Last December, we published in the "Shabbat" supplement about the dilemma facing the Basket Committee: whether to prioritize patients at an early stage over metastatic patients, and presented the benefit of this alongside the criticism.
An analysis of the decisions of the Medicines Basket Committee conducted by the Clalit and Maccabi health funds shows that this year a clear preference was given to treatments with therapeutic potential intended for cancer patients at an early stage of the disease, over treatments intended for severe and metastatic patients.
Illustration: Ruth Guili,
According to the study, 88% of treatments for an early stage of the disease, that is, treatment given before or after surgery to remove the tumor alongside chemotherapy, entered the basket of drugs. In contrast, only 20% of treatments for advanced or metastatic cancer were approved by the committee.
Thus, for example, this year the Medicines Basket Committee included in the basket early treatment of the drug Keytruda for patients with triple negative breast cancer, which is considered more violent. On the other hand, treatment with the drug Trudelby, for those patients at an advanced and metastatic stage of the disease, was not approved, even though it was found to prolong life by another six months.
"They were waived in advance"
Dr. Ariel Hammerman, former head of the Department of Evaluation of Drug Technologies at Clalit, explains, "The treatment given at an early stage of the disease is intended to reduce the risk that cancer cells will remain in the body and the disease will return. In contrast to treatment of metastatic disease in which the treatment stops the progression of a disease. The complementary treatment, which is sometimes given for many years, has a price and implications in terms of toxicity and side effects."
Dr. Ariel Hammerman. "Good drugs don't come in",
Dr. Hammerman adds, "If we continue this trend with our eyes closed, many good and life-prolonging treatments for metastatic diseases will not enter due to a shortage of resources. In fact, 75% of the drugs considered good and effective did not make it into the basket."
Prof. Tammy Peretz, a senior oncologist at Hadassah, called it "a heartbreaking dilemma. There is no doubt that it would have been desirable to introduce treatments for metastatic patients, which may lead to prolonged remissions. At the same time, it is important not to forget to budget for preventive treatments and early diagnosis."
Yafit Alperson Almalich, CEO of "Me Too", an association for breast, uterine and ovarian cancer patients: "The findings are worrying. There are women with metastases who live well for many years and feel that they are 'second class'. They gave up these sands in advance."
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