Health funds to start providing the medications as of Monday.
By JUDY SIEGEL-ITZKOVICHdrugs 88(photo credit: )
The directors of the four public health funds have agreed from Monday to provide patients with the 90 new medications and technologies that were approved for inclusion in the basket of health services by the National Health Council on Thursday.
Now that the council has okayed the list, which will cost the Treasury NIS 450 million, the cabinet is expected to give final approval at its Sunday meeting. Some two dozen of the council members present approved the additions, with one vote against and one abstention.
As desperate patients whose life-saving, life-extending and life-improving medications were not added to the basket covered by the health funds demonstrated outside the Health Ministry office where the meeting was being held - an annual ritual - the council members heard from basket committee chairman Prof. Menachem Fainaru, whose 16-member public committee had spent months on the painful and exacting process of selecting NIS 450 million worth of technologies out of NIS 2 billion worth of proposed medications and technologies. A handful of the demonstrators were invited to see senior ministry officials after the session ended.
A total of 160,000 patients will benefit by not having to purchase (or go without) drugs that cost as much as tens of thousands of shekels a month.
Health Minister Ya'acov Ben-Yizri said the Treasury will deduct one-sixth of the original financing it transfers to the health funds because the volunteer committee - appointed only at the end of October because of disputes with the Finance Ministry - was two months late in preparing its recommendations.
For the 2009 basket, the committee will be convened early so that its recommendations will be ready by November. A three-year agreement between the two ministries last year means that the funding available will be the same - but the Health Ministry has not managed to persuade the Treasury to update the basket's expansion automatically by two percent annually, a move recommended unanimously by health experts.
Fainaru, a former dean of the Tel Aviv University Medical School, said his committee was presented with 1,200 pages of material by the Heath Ministry's technology assessment branch, headed by Dr. Osnat Luxenburg, as well as over 600 letters from patients, organizations, MKs and others who were allowed to voice their opinions.
In addition, all praised the decision by Fainaru to open the committee sessions to the press for the first time since 1998 (albeit with restrictions such as no quotations or photos), which prevented leaks of information to the press and provided transparency of decisions.
The chairman added that the setting of priorities was guided by the need for including not only life-saving drugs, but also those that extended life and made life livable, such as drugs for the skin condition psoriasis, which can make some victims ashamed to appear in public.
He added that all were aware of the Solomonic decisions they were taking - that approving a drug for one disease automatically meant denying a drug for another. It took weeks to cut the list of 500 technologies down to 130, with a value of NIS 1.2 billion. Only on the last day, earlier this week, were they able after arguments to reach a consensus about the final 90.
Fainaru recommended that the minister finally consider the elimination from the basket of certain drugs that are less effective or that patients can afford themselves, even though, he said, "I know this is a Pandora's Box."
Neither of the two Israel Medical Association health council members attended the meeting, even though on Wednesday night the Israel Oncology Society, which is part of the IMA, protested that NIS 80 million worth of cancer drugs added to the basket are already provided by the health funds voluntarily to relevant patients or are received by them as part of supplementary health insurance. Society members said that in protest at the failure to add "completely new cancer drugs" to the basket, they would resign from the National Cancer Council that advises the ministry and no longer recommend drugs to the ministry for consideration, which they are asked to do every year.
Israel Cancer Association director-general Miri Ziv, who was unable to attend, sent a message to the health council meeting that the list could not be approved before it received a response to the oncologists' complaints.
After The Jerusalem Post suggested to the council that it prepare estimates of how much money would be saved to the economy by patients who take the medications being able to work and pay taxes, live at home instead of being hospitalized, and take care of themselves instead of hiring a foreign worker or a relative having to stay home, outgoing Health Ministry economist Gabi Bin-Nun said he would try to prepare such calculations for a few drugs.
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