New Government 'Health Basket' Funding Includes Over 100 New Drugs, Technologies

The inclusion of high-cost drugs for malignant, chronic and rare diseases came in some instances at the expense of drugs for widespread chronic diseases

Members of the “health basket” committee on Thursday 3, 2019.
אוליבייה פיטוסי

Health officials on Thursday issued details regarding the medications and medical technologies that will be added to the so-called “health basket” this year, meaning that they will be subsidized by the public health system. It includes 107 new drugs and technologies, which are expected to benefit 70,000 Israelis at a cost to the state of 500 million shekels ($134 million). The committee that developed the list allocated half of the sum to expensive new drugs and treatments for cancer.

The list still must be submitted to the Health Ministry’s Health Council and then sent for formal ratification by the cabinet. The newly subsidized drugs and technologies are expected to be available to the public in a few days.

The new items in the health basket cover tests and treatments for diseases affecting the eyes, lungs, heart and circulatory system, as well as the digestive tract. Also covered are treatments for diabetes and treatments in the fields of gynecology, neurology, genetic testing and addiction treatment.

The inclusion of high-cost drugs for malignant, chronic and rare diseases came in some instances at the expense of drugs for widespread chronic diseases. During the course of the committee’s deliberations, the funding for the new coverage was increased by 40 million shekels.

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In recent months, the 20 committee members reviewed 770 new drugs and technologies, which if funded in their entirety would have cost the state more than 3 billion shekels, according to estimates. The panel was therefore forced to decline funding for items despite their importance.

Committee members said this year’s basket was the most complex they had ever dealt with. Despite making decisions by consensus, they said they were not satisfied with the result. One committee predicted “we’ll need a good explanation” as to why some items were not included.

A considerable portion of the committee’s work dealt with expensive oncology drugs and treatments intended for types of cancer for which the state had not previously provided funding. The basket will offer new treatments for melanoma and cancer of the liver, digestive tract, kidneys, breast, ovaries and lungs. The committee also approved subsidies for nutritional assistance for a group of 147 children up to the age of 13 who have cancer. It also approved PET-CTs to diagnose paraneoplastic syndrome, symptoms of which could be a sign of cancer or neuroendocrine tumors.

The committee considered several new treatments for malignant blood tumors. It introduced a cell therapy that the U.S. Food and Drug Administration considers a breakthrough in treatment. It is to be made available to eight children and 75 adults at a cost of under a million shekels per patient. Some 100 million shekels of the basket has been devoted to hematology-oncology treatments.

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Consideration of funding for drug treatments for rare diseases affecting small numbers of patients prompted a large number of disagreements among committee members. The drugs are particularly expensive and parents of children suffering from these diseases have waged campaigns to include them in the basket.

The committee was forced to deny some of the treatments for these diseases, but approved the drug Crysvita for the treatments of rickets and for S-linked hypophosphatemia, which damages bones and muscles. The cost is about 674,000 shekels per patient and is expected to benefit a group of 34 patients. The committee also approved the drug Cholbam to treat a rare genetic metabolic disorder, at the cost of 1 million shekels per patient.

The committee approved new generation drugs for type 2 diabetes — SGLT2 inhibitors that bring about a reduction in blood glucose levels. It also approved expanding the use of flash glucose monitoring technology, which makes it possible to monitor blood sugar with a sensor.

The use of Pradaxa anticoagulants and the drugs Eliquis and Xarelto to prevent a stroke was expanded. At a cost of some 50 million shekels, the drugs will be made available to some 20,000 patients suffering from cardiovascular diseases.

The committee increased the age range of women eligible for precancerous cervical exams, which up to now had been restricted to women of 35 and older. It will now be available at state funding to women between 30 and 34. Some 130,000 more women will now be covered. The state will also finance natural hair pieces for patients with alopecia areata, an autoimmune disorder that causes baldness.

The basket offers more funding for treatments for tobacco and nicotine addiction. These drugs, Champix, Zyban and Nicotinell, were left out of the basket last year due to their high cost. This year their price was considerably reduced and they will be subsidized for patients even if they don’t receive anti-addiction therapy. The basket will also offer increased funding to scan for genetic diseases prevalent among specific population groups, such as Ashkenazi Jews, Druze Arabs or Palestinians.

Among the drugs not funded is Vimizim to treat Morquio A, a genetic syndrome that causes problems with bone development, growth and mobility. The drug’s cost is 1.95 million shekels per patient and would have covered a group of 16 patients. Luxturna, a one-time genetic therapy for an inherited retinal disease was also left out. Treatment costing 3.2 million shekels would have benefited four patients. The committee ultimately also decided to omit an innovative treatment for an aggressive cancer, glioblastoma, with electric fields in the brain. The treatment costs 28 million shekels and would benefit 145 patients.