Assuta Ashdod University Hospital.
(photo credit: EYAL TOUEG)
The Health Basket Committee headed by Prof. Ronni Gamzu managed to satisfy tens of thousands of patients with a variety of diseases on Friday morning, by adding NIS 460 million worth of lifesaving and life-improving medical technologies for 2018.
Some of the 135 technologies will not require raising the budgets of the four health funds, because they replace other drugs; an additional NIS 40m. will be spent on including children up to 16 in the Health Ministry’s basic dental care program.
Medicines added to the basket include NIS 65.6 million for the treatment with the drug Spinraza of 94 children suffering from spinal muscular atrophy, the second-most expensive on the list of 135 technologies, but not another very expensive drug, Exondys, for Duchenne muscular dystrophy in children. The most expensive item, Darzalex for 334 patients suffering from multiple myeloma, will cost an estimated NIS 75m. in 2018. Orkambi, a drug for 45 patients with cystic fibrosis, has a price tag of NIS 24 million.
The committee approved a flash device (eliminating the need to use needles) for monitoring glucose levels in 3,300 adults with type I diabetes, at a cost of NIS 20m., but not Champix (varenicline) to help 40,000 people to quit smoking.
Prime Minister Benjamin Netanyahu held a press conference in his Jerusalem office as acting health minister along with Tel Aviv Sourasky Medical Center head Gamzu, a former ministry director-general who for the first time chaired the basket committee, ministry director-general Moshe Bar Siman Tov and committee coordinator Dr. Osnat Luxenburg.
Netanyahu said he hopes former health minister MK Ya’acov Litzman will soon return to run the ministry as a deputy minister (after he resigned as minister over Shabbat issues). The prime minister praised the country’s health system as being “one of the best in the world, but with challenges,” including the aging of the population and the need to add mediations to those provided by the health funds. As for Spiranza, while it is not lifesaving, it does significantly improve the condition of affected children and “give them a new horizon of hope,” he said.
Gamzu said that besides the spinal muscular atrophy drug and treatments for other “orphan” (rare) diseases, medications for neurological, cardiological, respiratory, metabolic and other diseases were added, “and not just those for cancer,” including medicines for people of all ages, from infants to the elderly. Gamzu berated some pharmaceutical companies that have behaved “piggishly,” demanding very high prices for their new medications. Except for spinal muscular atrophy, for which there was no alternative and the medicine was endorsed by professionals in the field, said Gamzu, “we will not include drugs with exaggerated prices in the basket.”
Pharmaceutical manufacturers and importers had proposed for the basket some 700 technologies at a cost of NIS 2.5 billion.
Asked why the government did not offer additional money to expand the basket, given the fact that there was NIS 20b. in surplus tax collection this year, Gamzu said that was the decision of the government and not within the purview of the committee.
Bar Siman Tov said the committee, representing the health funds, various ministries, doctors and the public, “managed to do the impossible, taking relatively little money but adding a lot” to the basket and “keeping Israel at the forefront of medicine. It gets more complicated every year, as drugs get more expensive, there are more sick people and there is aging of the population.”
Asked to comment, Shaare Zedek Medical Center head Prof. Jonathan Halevy, who previously headed the basket committee several times, praised the current committee for its decisions. “Some things that were rejected would have been nice to have,” he said, but in general the final choices were “very balanced.”
MK Tamar Zandberg, chairwoman of the Knesset Anti-Drug Committee, commented on the decision not to add Champix: “While state tobacco tax revenues exceed NIS 6b. a year, and 8,000 Israelis and Israelis die each year from the damage of tobacco, the state refuses to subsidize the tools for quitting smoking. The time has come for us to start investing seriously in quitting smoking in parallel with the more significant steps to prevent the entry of new smokers by restricting advertising and taxation on smoking products.”
Shmulik Ben-Ya’acov, head of the Association for Patients’ Rights, said that while “the committee faced a particularly difficult challenge this year, the budget remains limited, adding only about 1% to the health funds’ budgets. The annual supplement should be proportional to rise in the state budget and automatically be 2% per year. If the government had accepted these recommendations, there would have been many fewer disappointed patients this year, and the inadequate patients’ representation in the committee is a complex and profound problem.
“In addition, the high cost of drugs for the treatment of rare diseases necessitates a reevaluation of the list of ‘severe illnesses’ according to which the funds are budgeted and adapted to the challenges and technological level of today,” Ben-Ya’acov said.
The full list (in Hebrew) of the additions to the basket will be published on the ministry’s website at www.health.gov.il.