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Photo by: Judy Siegel-Itzkovich
Health committee recommends Treasury subsidize abortions
By JUDY SEIGEL
31/12/2013
Proposed NIS 300 million expansion to health basket ‘gives a voice to groups who have not been heard’.
 
An 18-member public committee, headed by Shaare Zedek Medical Center director-general Prof. Jonathan Halevy, presented its recommendations for the new health basket to Health Minister Yael German on Monday.

The basket committee’s recommendation that the Treasury, for the first time, subsidize NIS 2,500 of the cost of approved abortions for women aged 20 to 33, affecting some 6,300 women who would otherwise have to pay all costs out of pocket, was the most sensational change proposed.

However, the additional drugs and indications for schizophrenia, osteoporosis, benign prostatic hyperplasia (BPH), cancers and more are the recommendations expected to have the most impact on patients.

Halevy, an internal medicine and liver expert, will present the list to the National Health Council – that usually rubber stamps the list – on Wednesday, and to the cabinet on Sunday for formal approval.

The four health funds will supply the additional medical technologies to relevant patients starting January.

The list, at an additional annual cost of NIS 300 million to the Treasury, includes 83 new medications, technologies and indications for existing technologies.

A small number of drugs replace existing medications and thus will not carry additional costs.

German said that the two months of sessions held by the committee, which included numerous new members, were “completely transparent, with careful and professional preparation” by Dr. Osnat Luxenburg and her small staff in the ministry’s medical technologies department.

Luxenburg’s staff prepared some 3,500 pages of background for the committee members on the 600 different medical technologies that were candidates for inclusion in the basket, worth NIS 2 billion.

“Today we are enriching the health system with additional medications, and I’m excited about it,” the minister said.

Halevy, who served for the second time as chairman of the basket committee, said the discussions and reading material were as enriching an experience as if he “had received a degree [in pharmacology] from Harvard.”

While the new technologies proposed will save and extend lives, and improve the quality of lives for tens of thousands of patients, Halevy said the basket should be expanded by more than the NIS 300 million given by the Treasury, a sum allotted for past committees that has remained static.

“I personally advocate automatic updating of the basket” rather than the Treasury deciding every few years how much it will expand the basket, he said, “but it is not my job to do so.”

“The expansion of the basket for 2014,” the Shaare Zedek chief added, “gives a voice to groups who have not been heard in the past. It includes nearly all the medical specialties. When setting priorities among NIS 2 billion- worth of technologies and choosing NIS 300 million- worth, one has to forgo some of them, but there are no lifesaving drugs that are not in the basket. I am proud as an Israeli citizen of this expanded basket, and there is no precedent for it among Western countries.”

Halevy was proud of social improvements that the additions would bring. These include the possibility for patients with schizophrenia and their psychiatrists to choose among several medications for the first treatments, rather than forcing them to first use other, usually cheaper, drugs that commonly prove to be unsuccessful.

Among the drugs proposed by the committee are (by commercial names) Zyprexa, Seroquel, Abilify and Fanapt.

“Although we are not yet offering everyone personalized medicine, such drugs will suit patients better than before,” Halevy said.

Additional changes to the basket include: New technologies such as Avodart and Duodart for BPH that reduce the risk and the need for surgery; expanded use of Evista, Actonel and alendronate drugs for osteoporosis; medications for treating chronic obstructive pulmonary disease; Stribild for HIV carriers; dental care for people up to 30 who suffer from a congenital lack of six teeth or more; and a whole gamut of oncology drugs.

In addition, men at “high risk” of the papilloma virus, which can cause cervical cancer in their partners, will be entitled to free Gardasil injections.

Indications for medical foods for both children and adults were expanded, and two more drugs for multiple sclerosis will be added.

A device that repairs leaks for some mitral valve patients and a drug for Cushing’s disease were also included in the recommendations.

Halevy said that the committee members did not vote, but studied the material, debated the candidate drugs and reached a consensus.

There was a lot of pressure from the lobbyists of pharmaceutical companies and patients’ groups, the professor said, but “this didn’t affect us. We decided based on evidence.

Initially, we discussed priorities without even knowing what added price to the basket they would entail.”

The complete list of the new medical technologies will be published on the Health Ministry’s website (www.health.gov.il) after being approved by the cabinet.

Meretz MK Ilan Gilon said that the Knesset would soon discuss again a proposal for a two percent automatic update of the basket, even though Treasury professionals constantly oppose it, because they want to decide by how much the basket will be expanded each time.

The bill would also update the basket according to demographic changes in the population.
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