Many at risk because vital drug lacks funding

Drug successfully stops severe hemorrhaging in wounded soldiers, women after childbirth, stroke patients and accident victims.

The Knesset Labor, Social Affairs and Health Committee demanded on Wednesday that an expensive drug that successfully stops severe hemorrhaging in wounded soldiers, women after childbirth, stroke patients and accident victims be paid for by the Health Ministry until it is added to the basket of health services. The annual cost of treating some 600 emergency cases of all types with the drug, Novo Nordisk's Novoseven, was estimated at NIS 15 million. Committee chairman Haim Katz was outraged by the fact that in most cases, the NIS 23,000 per case was not given in hospitals, even though it could save lives, prevent disability and preserve the fertility of 500 women each year who today needlessly undergo hysterectomies. Novoseven was developed for hemophiliacs who lack natural clotting factors. Ironically, it was Prof. Uri Martinovich, director of the National Hemophilia Center at Sheba Hospital, Tel Hashomer, who proved in research that the drug is effective in 77 percent of severe hemorrhage cases not due to hemophilia. As a result, the IDF has given orders that seriously hemorrhaging soldiers be given Novoseven in all hospitals at the army's expense. However, since it is not in the basket of health services paid for by the health funds or the Health Ministry, it is usually not given to civilians who could greatly benefit from the treatment, Martinovich said. He added that although the discovery of its extra uses was an Israeli one, it is used widely by military forces in the United States, the United Kingdom and elsewhere as well as in a growing number of civilian cases, but not in Israel. The US Army used Novoseven on 300 of its soldiers wounded in Iraq. Dr. Idit Matot of Hadassah-University Hospital in Jerusalem's Ein Kerem told the committee that when she asked for approval to use Novoseven for urgent cases, she was often refused because of the expense. "Some get it within seven hours, as required, while others get it too late or not at all," she said. She reported on the case of a young woman who bled severely after giving birth, and instead of getting the drug to save her uterus, it was removed in a hysterectomy, making her unable to bear more children. Doctors said at the meeting that "hundreds of Israelis" die needlessly each year because the expensive, genetically engineered drug is not supplied for such uses. Dr. Yitzhak Zeides, deputy head of Sheba Hospital, said that "every cent spent by a hospital for drugs that are not funded by the Health Ministry come at the expense of other lifesaving drugs." While the hospital recognized Novoseven as a lifesaving drug, it just could not cover the costs, he added. Health Ministry deputy director-general Yitzhak Berlovich, who heads its medical branch, said that the drug is "not yet registered for this indication [hemorrhage not due to hemophilia] because of the fact that adequate scientific proof has not yet been brought before the ministry. Its use in hospitals for other indications is done in a roundabout way. The ministry is ready do to all that is needed to speedup its registration so it is recognized" for non-hemophilia hemorrhage, he said. But this still does not mean the ministry would supply the funds or include it in the basket of health services for non-hemophiliacs; extra allocations from the Treasury are needed for this.