The Ministry of Health claims that it is intended to change the compensation procedure. However, the process is hindered by the fact that the State Health Fund has not yet calculated how much it would cost.
Marijampolietė lost an eye
Lina from Vilnius (the real name is known to the editors, – author. past) says that in 2009 A mother living in Marijampole was diagnosed with age-related macular degeneration. Doctors in the capital confirmed the disease for a woman in her seventies, but did not recommend any treatment.
The following year, Lina’s mother’s eyesight began to deteriorate rapidly, but the doctors at the private clinic only suggested that she take food supplements.
in 2010 In autumn, the elderly woman who visited the doctors of Vilnius Santaras Clinic again was offered an injection into the vitreous body of the eye. It is true that doctors could not offer medicine for eye disease. Instead, he applied a drug against intestinal cancer. It has been seen to help some people with age-related macular degeneration.
Unfortunately, Lina says, the injection gave the opposite result. The interviewer’s mother’s eyesight has deteriorated significantly. The elderly woman lost her central vision, so when the doctors realized that the medicine for bowel cancer was a bad idea, they stopped offering this treatment.
in 2012 Ophthalmologist at Kaunas clinics, prof. Vilma Jūratė Balčiūnienė stated that the patient’s left eye was already lost.
“Not long after, my mother’s vision in her right eye also got worse. Colors disappeared, images, people and things were deformed”, – to the portal lrytas.lt said Lina.
At that time, it was already possible to obtain a biological drug in Lithuania for the treatment of retinal disease. For the next two years, Lina’s mother received drug injections into the vitreous of the eye every 2-3 months in Kaunas clinics.
“The vision in the right eye started to improve,” assured the interviewer.
Lina says that she received more good news. in 2014 a new generation drug appeared, and the cost of biological therapy was covered by the State Health Insurance Fund (VLK).
It hurts not to get help
in 2016 the woman was given the last injection of the effective drug. Lina found out that the Ministry of Health (SAM) only allows compensation for the first two years of treatment with state funds.
“I applied to the State Sickness Fund, wrote down my mother’s entire history. The answer was not encouraging – this is the ministry’s position, the established procedure and treatment with progressive medicine will no longer be compensated,” Lina recalled.
Lina’s mother is 86 years old today. She is again forced to hope that the drug for bowel cancer will help to save the remnants of her vision. However, without effective treatment, her vision deteriorates again.
“My mother is almost blind. While the advanced drug was administered, the vision in the right eye was almost restored to normal. And now there is no more central vision. Only the peripheral remains. The injections she receives now not only do not improve her vision, but also do not stop the deterioration,” complained Lina.
The woman added that her mother was a paramedic, worked in the ambulance service and devoted her whole life to saving people.
“It hurts when a person cannot get effective help in old age. Blindness is scary. There is treatment that helped my mother, but the bureaucratic deadline prevented the possibility of preserving her health,” the interviewer consoled.
The situation angers doctors
VJBalčiūnienė, president of the Society of Ophthalmologists of Lithuania, explained that retinal diseases are chronic and require lifelong treatment. Therefore, the ophthalmologist is outraged by the procedure when the treatment that gave a person hope to save his vision is stopped due to bureaucratic obstacles.
“Has anyone heard of treating diabetes and hypertension for two years?” We have a chronic disease and it needs to be dealt with accordingly so that a person’s vision is not lost. I can’t count how many letters and letters we wrote to various institutions. It was explained to us that the drug was submitted for registration with data on its effectiveness for a period of two years.
But after all, it is clear that if the drug is effective and helps a person, the treatment should be continued. It hurts that such things need to be proved,” said VJBalčiūnienė.
The doctor of Kaunas clinics says that the injections of biological drugs into the vitreous body were expensive at first. 12 years ago, it cost about 4,000 litas, and now it costs about 300 euros. According to the professor, more than 2,000 people are already receiving this type of treatment in Lithuania. patients with retinal diseases.
According to VJBalčiūnienė, the medicine needed by the patients is currently being supplied with interruptions.
“VLK does not control the process, purchases of required quantities. Medicines run out, they expire – we have to cancel planned procedures and constantly fight with VLK, instead of treating patients in a planned and efficient manner,” complained the professor.
According to her, doctors would be able to choose the most appropriate drug for the patient if biological therapy was included in the A list of compensatory drugs and medical aids.
Calculates how much it would cost to change the order
VLK representatives claim that there have been no interruptions in the supply of these medicines for the past few years, and the procedure for the procurement and reimbursement of medicines can only be changed by the Commission for the Compensation of Medicinal Products and Medical Aids established by the Minister of Health.
SAM informed that Ranibizumab and/or Aflibercept are reimbursed for the treatment of macular and posterior pole degeneration, retinal vascular occlusions and diabetic retinopathies.
“The conditions of prescribing and the duration of treatment are determined based on the clinical data that were submitted when proposing to include these drugs in the list of compensable drugs,” states the SAM’s comment transmitted to lrytas.lt.
It also states that the aforementioned 2-year term is intended to be waived.
“Judging by the results of recent clinical trials and long-term follow-up studies, it can now be seen that intravitreal therapy with vascular endothelial growth factor (VEGF) antagonists can effectively slow the progression of the disease. Clinical trial data show that KEAF inhibitors can be used safely for approximately 7 years in the treatment of age-related macular degeneration (AMD), so the Ministry of Health would agree that the current prescribing conditions should be reviewed and patients could be reimbursed for treatment beyond 2 years.
It should be emphasized that there are not many alternatives to stop the disease, but clinical experts point out that the effectiveness of treatment with KEAF inhibitors is related to compliance with the treatment regimen. If the treatment regimen is not followed, the disease may progress. A necessary condition for effective treatment is the patient’s motivation to adhere to the prescribed treatment regimen. Patients must be made aware of the risks associated with injections into the vitreous body of the eye, as well as the symptoms of complications or adverse reactions to the drug, so that they can notice them in time and consult a doctor,” says SAM.
The representatives of the Ministry emphasized that they are aware of the situation arising from the treatment of patients suffering from retinal diseases, the issue has been discussed several times by the Commission for the Compensation of Medicinal Products and Medical Aids.
However, the solution to the problem continues to hang in the balance, as the VLK has no way of calculating how much state funding would be needed if the current restrictions on the number of injections and duration of treatment were lifted. VLK was instructed to do this on April 6. So, more than a month and a half ago.
“After receiving VLK’s information, the Commission will continue the consideration of the issue,” say SAM representatives.
Tags: Lithuania eye diseases treated drugs intestinal cancer-