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.
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
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.
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.
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
“Today we are enriching the health system with additional
medications, and I’m excited about it,” the minister said.
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
“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
“Although we are not yet offering everyone personalized
medicine, such drugs will suit patients better than before,” Halevy
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.
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
Halevy said that the committee members did not vote, but
studied the material, debated the candidate drugs and reached a
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
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.