The recommendations as to which new drugs and medical treatments will be added to the state-subsidized health care “basket” will presented Tuesday. The “drug basket” committee, headed by Prof. Jonathan Halevy, has been debating for months some 700 requests for new drugs, vaccines, tests and technologies to be added in 2017.
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All the proposed new drugs and treatments would cost an estimated 2.5 billion shekels ($650 million) a year in added costs, while the committee’s job was to decide which would be included in the additional 450-million-shekel budget only allocated for this year.
The 2017 budget increase was 150 million shekels higher than the 300 million shekels added to the 2016 health budget for such new drugs and therapies, but as in every year, the amount will still leave many patients disappointed after they discover that this year many essential and expensive drugs are still not subsidized by Israel’s national public health system.
The state-subsidized health care basket in Israel is considered quite broad and relatively up-to-date. In recent years most advanced drugs have been added, sometimes only a few months after they received regulatory approval. However, the skyrocketing prices of drugs in recent years along with erosion of the health budget has turned the committee’s job into an extremely difficult one, if not bordering on the impossible.
Committee members were required over the past few days in the last committee meetings to decide as to the fate of drugs that would cost an estimated 1 billion shekels a year, those which were ranked the highest in earlier meetings. These drugs have been shown to have significant clinical effectiveness and influence on patients’ quality of life.
The various drugs come with a very wide range of price tags, from a few shekels a year per patient to 1.5 million shekels a year. In addition, some drugs and treatments will benefit thousands of patients a year, while others may apply to only a single patient in Israel.
The drugs and therapies under consideration affect almost the entire range of the medical profession: cancer, blood diseases, cardiology, genetics, ophthalmology, clinical nutrition, gynecology, neurology, vaccines, rehabilitation and physiotherapy, funding for abortions and many more, including a number of extremely rare diseases.
The committee actually discusses the “indications” for treatment and not the introduction of the actual technology or drug. This means the committee actually discusses in what cases the patient will be entitled to a certain drug, or therapy, from the health basket. For example, some cancer patients will be allowed to use certain new, or expensive drugs – but only after they have been treated with the more common drugs and found them to be ineffective.
Some of the cases the committee has discussed relate to expanding the use of certain therapies, such as using a drug approved for one type of cancer for other types, or allowing a drug to now be used as a frontline treatment, instead of requiring the use of a different drug first.
The committee had greater freedom to maneuver this year. This is both because of the larger budget and the accelerated pace of adding various cancer treatments and drugs to the health basket in recent years which has reduced some of the pressure – but as happens every year, there is still not enough money to go around.