The Israeli Lung Cancer Association warned the Director General of the Ministry of Health, Prof. Nachman Ash, that the unprecedented approval given to the Clalit Health Insurance Fund to reduce doses of drugs for lung and skin cancer patients could result in the doctors being charged with a criminal offense and also being sued in civil lawsuits.
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This was reported this morning (Sunday) by Israel Hayom commentator and health correspondent Ran Reznik.
This is a criminal offense of administering a medication in violation of the legally prescribed dosage, as well as medical malpractice claims that may be filed against them and the health funds.
The extraordinary warning was conveyed following the special discussion held last Tuesday in the Knesset Health Committee on the unprecedented authorization of Prof. Nachman Ash, the Chief of General Staff, to comprehensively dictate to oncologists to give lung and skin cancer patients reduced doses of expensive drugs that are fully budgeted for in the drug basket.
This is contrary to the recommendations of a professional committee that the Ministry of Health itself established, contrary to the legal registration of the drug in the Ministry of Health and the dosage listed in the drug basket, and also despite sharp criticism from some of the country's top oncologists.
In a reasoned legal opinion, Attorney Dr. Matan Gutman warned on behalf of the association that the approval given by Prof. Ash is "illegal and unconstitutional, and is an unprecedented position and a blatant and prohibited interference in the discretion of the treating physician, in illegally granting permission to the health insurance fund to deviate from the principle of registration stipulated in the Pharmacists' Ordinance.".
Attorney Gutman further wrote that this is "creating discrimination between patients from different health insurance funds, ignoring the position of professional bodies, and allowing the combination of economic considerations in the provision of health services that have already been included in the health basket, and have an approved budgetary source.".
The Ministry of Health responded: "The draft circular from the Ministry's Director General was formulated by the professional elements of the Ministry of Health after receiving an opinion from a professional committee appointed for this matter. The attached opinion will be examined and considered along with the other comments to the draft circular.".
Clalit responded: "An independent committee that included senior oncologists in Israel and the heads of the Ministry of Health determined, after intensive and thorough staff work, that both methods should be permitted based on weight and in a fixed dosage." It was also stated that "all studies on the drug prior to its registration were conducted on a weight-based dosage basis. A subcommittee of the Ministry of Health determined that the drug manufacturer effectively forced the use of doses that were double the 100 mg dose when it removed 50 mg ampoules from the market.".
""The Ministry of Health has published a draft circular supporting the general position and stating that the health insurance fund has the right and even the obligation to determine a binding medical treatment policy for medical teams, including its right to determine treatment regimens and drug dosages, while determining an informed medical policy, based on solid professional foundations.".
