Israel's Public Healthcare System to Subsidize 141 Drugs, Including Innovative Depression Treatment

List includes a genetic test for BRCA1 and BRCA2 genetic mutations and a gene therapy which costs 2.8 millions shekels per patient

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General image of various kinds of drugs
General image of various kinds of drugs.Credit: Yves Herman / Reuters

Israel’s drug panel announced over the weekend which treatments will be added this year to the basket of services for the country’s residents.

The list, compiled after three months of debates, includes 141 drugs, exams, vaccinations and accessories at a cost of 500 million shekels ($145 million) designated for over 210,000 Israelis. About half of the amount was allocated for drugs, tests and treatments in the field of oncology and hematology-oncology. The list also includes tests and vaccinations in the field of preventative medicine and early detection.

Besides treatments for cancer and malignant blood diseases, the committee, headed by Prof. Zeev Rothstein, approved drugs for eye diseases, preventing HIV infections and an innovative treatment for major depressive disorders, as well as drugs for treating neurological disorders, lung diseases, diabetes, skin diseases and heart diseases.

The committee discussed about 900 drugs and new technologies worth about 3 billion shekels in sometimes heated sessions this year. “Every drug that reached [the final stage] deserved being in the list and deserved public funding, be we are forced to slice some out,” said one of the committee members of the finalists that were left out.

The challenge to assist a large number of patients grows from year to year due to the rise in drug prices, population growth, an aging population and budgetary limits, which have changed little in recent years. The presence of a caretaker government added to the uncertainty.

Some mental health patients may get relief through the approval of Spravato, a nasal spray used for treatment-resistant depression, which is allowed for use after two unsuccessful conventional depression treatments.

For HIV carriers, the committee approved the drugs Pifeltro, Delstrigo and Dovato. It also approved Truvada, a daily pill that can help prevent HIV. Truvada costs about 2,000 shekels a month and is intended for a group of about 3,000 people who are at risk of contracting the virus.

Some of the approved cancer treatments cost hundreds of thousands of shekels per year per patient, such as Keytruda, which is used for treating head, neck and other forms of cancer; Libtayo for melanoma; Tafinlar and Mekinist, which together treat anaplastic thyroid cancer; and Opdivo for colon cancer. The list also includes treatments for non-small-cell lung cancer, ALK-positive lung cancer, certain types of breast cancer, ovarian cancer and kidney cancer, bladder cancer, melanomas and lymphomas.

For the first time, the committee decided this year to add a technology developed in Israel for treating glioblastomas, which are malignant brain tumors.

One piece of good news coming out of the committee is the inclusion of tests for the common BRCA1 and BRCA2 mutations, which are known as significant predictors of breast and ovarian cancer for Ashkenazi women between the ages of 30 and 65. The tests identify the risk, follow-up and possible preventative intervention. The Health Ministry expects to screen around 16,000 women in the coming year, of which statistically around 400 will have the mutation.

The most expensive approval was for Luxterna, a gene therapy for patients with inherited retinal disease, at a cost of 2.86 million shekels per patient.

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