Oncologists: Decrees on Reimbursement Limits Damage Patients

Prague, 23. August 2006 – Czech Oncological Society of CLS JEP (COS) strongly objected today to the Ministry of Health decree No. 368/2006 Coll. (and 387/2006 Coll.) on reimbursement limits for medicines which is effective from 1. August 2006 and called for its immediate amendment. COS also pointed out that due to the limits imposed by the decree No.101/2006 Coll. on reimbursement for medical treatment, treatment availability in the first six months of 2006 fell under European average. Both decrees preclude patients from access to new effective medicines and demean oncologists’ medical options. Professionals demand legislative institution of centres for provision of expensive treatment and increase of funds for the centres so that patients with clear and concrete indications can be given effective treatment by modern medicines. According to COS, a system reform in medical care is inevitable, introducing commercial additional insurance so that savings in public health insurance are brought about by having the patient pay for inexpensive drugs.

“An expensive new medicine cannot be introduced without financial means intended for treatment of another patient being taken away,” President of COS, Prof. MUDr. Jiří Vorlíček, CSc. said. “The reality which the ministry’s decree brings is such that the most effective treatment can be given to a new patient only after the death of another, longer treated, patient.” Such a situation is, according to Vorlíček, ethically unacceptable to the attending physicians. Some of them, in order not to have to choose between their patients those that will stand a better chance of a more successful outcome of the treatment, rather do not use expensive modern medicines at all. “The advancements in oncological treatment do not, paradoxically, serve Czech patients,” he said.

But new effective medicines change perception of certain oncological illnesses. Thanks to modern treatment patients survive in long-term and their illness can be deemed chronic just like diabetes, hypertension or asthma. At the moment, for example, patients with a precisely defined type of breast carcinoma are not receiving the right treatment. As a consequence around 300 women die unnecessarily every year. Drug named Herceptin, medicated at an early stage of the illness, could fully save their life, not merely – though significantly - extend it as is in oncology usual. Herceptin is the cheapest modern drug when assessed against its effect on patients. For patients with a certain type of lymphoma, a drug named Mabthera is a cure. In the first six months of this year almost 200 patients less than was needed were treated with this medicine and in the next six months the number will go down even further. A third concrete example is a medicine named Glivec, thanks to which patients with myeloid leukaemia survive in long-term. “Because of Ministry of Health decrees modern drugs are not medicated to all patients in need. Patients suffer harm as a consequence and that is something that we haven’t seen yet in the Czech Republic,” Professor Vorlíček emphasised.

Czech Oncological Society consistently endeavours to optimize costs by way of creating a system of centralized care. Professionals have already proposed a network of oncological workplaces for provision of demanding treatment, issued recommended treatment procedures for attending physicians, worked out a system of care quality control and peer review and set up registers of patients for rationalization of treatment with expensive medicines. The Ministry of Health and the medical insurance companies do not reflect on these activities. COS as a professional medical authority is nevertheless open to further dialogue and believes that an agreement that will result in better care for oncologically ill patients in the Czech Republic is possible.