Filenews 26 January 2022 - by Marilena Panagi
There are still 600 pharmaceutical preparations for serious diseases outside the GHS, while both the Ministry of Health and the organized patients have repeatedly raised the issue in letters before the Health Insurance Organisation (HIO) since March 2021, but there has been no progress in advancing the necessary procedures.
Controversies and intense disagreements existed during a meeting held on Monday afternoon at the Ministry of Health, with the General Director Christina Giannaki attacking the management and administration of the Organization, with the organized patients demanding the immediate resolution of the problem, which afflicts and endangers dozens of patients every day, and the Minister of Health giving an order for the establishment of a committee in which a representative of the Federation will participate. Cyprus Patients' Associations (OSAK) will have a timetable to resolve all outstanding issues in one month.
Michalis Hadjipantelas, in response to the HIO's argument that for the non-inclusion of medicines in the GHS there are also economic reasons, stressed that both he and the President of the Republic have expressed many times their readiness to proceed with any actions required in order for patients to ensure the formulations they need are available, at the time they need them, without suffering and putting their health or life at risk, as is the philosophy and structure of the GHS.
The meeting aimed to study all the outstanding issues in the General Health System, but focused on the issues related to the pharmaceutical sector and the meeting will be repeated next week with the aim of putting everything else in the discussion and setting in motion solutions.
Serious were the complaints made during the meeting by the OSAK regarding the pharmaceutical sector, which concern both the delays observed by the Organization in relation to the inclusion of medicines in the GHS, and the Advisory Scientific Committee on Medicines of the HIO, which according to the organized patients, "it does not operate autonomously".
Analytically:
> SEF has no autonomy. It depends on the HIO, which is an insurance organization that pays, which creates problems, since scientific decisions are taken on the basis of the financial arguments put forward by the Organization.
> There is a long delay from the start of discussions in the special committees for updating the SEF's drug protocols, until the approval for the inclusion of a drug in the GHS list (the approval of the recommendation by the HIO is required).
> There is a problem and delay in the update of pharmaceutical protocols by the SEF, with the result that the attending doctors are forced to appeal to the committee of nominal requests of the Ministry of Health, in order to have access to the medicines of their seriously ill patients, with the expected delays from the procedure and serious consequences on the health of the patients (when there are no protocols the formulation is not available from the GHS but from the Ministry of Health through time-consuming procedures, which include tenders).
> Many innovative and "unique" medicines have not yet been included in the GHS on the basis of protocols, due to the long delay observed in the HIO procedures and in the work of the institutional bodies for the approval of medicines.
> There is a serious problem regarding patients' access to non-prescription drugs, which are deemed necessary for the complete treatment of patients.
> There are serious shortages of medicines (e.g. medicines for haematology patients) and consumables in the GHS, which are currently purchased on the basis of the cheapest and not on the basis of the quality or the specific needs of each patient.
As the president of OSAK Marios Kouloumas mentioned in "F", "during the meeting, everything that we, as an organized movement of patients, supported for so many months, were confirmed and the huge problems that exist regarding the inclusion of medicines in the GHS were revealed and we must stress that these are not weaknesses of the System itself, but they are due to the terrible delay observed by the HIO in the procedures, while there may also be a problem in the operation of the various institutions that operate within the HIO and are competent to deal with issues related to medicines.
The pending issues, said Mr. Kouloumas, are many: "First of all, we have about 600 formulations that concern serious diseases and their non-inclusion in the GHS obliges doctors and patients to follow the time-consuming procedures of the committees of the Ministry of Health and their supply through offers. And on this issue, but also on the way the SEF operates, and of course other relevant issues, both we as OSAK and the Ministry of Health, as it was established by the letters presented yesterday by the Director General, have contacted the HIO many times in the last one year. The director-general even presented letters she had sent since March 2021 to the HIO but did not receive, as she said, any reply."
Regarding the remaining outstanding issues on the issues of medicines, Mr. Kouloumas referred to "the non-signing of the memorandum of cooperation between the HIO and pharmaceutical companies for the medicines that joined the GHS during the second phase of its implementation". Also, "there is the issue of drugs losing their patent" and explained: "At the moment we have a formulation, which is still in the time of protection of its patent. In the GHS, however, there are other similar drugs. When the first formulation loses its patent (after the time specified internationally has elapsed), this formulation remains in the System but its price in many cases is much higher than the other corresponding ones, resulting in the patient either being forced to change medicine, which is unacceptable, or being forced to pay large amounts of money out of his own pocket as a supplement, which may be €100 and €200 depending on the formulation". On this issue, he said, "the agreement between the HIO and the companies on the price of these drugs and the compensation that the companies will receive from the Organization is pending, so that the patient does not bear the cost".
On the table all the loose ends - Next week's new meeting
Monday's meeting lasted only an hour due to other obligations of the health minister. However, it was decided that a new meeting will be held next week in order to discuss all the remaining outstanding issues observed in the GHS and concern both the pharmaceutical sector and other issues.
As far as medicines are concerned, the OSAK raised the issue of the inclusion of specific Non-Prescription Drugs for specific groups of chronic patients when the formulations are included in the medical protocol. At the same time, the way of supplying consumables and the way they are disposed of to patients are pending. On this issue, the OSAK has submitted a relevant plan to the HIO but has not, for the time being, received a response.
As far as the remaining pending issues are concerned, it is expected that the non-inclusion of private TAEP in the GHS, the delay in the operation of on-call clinics and the request of organized patients for the abolition of "horizontal" restrictions on visits to health professionals, access to medicines and the number of diagnostic tests that the citizen is entitled to during a year will be discussed.
