Filenews 19 November 2021 - by Marilena Panagi
There remain about 600 innovative/specialized treatments outside the GHS, although for some of them the necessary protocols have been updated and doctors have more than one option available to them through the procedures of the Ministry of Health.
For thousands of patients, however, the procedures have not changed; they still do not have the choice of the formulation they will receive since their supply is still done through tenders, which results in them having at their disposal only the cheapest available medicine.
"It is unacceptable that we have fought for the implementation of the GHS, that we have fought to escape from the procedures of the past and that patients continue to suffer in order to get the medicines they need at the time they need," Marios Kouloumas, president of the Federation of Cyprus Patients' Associations, told "F".
The OSAK added Mr. Kouloumas, "has already sent a letter both to the Ministry of Health, and specifically to the Minister himself, and to the OYO asking him to expedite all procedures, expressing both our strong protest and our concern that the WHO continues old practices and mentalities, and allows the inclusion in the System of only one drug, taking into account only the cost of the drug as the most important factor in determining its use, the cheapest that is.
For a huge number of specialized treatments, nothing has changed and we follow practices that afflict and put the health of patients at risk for decades and we expected, as provided by the legislation, that these things would have changed with the implementation of the GHS".
Continuing, Mr. Kouloumas brought as an example "the drugs for metastatic breast cancer for which the protocol has been updated by a special committee since the beginning of 2021 and the guidelines have been validated, but the process has not yet changed". Specifically, as explained by the president of OSAK, "while we expected the process to go ahead and the planning to be completed as provided for by the relevant legislation, i.e. to publish the guidelines and negotiate for the inclusion of all available medicines in the GHS, so that patients have immediate access and their doctors have at their disposal all the options, unfortunately we have been informed that the purchasing and procurement directorate of the Ministry of Health (GOP) has been instructed to proceed again with the tender process to ensure the cheapest formulation."
"Another typical example of the filibuster for the inclusion of innovative medicines in the GHS is Reblozyl, the only therapeutic drug whose inclusion is pending, and has been approved by the EMA in June 2020. A relevant file has been submitted by the manufacturing company, and its inclusion has been requested by the doctors and the National Thalassaemia Committee.
At the same time, said Mr. Kouloumas, "we have been informed that out of the approximately 600 available innovative therapies, only 3 or 4 formulations have been included in the GHS with the procedures included in the law of the System and at the same time patients continue to suffer through the procedures of the Committee of Nominal Requests, which can approve every week dozens of requests of doctors for the provision of specialized medicines to their patients, but the way in which orders for medicines are made by the GOP leads to huge delays, as these treatments have to be ordered per patient and not in large quantities, which also troubles the GOP, which is already understaffed.
As a result, a patient is now approved by the Committee on Nominal Requests but is forced to wait up to 2 or 3 months to start treatment and we all realize that when a person suffers from cancer or other serious illness, 2 or 3 months is a very long time."
"These issues should have already been settled," the OSAK president said, saying that "we expect the immediate intervention of the Minister of Health to speed up the procedures and make public all relevant prescribing protocols and start the negotiation process for the inclusion of all innovative/specialized therapies in the GHS. The OSAK will not tolerate further obstructionism and regressions in the relevant issue and we will certainly not allow a return to practices and mentalities of the past that limited patients' access to innovative therapies."
Suffering of hospitalized patients and their relatives
Another problem observed, said Mr. Kouloumas, concerns the access of patients who are hospitalized to medicines that are included in the GHS. Specifically, as he explained, "when a hospitalized person needs medicines, his doctor and a relative or friend of his should prescribe to go to the neighbourhood pharmacy to get them, because these drugs are not present in the hospital pharmacies. We understand that this is because of both the legal procedures and some agreements that have been made before the GHS's implementation, but in practice, as we see, it troubles patients and therefore a way must be found that does not affect what has been agreed, but also solves the problem.
Perhaps, said Mr. Kouloumas, "there should be a social support service to help patients who may not have relatives or someone of their own at the time they need their medicines from the neighbourhood pharmacy. Also, the issue of transferring all treatments from hospital pharmacies to the wards needs to be sorted out, because here too we are seeing inconvenience to patients or their relatives and these things probably need to be corrected."
