Filenews 12 May 2025 - by Marilena Panayi
Patients are at risk waiting for the approval of the requests that their doctors submit to the Health Insurance Organization for specialized treatments. The MPs are setting up the HIO on the wall for serious delays and rejection of requests. The Federation of Cyprus Patients' Associations submits its previous proposal for the rapid inclusion of new specialized medicines in the GHS, in order to free doctors and patients from the process of nominal requests and the HIO does not take a public position on the complaints, resulting in dozens of questions that remain unanswered.
In essence, the HIO has complained several times in the last year about its understaffing with its competent department operating with "loan" and expiration date officials of the Ministry of Health.
The facts and the fact that the doctors who participate in the Nominal Requests Committee of OAY, which examines the relevant requests, probably have a different perception of things than their colleagues who submit the requests on behalf of their patients.
At the same time, complaints are submitted to the Patient Observatory of the Federation of Cyprus Patients' Associations by patients, who claim that while they were waiting for a response to their request for specialized treatment, they then found out that their doctor had never submitted the relevant request to the HIO. In response to this particular example, of course, doctors, of various specialties, refer to their positions in the background, to the difficulty they face in their attempt to complete the "complex" and overly demanding electronic application in the GHS software.
The parameters are many, the data are enough and each side has its own solutions to propose. The average waiting time for the examination of a request by the competent committee of the HIO, as we are informed, reaches three weeks. As doctors, MPs and organized patients denounce, the specific period for seriously ill people and especially for cancer patients is too long "and enough to make taking a treatment unnecessary in the end, with all that this may entail for a person's life".
The chairman of the parliamentary health committee, Efthymios Diplaros, referred to "doctors, oncologists, who called in a frenzy, claiming that while they themselves consider that a treatment is appropriate for their patients, the competent HIO Committee rejects their requests".
MP Andreas Apostolou said that the issue "has three different aspects: the delay in the examination of requests, the rejection of some requests and the fact that many of the specialized medicines that fall under the competence of the Nominal Requests Committee should have already been included in the GHS and administered without other procedures to patients who meet the criteria".
The honorary president of OSAK, Marios Kouloumas, reiterated the position of the Patients' Federation "for the inclusion of as many specialized treatments as possible in the GHS, on the basis of an earlier recommendation of OSAK, so that the Nominal Claims Committee concludes only the cases that should be concluded and that these dangerous and unnecessary delays that work to the detriment of patients are not created".
This issue is expected to be transferred next week to the Parliament, where the HIO will also be asked to give its own answers and explanations for the problem that has been created.
How the mechanism works, understaffing, gaps and waiting time
The Health Insurance Organization undertook the process of nominal requests for medicines last January. The data are listed, according to the information that "F" obtained from the HIO.
The competent Committee for Nominal Requests for Medicines of the HIO: Doctors' requests are examined by the Committee for Nominal Requests for Medicines. Those that are rejected and objections are examined by the Revision Committee. EOAF consists of five doctors, of various specialties and two pharmacists. It meets on Thursdays, every two weeks and examines around 80 requests, on average, per meeting. 80% of requests are approved. EOAF does not consider requests concerning patients who are already receiving treatment and their doctors request its continuation. It only examines new requests.
On average, twice a week the Emergency Committee meets on an emergency basis, which deals with requests of an urgent nature (a matter of life and death or the start of treatment). For the most part, these requests are approved.
As mentioned in "F", 20% of the rejected requests mainly concern cases in which the Commission considers that there are other alternative therapeutic solutions within the GHS.
Time that elapses until the examination of a request: According to the data obtained from the HIO, the time that elapses between the submission of a request and its examination and the notification of the doctor is, on average, three weeks. In cases where the request is approved, the doctor will be informed the next day. In cases of rejection, there is a relative delay since in order for the doctor to be able to submit an objection and address the review committee, he must also have the minutes of the EOAF meeting in his hands.
Doctors' complaints about the application forms: The way in which requests are submitted to the HIO seems to be of particular concern to all doctors, who complain about excessive demands and unnecessary bureaucracy. This issue has been raised by doctors several times at the HIO.
The data at the HIO: The competent Department of the HIO operates with 3 officers who have been seconded to the Organization by the Ministry of Health. The secondment of one of these officers ends at the end of May and returns to the Ministry and the second at the end of June. A fourth officer, who had also been seconded from the first days of his secondment, is absent on sick leave. All seconded officials will return to the Ministry of Health soon, since the Pharmaceutical Services must prepare for the purposes of the Cyprus Presidency of the EU.
Three weeks ago, the HIO proceeded with the recruitment of a female officer who is being trained and two more officers are expected, who also have to first go through the necessary training before undertaking normal duties in this particular service. Another HIO officer who deals with patients' requests has additional duties. In the same way, some other officials in the pharmaceutical sector are assisting, but these procedures are not their permanent or only employment. The procedure is dealt with by all the officials of the competent Sector, who, however, perform other duties.
