYHA(the New York Heart Association) Functional Class I或II" 
  and "條件3"
  and "條件4"

/*規則3*/
define "規則3=不需檢附報告":
  exists (
    [Observation] RasObservation
    where RasObservation.status = 'final'
    and exists (
      RasObservation.code.coding ObsCodeCoding
      where ObsCodeCoding.code = '69548-6'
      and ObsCodeCoding in CodeConcept.LOINC
    )
    and not exists (
      [DocumentReference] DocumentRef
      where exists (
        RasObservation.derivedFrom DerivedFromRef
        where (DerivedFromRef.reference = 'DocumentReference/' + DocumentRef.id
               or DerivedFromRef.reference = DocumentRef.id)
      )
      and exists (
        DocumentRef.content ContentRecord
        where ContentRecord.attachment.url is not null
      )
    )
  )

/*規則4*/
//條件1
define "規則4-1=12週內之疾病影像檢查及報告":
  exists (
    [DiagnosticReport] O
    where exists (
      O.code.coding Cdg
      where (
        Cdg in CodeConcept.ICD10PCS2023Image
        or Cdg in CodeConcept.ICD10PCS2014Image
      )
      and Cdg.code in CodeConcept.PembrolizumabImage
    )
    and O.effective is not null
    and FHIRHelpers.ToDateTime(O.effective) >= Today() - 84 days
    and FHIRHelpers.ToDateTime(O.effective) <= Today()
  ) 

define "規則4-2-使用免疫檢查點抑制劑之治療計畫":
  exists (
    [Claim] C
      where exists (
        C.supportingInfo Cs
          where exists (
            Cs.category.coding coding
              where coding in CodeConcept.NHIPASSupportingInfoType
              and coding.code = 'carePlanDocument'
          )
          and exists (
            [DocumentReference] D
              where (
                (Cs.value as Reference).reference = 'DocumentReference/' + D.id
                or (Cs.value as Reference).reference = D.id
              )
              and exists (
                D.content Content
                  where Content.attachment.title is not null
                    and Matches(Content.attachment.title, '(?i).*免疫檢查點抑制劑治療計畫.*')
              )
          )
      )
  )

define "規則4":
  "規則4-1=12週內之疾病影像檢查及報告"
  and "規則4-2-使用免疫檢查點抑制劑之治療計畫"

define "主要規定一":
  "初次申請" and
  "規則1"
  and "規則2"
  and "規則3=不需檢附報告"
  and "規則4"


//============================================
// 主要規定二：續用條件－治療持續給付
//============================================

/*規則1*/
//條件1
define "規則1-1=以i-RECIST標準(HCC患者以mRECIST標準)評定藥物療效反應，依下列原則申請續用：有療效反應(PR及CR)者得繼續用藥；":
  exists (
    [Observation] RasObservation
      where exists (
        RasObservation.code.coding ObsCodeCoding
          where ObsCodeCoding.code in CodeConcept."IREC疾病狀態評估"
            and ObsCodeCoding in CodeConcept.NHITreatmentAst
      )
      and RasObservation.value is not null
      and RasObservation.value is FHIR.string
      and Matches((RasObservation.value as FHIR.string).value, '(?i).*(iPR|iCR).*')
  )

//條件2
define "規則1-2=未出現疾病惡化(PD)或未出現中、重度或危及生命之藥物不良反應者，應停止用藥；":
  exists (
    [Observation] RasObservation
    where exists (
      RasObservation.code.coding ObsCodeCoding
      where ObsCodeCoding.code in CodeConcept."IREC疾病狀態評估"
        and ObsCodeCoding in CodeConcept.NHITreatmentAst
    )
  )
  and not exists (
    [Observation] RasObservation
    where exists (
      RasObservation.code.coding ObsCodeCoding
      where ObsCodeCoding.code in CodeConcept."IREC疾病狀態評估"
        and ObsCodeCoding in CodeConcept.NHITreatmentAst
    )
    and RasObservation.value is not null
    and RasObservation.value is FHIR.string
    and Matches((RasObservation.value as FHIR.string).value, '(?i).*iCPD.*')
  )
  and not exists (
    [Claim] C
    where exists (
      C.diagnosis Diag
      where Diag.type.text is not null
        and exists (
          Diag.type.text T
          where Matches(T, '(?i).*中、重度或危及生命之藥物不良反應.*')
        )
    )
  )

//條件3
define "規則1-3=未出現疾病併發症或輕度藥物不良反應等，或沒有暫停用藥超過原事前審查核定日起24週期限者":
  Reusable."醫令類別為1"
  and not exists (
    [MedicationRequest] CurrentMR
    where CurrentMR.intent = 'plan'
      and (CurrentMR.status is null or CurrentMR.status in { 'active', 'completed', 'on-hold' })
      and exists CurrentMR.dosageInstruction
      and CurrentMR.dosageInstruction[0].timing.repeat.bounds is Period
      and (start of (CurrentMR.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
      and exists (
        CurrentMR.medication.coding Cdg
        where Cdg in CodeConcept.NHIMedication
          and Cdg.code in CodeConcept.L01FF02
      )
      and exists (
        [MedicationRequest] PreviousMR
        where PreviousMR.id != CurrentMR.id
          and PreviousMR.intent = 'plan'
          and (PreviousMR.status is null or PreviousMR.status in { 'active', 'completed', 'on-hold' })
          and exists PreviousMR.dosageInstruction
          and PreviousMR.dosageInstruction[0].timing.repeat.bounds is Period
          and (end of (PreviousMR.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
          and (end of (PreviousMR.dosageInstruction[0].timing.repeat.bounds as Period)) < (start of (CurrentMR.dosageInstruction[0].timing.repeat.bounds as Period))
          and exists (
            PreviousMR.medication.coding PrevCdg
            where PrevCdg in CodeConcept.NHIMedication
              and PrevCdg.code in CodeConcept.L01FF02
          )
          and days between (end of (PreviousMR.dosageInstruction[0].timing.repeat.bounds as Period)) 
              and (start of (CurrentMR.dosageInstruction[0].timing.repeat.bounds as Period)) > 168
      )
  )

//條件4
define "規則1-4-0=SD評估記錄":
  [Observation] RasObservation
    where exists (
      RasObservation.code.coding ObsCodeCoding
        where ObsCodeCoding.code in CodeConcept."IREC疾病狀態評估"
          and ObsCodeCoding in CodeConcept.NHITreatmentAst
    )
    and RasObservation.value is not null
    and RasObservation.value is FHIR.string
    and Matches((RasObservation.value as FHIR.string).value, '(?i).*(iSD|SD).*')

define "規則1-4-1=檢查是第一次被評估為SD":
  exists "規則1-4-0=SD評估記錄"
  and singleton from "規則1-4-0=SD評估記錄" is not null

define "續用規則1":
  ("規則1-1=以i-RECIST標準(HCC患者以mRECIST標準)評定藥物療效反應，依下列原則申請續用：有療效反應(PR及CR)者得繼續用藥；"
    or "規則1-4-1=檢查是第一次被評估為SD")
  and "規則1-2=未出現疾病惡化(PD)或未出現中、重度或危及生命之藥物不良反應者，應停止用藥；"
  and "規則1-3=未出現疾病併發症或輕度藥物不良反應等，或沒有暫停用藥超過原事前審查核定日起24週期限者"

/*規則2*/
define "續用規則2":
  "規則2" and "規則4-1=12週內之疾病影像檢查及報告"

define "主要規定二":
  "續用申請" and
  "續用規則1"
  and "續用規則2"


//============================================
// 主要規定三：藥品使用規則
//============================================

/*規則1*/
//條件1
define "規則1-1=位病人每個適應症限給付一種免疫檢查點抑制劑且不得互換":
  exists (
    [MedicationRequest] MRmed
    where MRmed.intent = 'plan'
    and exists (
      MRmed.medication.coding Cdg
      where Cdg in CodeConcept.NHIMedication
      and Cdg.code in CodeConcept.L01FF02
    )
    and Reusable."醫令類別為1"
    and exists MRmed.dosageInstruction
    and MRmed.dosageInstruction[0].timing.repeat.bounds is Period
    and (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
    and (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
    and not exists (
      [MedicationRequest] M
      where (M.intent in {'plan', 'order'})
      and exists (
        M.medication.coding Cdg
        where Cdg in CodeConcept.NHIMedication
        and Cdg.code in CodeConcept.L01FFexceptL01FF02
      )
      and exists M.dosageInstruction
      and M.dosageInstruction[0].timing.repeat.bounds is Period
      and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
      and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
      and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) <= 
          (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period))
      and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) >= 
          (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period))
    )
  )

//條件2
define "規則1-2=治療期間亦不可合併申報該適應症之標靶藥物，無效後或給付時程期滿後則不再給付該適應症相關之標靶藥物。":
  exists (
    [MedicationRequest] MRmed
    where MRmed.intent = 'plan'
    and exists (
      MRmed.medication.coding Cdg
      where Cdg in CodeConcept.NHIMedication
      and Cdg.code in CodeConcept.L01FF02
    )
    and Reusable."醫令類別為1"
    and exists MRmed.dosageInstruction
    and MRmed.dosageInstruction[0].timing.repeat.bounds is Period
    and (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
    and (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
    and not exists (
      [MedicationRequest] M
      where (M.intent in {'plan', 'order'})
      and exists (
        M.medication.coding Cdg
        where Cdg in CodeConcept.NHIMedication
        and (Cdg.code in CodeConcept.L01FE
        or Cdg.code in CodeConcept.L01FG
        or Cdg.code in CodeConcept.L01EC
        or Cdg.code in CodeConcept.L01EX05)
      )
      and exists M.dosageInstruction
      and M.dosageInstruction[0].timing.repeat.bounds is Period
      and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
      and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
      and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) <= 
          (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period))
      and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) >= 
          (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period))
    )
  )

//條件3
define "規則1-3=總使用療程以2年為上限":
  Sum(
   [MedicationRequest] MRTotal
  where (MRTotal.intent = 'plan' or MRTotal.intent = 'order')
  and (MRTotal.status is null or MRTotal.status in { 'active', 'completed', 'on-hold' })
  and exists MRTotal.dosageInstruction
  and MRTotal.dosageInstruction[0].timing.repeat.bounds is Period
  and (start of (MRTotal.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
  and (end of (MRTotal.dosageInstruction[0].timing.repeat.bounds as Period)) is not null
  and exists (
  MRTotal.medication.coding Cdg
  where Cdg in CodeConcept.NHIMedication
  and Cdg.code in CodeConcept.L01FF02
   )
  return
  days between
  start of (MRTotal.dosageInstruction[0].timing.repeat.bounds as Period)
  and
  end of (MRTotal.dosageInstruction[0].timing.repeat.bounds as Period)
   ) <= 730

//條件4
define "規則1-4=每次申請以12週為限":
  exists [MedicationRequest] MRPlan
  where MRPlan.intent = 'plan'
  and exists (
  MRPlan.medication.coding Cdg
  where Cdg in CodeConcept.NHIMedication
  and Cdg.code in CodeConcept.L01FF02
   )
  and days between
  start of (MRPlan.dosageInstruction[0].timing.repeat.bounds as Period)
  and
  end of (MRPlan.dosageInstruction[0].timing.repeat.bounds as Period)
  <= 84

define "主要規定三":
  "規則1-1=位病人每個適應症限給付一種免疫檢查點抑制劑且不得互換"
  and "規則1-2=治療期間亦不可合併申報該適應症之標靶藥物，無效後或給付時程期滿後則不再給付該適應症相關之標靶藥物。"
  and "規則1-3=總使用療程以2年為上限"
  and "規則1-4=每次申請以12週為限"


//============================================
// 審核結果
//============================================

define "MainRule1_Pass":
  if "初次申請"
  then "主要規定一"
  else null

define "MainRule2_Pass":
  if "續用申請"
  then "主要規定二"
  else null

define "MainRule3_Pass":
  "主要規定三"

define "大腸直腸癌Pembrolizumab申請結果_布林":
  case
    when "初次申請" then ("MainRule1_Pass" and "MainRule3_Pass")
    when "續用申請" then ("MainRule2_Pass" and "MainRule3_Pass")
    else false
  end

define "大腸直腸癌Pembrolizumab申請結果":
  case
    when "申請類型未知" then '申請未通過：無法判斷申請類型'
    when "初次申請" and "MainRule1_Pass" and "MainRule3_Pass" then '初次使用大腸直腸癌之Pembrolizumab(一線治療)用藥申請 - 通過'
    when "初次申請" then '初次使用大腸直腸癌之Pembrolizumab(一線治療)用藥申請 - 未通過'
    when "續用申請" and "MainRule2_Pass" and "MainRule3_Pass" then '續用大腸直腸癌之Pembrolizumab(一線治療)用藥申請 - 通過'
    when "續用申請" then '續用大腸直腸癌之Pembrolizumab(一線治療)用藥申請 - 未通過'
    else '申請未通過'
  end


//============================================
// 申請審核報告（根據申請類型顯示相關檢核）
//============================================

define "申請審核報告":
  '\n' +
  '\n=== 大腸直腸癌之Pembrolizumab(一線治療) 申請審核報告 ===\n' +
  '\n【申請類型】' + "申請類型" + '\n' +
  
  case
    when "初次申請" then
      '\n【初次使用條件檢核】\n' +
      '主要規定一：' + case when "MainRule1_Pass" then '通過' else '未通過' end + '\n' +
      case when "規則1"
        then '● 符合：診斷及疾病條件'
        else '▲ 不符合：診斷及疾病條件'
      end + '\n' +
      case when "規則2"
        then '● 符合：病人身體狀況及實驗室檢查'
        else '▲ 不符合：病人身體狀況及實驗室檢查'
      end + '\n' +
      case when "規則3=不需檢附報告"
        then '● 符合：不需檢附報告'
        else '▲ 不符合：不需檢附報告'
      end + '\n' +
      case when "規則4"
        then '● 符合：疾病影像檢查及治療計畫'
        else '▲ 不符合：疾病影像檢查及治療計畫'
      end + '\n'
    
    when "續用申請" then
      '\n【續用條件檢核】\n' +
      '主要規定二：' + case when "MainRule2_Pass" then '通過' else '未通過' end + '\n' +
      case when "續用規則1"
        then '● 符合：療效評估及用藥狀況'
        else '▲ 不符合：療效評估及用藥狀況'
      end + '\n' +
      case when "續用規則2"
        then '● 符合：病人身體狀況及影像檢查'
        else '▲ 不符合：病人身體狀況及影像檢查'
      end + '\n'
    
    else '\n【錯誤】無法判斷申請類型\n'
  end +
  
  '\n【藥品使用規則檢核】\n' +
  '主要規定三：' + case when "MainRule3_Pass" then '通過' else '未通過' end + '\n' +
  case when "規則1-1=位病人每個適應症限給付一種免疫檢查點抑制劑且不得互換"
    then '● 符合：每個適應症限給付一種免疫檢查點抑制劑且不得互換'
    else '▲ 不符合：每個適應症限給付一種免疫檢查點抑制劑且不得互換'
  end + '\n' +
  case when "規則1-2=治療期間亦不可合併申報該適應症之標靶藥物，無效後或給付時程期滿後則不再給付該適應症相關之標靶藥物。"
    then '● 符合：治療期間不可合併申報標靶藥物'
    else '▲ 不符合：治療期間不可合併申報標靶藥物'
  end + '\n' +
  case when "規則1-3=總使用療程以2年為上限"
    then '● 符合：總使用療程≦2年(730天)'
    else '▲ 不符合：總使用療程超過2年上限'
  end + '\n' +
  case when "規則1-4=每次申請以12週為限"
    then '● 符合：每次申請≦12週(84天)'
    else '▲ 不符合：每次申請超過12週限制'
  end + '\n' +
  
  '\n【申請結果】\n' +
  "大腸直腸癌Pembrolizumab申請結果" + '\n' +
  '\n====================\n'

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