Filenews 17 May 2025 - by Marilena Panayi
This summer is expected to be particularly demanding for the Health Insurance Organization, with the GHS facing two major challenges.
The Health Insurance Organization, on the one hand, is under fire for the first challenge concerning the management of specialized medicines and on the other hand, it is trying to prepare itself properly so that it will not be in the crosshairs again in October when it will be called upon to undertake the program of sending patients abroad.
The serious understaffing, the secondments that expire at the end of the month and the protests of the specialist doctors, in the interview given by the general director of the Health Insurance Organization, Iphigenia Kammitsi, to "F".
The roadmap for the transfer of the program of sending patients abroad has been completed, said Mrs. Kammitsi. "We have a detailed and comprehensive record of all the actions required, with clear and realistic timelines." He explained that a team of HIO officers has been set up that will be trained in the coming period by the officers of the competent Department of the Ministry of Health and noted that these officers "together with officials of the Ministry of Health who will be seconded to the HIO, will form the incident management team".
The need to amend the legislation in order to enable the Organization to operate the programme is a concern for the observance of the October timetable. "The passage of the relevant legislative regulations before the start of the summer holidays of the Parliament is crucial, in order to enable the full operational readiness of the HIO by October 1, 2025. We plan to ask the Ministry of Health that the necessary amendments be submitted for a vote under the urgency procedure."
At the same time, the HIO expects to be informed about the number of officials of the Ministry of Health who will be seconded, noting that "the duration of the secondment of these officers must be for 12 months, in order to ensure the transfer of know-how to the Organization".
Secondments that expire at the end of the month
"The understaffing of the HIO is a timeless and serious issue. The Organization proceeded with procedures to fill 19 new and vacant positions, which were already approved in the 2023 budget. Recently, and with the unfreezing of additional positions, the total number of new hires is expected to rise to 44 officers." The Organization also intends to proceed with the recruitment procedures for assistant secretarial officers as well as with the filling of promotion and first appointment positions.
However, he said, "even with the completion of these recruitments, the needs remain significant, particularly in light of taking on two critical new responsibilities: managing patient shipments abroad and reviewing nominal requests for specialty medicines."
For the implementation of the two programs, Ms. Kammitsi said, "the secondment of officials from the Ministry of Health was set as a prerequisite. However, the experience with the secondment of personnel for specialized medicines has proved to be of limited use, as the seconded officers are expected to return to the Ministry by the end of May and June."
"The possibility of a repetition of the phenomenon in the case of missions abroad is of great concern to us, as if there is no immediate settlement of the issue of the secondment of officers, it is certain that operational problems will arise in this field as well," he pointed out.
Commenting on the intention of a group of GHS specialist doctors to proceed with the establishment of a guild protesting, among other things, the continuous fall in the unit price on the basis of which they are paid, the general director of the HIO explained the phenomenon without leaving much room for discussion.
"The GHS is based on a global budget, which means that the unit price of compensation is formed according to the total volume of operations carried out. The Organization monitors on a regular basis the progress of the data per specialty and proceeds to targeted interventions, when this is deemed necessary".
However, he added, "in some cases there are phenomena of abuse. The HIO implements disciplinary measures, recommends scientific protocols, guidelines and promotes control mechanisms, and I must underline that over-use of services is also done on the part of beneficiaries."
In any case, he noted, "according to the data of the recent OECD report, Health at a Glance: Europe 2024, the salaries of specialist doctors under the GHS as a multiple of the average salary in Cyprus, compare very favourably with respect to the corresponding salaries of specialist doctors as a multiple of the average salary in most European Union countries".
The criteria of the Ministry of Finance are different. Health and other obligations of the HIO
Mrs. Kammitsi also submitted the position of the HIO after the complaints about delays and rejection of requests for the administration of specialized drugs to seriously ill patients.
"The primary and non-negotiable goal of the Organization is to serve the patient. On the basis of this principle, all requests are examined. Any new service or medicine that is included in the GHS must be evaluated on the basis of multifactorial criteria, including the overall budget of the System, which is based on the contributions of citizens, employers and the State. The operation of the Committee for Nominal Requests for Medicines (EOAF) in the Ministry of Health was governed by different criteria, which do not correspond to the obligations that the HIO has institutionally undertaken".
The Committee, as well as the Emergency Committee, said Ms. Kammitsi, "have been operating since January 1, 2025 under the responsibility of the HIO exclusively for GHS beneficiaries. The process of evaluating requests is complex and requires preparatory work and synergy from various stakeholders.
Cases of pharmaceutical products that are licensed and invoiced in Cyprus, but have not yet been included in the GHS List of Pharmaceutical Products, are referred to EOAF. In order for a drug to be included in the List, it must be preceded by the scientific evaluation by the competent Scientific Advisory Committee, the preparation of the necessary protocols by the respective special committees, the approval by the board of directors of the HIO, and then the financial negotiation with the company".
"The Agency fully shares the concerns of patients and healthcare professionals and for this reason, it has set as a strategic goal the gradual inclusion of as many medicines as possible in the list, proportionately reducing dependence on the status of nominal requests."
At the same time, "ways to speed up the process are being examined, but without violating the necessary stages of evaluation and authorisation provided for by the good management practices of medicines for the purposes of reimbursement within national health systems".
The process of examining a nominal request takes an average of a few weeks, and "understaffing remains a critical obstacle, which we recognize, but do not invoke as an alibi."
Based on the data that reflect the picture that has been formed to date, "since mid-January, when the first session of the Committee was held, and until its last meeting on May 8, a total of 675 applications for the start of treatment have been examined. Of these, 630 were examined by EOAF and 45 by the Emergency Examination Committee".
At the last EOAF meeting, "all requests submitted by May 2, 2025 were examined, confirming that there is no delay in the flow of requests for review. Based on the Agency's data, the rejection rate of requests stood at 15.7%, which suggests that the vast majority of submitted applications are positively evaluated. It is noted that applicants have the right to lodge an objection before the Review Council, which meets on a monthly basis.
