Panel to Choose Between 113 Remedies for State-subsidized 'Health Basket’

Committee is subject to heavy lobbying by commercial interests, nonprofit associations representing groups of patients, and individuals fighting for their lives.

The health committee determining the medicines and treatments to be subsidized by the state will begin a marathon series of deliberations on Sunday to arrive at the final list of drugs and technologies to be added to the 2014 slate.

The meetings are scheduled to start early Sunday morning and stretch into the night. Once the list is finalized, it will be submitted to the Health Ministry for approval.

The panel, headed by Shaare Zedek Medical Center director Prof. Jonathan Halevy, will have to choose from the 113 remedies, costing a total of 1.2 billion shekels ($343.6 million), that reached the final stage. However, the committee has only 300 million shekels at its disposal to add new remedies to the existing “health basket.”

The panel began its deliberations in early October and has already whittled down the list from 650 drugs and technologies that had been proposed.

During the committee meetings, members ranked all the proposed remedies in accordance with various criteria – such as effectiveness, cost, alternatives available, accumulated experience with the remedy, the prevalence of the illness the remedy is used to treat, and whether the treatment saves lives.

The committee does not only deal with new remedies, but addresses requests to broaden the use of drugs and technologies already in the basket but whose use is restricted. The highest-ranking remedies reach the final decision stage.

The drugs and technologies to be discussed Sunday include drugs that treat various types of cancer and cardiovascular problems; immunizations; and treatments for conditions in the areas of rheumatology, hematology and gynecology. Remedies for diabetes, lung problems, eye diseases, mental illnesses, AIDS and more are also being considered. Proposed technologies include respirators and hearing aids.

The committee must also decide whether to broaden the funding now provided for abortions. Currently, the state only subsidizes abortions under certain circumstances, such as for medical reasons or in cases of sexual assault.

The committee will also weigh funding for birth-control drugs or intrauterine devices for certain groups of women, as well as inhaled flu vaccines for children ages 2-5, which are now covered by only some of the health maintenance organizations.

Naturally, the committee is subject to heavy lobbying by commercial interests, nonprofit associations representing groups of patients, and individuals fighting for their lives.

The most publicized campaign this year was by Eli Kublon, 30, who had most of his small intestine removed due to a blood clot and is now permanently attached to IV to receive nutrition. He is seeking approval for a drug called Neotex – which costs around a million shekels a year – claiming that, without it, his system will collapse within five years.

Though the committee considered the drug, it ranked it very low. In a statement, the panel said, “The drug, despite its clinical importance to patients, does not save lives and, according to the extensive medical literature, in many of the patients it leads to only a partial (up to 20 percent) reduction in the need for intravenous nutrition.”

An appeal filed by Kublon did not alter the decision.

Emil Salman