Israel's Newly Approved Subsidized Health Basket Focuses on Preventive Medicine

The cost of the new items on the list, known as the health basket, is NIS 300 million, putting the value of the entire basket at around NIS 7.3 billion.

Dan Even
Dan Even
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Dan Even
Dan Even

The government has released its list of medicines, treatments and technologies it will cover next year, including 88 new medications and technologies, with the focus on preventive medicine. All told, the additions will benefit at least 300,000 Israelis.

The cost of the new items on the list, known as the health basket, is NIS 300 million, putting the value of the entire basket at around NIS 7.3 billion.

The committee that deliberates additions to the basket focused on preventive medicine, including vaccinations against the papilloma virus linked to cervical cancer, to be made available to 52,000 eighth-grade girls.

A diagnostic test to be covered by the government is nuchal translucency testing, an ultrasound test that checks pregnant women for certain fetal birth defects, affecting some 52,000 women.

Also included will be genetic tests for couples planning pregnancy, which some 143,000 Israelis annually will be eligible for the government's expense.

These new medications, treatments and technologies will be available to Israelis in January after approval by the Health Council and the cabinet.

The health basket committee has 18 members, including senior officials in the health care system, senior physicians, economists, a rabbi and an ethics expert. It also includes representatives of the public and of the four health maintenance organizations. The chairman is Prof. Jonathan Halevy, director of Shaare Zedek Medical Center in Jerusalem.

Nuchal translucency testing, which can detect Down's syndrome and other defects, is now done only privately or through supplemental HMO health insurance. The test is performed between weeks 11 and 14 of a pregnancy.

Among the pre-pregnancy tests the state will fund is one for fragile X syndrome, the most common form of inherited mental retardation in boys. Another test looks for a genetic tendency toward spinal muscular atrophy, which attacks the nerves of the spinal cord and is the most common genetic cause of infant death.

The government will now also cover testing for a variety of genetic disorders carried by Jews of various ethnic origins - Ashkenazi, Iraqi, Yemenite, Moroccan and from the Caucasus - as well as rare genetic disorders in Israel's minority groups.

The committee also approved government funding for a pacemaker for the diaphragm for 15 people a year with muscular dystrophy. The apparatus will postpone the need to put these patients on respirators.

Four new psychiatric medications will be included in the basket, among them Fanapt for schizophrenia, Rispheridone for certain psychiatric conditions in children, Decapeptyl for certain sexual disorders, and Suboxone to treat opiate addicts. Also included are expensive drugs to treat cancer including Caprelsa for advanced thyroid cancer and Erivedge for certain kinds of skin cancer.

The committee has also approved dental treatments for a variety of disorders, including people with nine or more teeth missing from birth.

Government funding for a new medication for diabetes sufferers, Victoza, to treat 7,477 diabetics annually, has also been approved.

The committee also gave the nod to expensive technologies that can be given to one patient per year. One of these is a genetic test before implantation of a fetus following IVF, to diagnose the presence of Li-Fraumeni syndrome, a rare disorder that greatly increases the risk of certain kinds of cancer. This test costs NIS 52,480.

The committee decided not to include in the basket genetic testing for relatives of people who died young from a heart attack, Botox for treatment of facial tics, an implant for electrical heart stimulation in cases of cardiac insufficiency, and the freezing of women's eggs so they can become pregnant at a later age.

The high number of Israelis expected to benefit from the new additions to the basket, 300,000, shows that the committee has returned to its trend of approving treatments and technologies that affect large groups of patients. Last year it departed from this trend, focusing on expensive medications. It added 77 of these to the basket, which benefited more than 30,000 patients.

Two years ago the committee approved 52 additions affecting 230,000 patients, and the year before that 80 additions affecting more than 100,000 patients, including workshops to stop smoking.

The health care system is already looking ahead to struggles over the 2014 health basket, whose approval seems threatened by the delay in approving the state budget until after the January election. There are also concerns about expected cuts to ministries' budgets that could affect the basket.

In recent years, bills to automatically update the health basket have been defeated by opposition from the Finance Ministry.

The committee deliberating on the additions to the health basket.Credit: Alon Ron

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