Eighty-eight medical technologies – prescription drugs, screening tests, medical
nutrition products and devices – will be added to the 2013 basket that the four
public health funds provide their members, following a NIS 300 million
allocation from the Finance Ministry.
The public “basket committee” of
health experts and public representatives – which Shaare Zedek Medical Center
director-general Prof. Jonathan Halevy chaired for the first time on Tuesday –
announced its recommendations for inclusion in the basket. The list, which the
committee chose out of hundreds of technologies that would have cost NIS 2
billion were they all to go in the basket, will be presented to the Israel
Health Council for formal approval on Wednesday, and then to the cabinet on
Halevy said that chairing the committee during the past two
months had been “the most fascinating and challenging task in my career.” He has
been given the job for next year as well.
Halevy, who has run the
Jerusalem hospital since 1988, worked as an internal medicine and liver expert
at the Rabin Medical Center-Beilinson Campus before joining Shaare Zedek, and in
recent years also headed Israel Transplant as a volunteer.
He told The
Jerusalem Post that the 88 technologies, some of which replaced less-successful
medications and thus did not cost any additional money, made for an admirable
balance between life-saving and lifeextending drugs and disease prevention,
based on medical, social and compassion considerations.
In the preventive
category will be free vaccination for eighth-grade girls against human papilloma
virus (HPV), to prevent them from contracting cervical and other cancers via
sexual contact when they get older. The School Health Service will carry the
three-part vaccination at NIS 244 per girl.
Though some countries that
have more funding for their health systems administer the shots to boys as well
so they don’t infect girls, boys here will not receive the shots.
preventive item is screening for carriers of diseases with a 1:60 risk in the
These include Fragile X, SMA, Canavan, MLD, ICCA, Costeff,
PCCA, ICCA and mutations common in the Arab population. As the health funds do
not include such screening even in supplementary health insurance packages, and
people with low incomes often cannot afford to pay privately for these services,
the items’ inclusion in the basket will especially help the socioeconomically
As for life-saving and lifeimproving drugs, the list
includes medications for respiratory, kidney and gastroenterological diseases;
diabetes; psychiatric disorders; AIDS; hematological, neurological,
endocrinological, cardiovascular and endocrinological disorders; and dental
treatment for people under the age of 30 with specific syndromes and
Although reactions to the decisions were positive (except from
some pharmaceutical companies whose entries were not accepted), many agreed that
the annual NIS 300m.
increment over the past three years was not enough.
But this is the purview of the Treasury, which prefers to decide the size of the
Halevy said he was sure that for 2014, the budget for
the next increment would be “at least NIS 300m.,” but he hoped for
Israel Cancer Association director-general Miri Ziv, Kadima MK Dr.
Rachel Adatto and Meretz MK Ilan Gilon all called for an annual automatic update
of the basket by 2 percent – or around NIS 600m. – rather than having the
Treasury approve the amount each year, but the Health Ministry has been unable
to persuade the Treasury to give up some of its decision-making
Halevy said that if the budget were doubled, he would add more
drugs and technologies for psychiatric, cardiovascular and respiratory
Adatto, a former deputy director- general at Shaare Zedek, said
that the Treasury’s refusal to allow automatic updating was serious, considering
the aging and natural growth of the population – factors that would make more
But she praised the members of the committee for their
As a gynecologist by training, Adatto said the HPV
vaccine was very important, but that it should have been financed as part of the
Health Ministry’s special budget for vaccines and not as part of the NIS 300m.
for expanding the basket.
She added that the government had “fought every
attempt in the Knesset to set down the activities of the basket committee and
updating of the basket through primary legislation, which was the original
intention of the Knesset with the passage of the National Health Law in 1994,
and not the way the government runs it today.”