Drugs Subsidy in Israel to Remain Steady in 2020 Despite Price Hikes, Population Growth

Ministries agreed to allocate 500 million shekels for the healthcare basket, but officials say the budget must be expanded yearly

The health basket committee holds a discussion on September 1, 2019.
Emil Salman

The Israeli Health and Finance Ministries agreed Thursday to allocate 500 million shekels ($144 million) for medication subsidies in 2020, the same figure as in the past three years, despite appeals by healthcare officials that the budget must be expanded to keep up with price hikes and population growth.

The drugs panel, headed by Hadassah Medical Center Director-General Ze’ev Rotstein, has been meeting for two months and must still decide which of the 900 new medications and technologies to include in the so-called "health basket." Among these are certain cancer drugs and drugs to treat rare diseases, some costing hundreds of thousands of shekels per patient.

Currently, the committee’s 21 members are ranking the various technologies according to non-financial parameters such as effectiveness and clinical contribution. As the year's-end deadline approaches, price considerations will become more important.

Health system officials say the amount approved for the basket is insufficient, and should factor in population growth. They also claim that the budget must also be stretched further each year due to the steady rise in costs of new medications and technologies. However, some in the ministry and committee claim that drug companies are overcharging for some medications, and that medications whose high cost is not justified won’t be included in the basket.

The committee will discuss expanding the use of immuno-oncological drugs, including Keytruda (Pembrolizumab), Nivolumab and Atezolizumab, which are used to treat metastatic cancers of the head, neck, lungs, breast, skin and kidneys, as well as tumors of the digestive tract. The committee is also discussing first-line biological drugs for chronic lymphocytic leukemia.

Other cancer drugs under discussion are Lynparza and Talzenna, which was also considered last year, for cancer patients with a mutation of the BRCA gene. The committee will also discuss the inclusion of Mammaprint, a genomic test to identify women at risk for a recurrence of metastatic breast cancer, and a special type of helmet used with electric field therapy for glioblastoma.

Also under consideration is a low-dose radiation CT test for early detection of lung cancer among heavy smokers, and a computerized photography technology for the early detection of skin cancer for certain at-risk patients. The committee will also discuss a treatment for spinal muscular atrophy (SMA), a drug for Duchenne muscular dystrophy and other rare metabolic and neurological conditions.