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Health Minister Ya'acov Edri lauded the government and praised the "intervention" of acting Prime Minister Ehud Olmert on Sunday for expanding the basket of health services by NIS 310 million instead of the NIS 164 million originally allocated by the Treasury. But Israel Medical Association chairman Dr. Yoram Blachar poured cold water on the decision, calling it "Israbluff" and a "simple calculation manipulation" by the Finance Ministry.
Before the cabinet meeting, Olmert -- a former health minister -- told Edri that the basket would be expanded by nearly double the original figure. The National Health Council and the professional committee on expansion of the basket -- which comprises the medical technologies that health funds must supply their members -- 10 days ago had recommended an increase of NIS 466 million for 2006.
Edri -- whose portfolio is desired by both the Gil Pensioners Party and Shas -- told health reporters at a briefing in his office that he hoped the new government would expand the basket by even more. He said he wanted to add new members, especially public representatives and ethics experts -- to the committee that prepares a recommended list of new technologies to be added to the basket, and would press for a law that would automatically expand the basket by a fixed amount, such as 2%, each year. The annual pilgrimage of Health Ministry officials to Treasury budget officials, lobbying by pharmaceutical companies and demonstrations by desperate patients for lifesaving drugs was "embarrassing" and could be eliminated by a fixed annual increase, Edri said.
But Blachar claimed the whole exercise was phony. The two hundred million shekels promised by the Treasury, he said, would be divided up over seven months until the end of the year, and NIS 110 million would be transferred to the 2007 budget. "Thus, in fact, there is no real addition, except if it becomes clear that NIS 310 million will be entered into the base of the budget." Blachar said it was the first time that the government did not fully accept the recommendations of the public committee for expanding the basket (to raise the expansion to NIS 466 million), and that "the Treasury's budgets division will surely celebration its victory over patients."
Blachar also criticized the government's decision to wait at least until June to add a new approved indication for the drug Herceptin to the basket, because it has not yet been approved by the US Food and Drug Adminstration or the European drug authorities for preventing a recurrence of breast cancer in certain patients who have already undergone surgery, chemotherapy and/or radiotherapy for their tumors. "This contravenes the recommendation of the basket committee which urged its immediate introduction into the basket for such patients because its efficacy has been proven without a doubt," said Blachar.
At the cabinet meeting, Olmert said "the issue of medicines in the health basket is not a coalition matter. This is human life and I had previously instructed the Health Ministry and the Finance Ministry budgets division to find a way to increase the health basket so that we will be able to meet the special needs of a large population in the State of Israel that needs medicines, essential medicines for saving human lives. I hope that the proposal will be approved by the Cabinet today, even with the restriction that the 2006 state budget has yet to be approved, and that there will be a very significant NIS 310 million increase in the health basket... It is never possible to give accede absolutely to all applicants, to whatever is likely or liable to arise, but it seems to us that this is a worthy proposal."
Edri told reporters that his office was negotiating with pharmaceutical companies and drug importers about selling vital medications not included in the basket at pharmacies for "up to 50% less" than their regular price. The initial list, he said, will be announced after Passover.
Among the drugs covered by the NIS 310 million are Crestor and Ezetrol (to lower blood fats); Atacand, Oscaar, Ciovan for hypertension patients who cannot take ACE inhibitors; slow-release insulins for diabetics; drugs for HIV carriers, Prevnar vaccine against pneumococcus; Mabthera as a first-line treatment for follicular non-Hodgkin's lymphoma; Zyprexa and Seroquel for bipolar disease; Keppra for mostly young people with epilepsy; Exjade for young people with excess iron in their blood; and Plavix for patients who had a recurrent stroke after receiving aspirin. Many other vital drugs were not included in the basket.