Israel's 2023 health basket set to include over 120 new drugs, treatments

The health basket provided by the four health maintenance organizations in Israel is likely to be expanded by more than 120 medications and technologies for some 350,000 people at a total cost of NIS 650 million. The announcement was made on Wednesday by the public committee for the expansion of the basket of health services, chaired by Prof. Dina Ben-Yehuda.

Applications from pharmaceutical and medical technology companies to have their product added to the basket totaled a few billion shekels.

The recommendations are sent to the health and finance ministers and the National Health Council, which always give their approval before the additions go into effect. 

What's new in Israel's health baskets?

The recommendations were sent to the health and finance ministers and the National Health Council, which must give their approval before the additions go into effect.Among the recommendations are:

• Prevention and public health: Vaccination against shingles for at-risk populations and those age 65 and over; Prevenar vaccine against pneumococcal pneumonia; eyeglasses for children up to seven years of age; and the expansion of the ages eligible for screening tests during pregnancy.
• Cutting-edge cancer treatments: Immunotherapy drugs for breast, kidney, skin cancer and other malignancies; genetic tests for tumors to adapt the best treatment for the specific disease; drugs for multiple myeloma; personalized drugs; and advanced therapies.
• Treatments for chronic diseases: Drugs for the treatment of diabetes, kidney disease, neurological disease, pulmonary disease, and cardiac disease; various technologies that include a continuous hybrid system for sugar monitoring and insulin infusion by expanding eligibility for children with juvenile diabetes; treatment in communication-disorder clinics for people who stutter; and lung rehabilitation.

Health Minister Arye Deri said: “The recommendations of the Basket Committee submitted to me today concern all citizens of Israel. I am proud that the addition to the basket of medicines we brought this year is the largest ever in Israel – NIS 650 million. Thanks to this expansion, oncology drugs, prevention technologies and life-prolonging products that were not planned to join the basket entered this year. These technologies and medicines will allow the weaker sections to receive much better and much more advanced medicine. Blessings to all those involved in the craft.”

Criticism of package

The Obesity Research and Treatment Society expressed anger and frustration about the basket committee’s recommendations.

“I would like to congratulate the members of the basket committee for their complex, sensitive, and not simple work,” said the society’s chairman, Prof. Dror Dicker. “However, it is a pity that the State of Israel ignores a quarter of its population that suffer from the disease of obesity.

“There is no economic sense in the state’s preference to spend a total of NIS 20 billion per year on medications that are the consequences of the obesity epidemic on the economy and society, rather than allocating a budget in the basket to treat obesity. The results of obesity cost a fortune, but there is almost no investment in their treatment.”

The Israel Internal Medicine Society thanked the committee for taking its recommendations into account. However, its chairman, Prof. Avishai Ellis, said: “This is not enough. The government must allocate an orderly and significant amount of money to improve treatment conditions and hospitalization conditions, including the purchase of medical equipment for the internal departments, the addition of medical and paramedical standards and the realization of its promise to build wards and stop hospitalizations in the corridors.

Ben-Yehuda, dean of the Hebrew University of Jerusalem's Faculty of Medicine and a leading hematologist at Hadassah-University Medical Center who was serving for the first time as chairman of the committee, said: “I thank the health minister and Health Ministry for the trust you have placed in me. This was one of the most complex challenges in the health system. I thank the professional team in the ministry’s technology division who prepared the materials for the discussions.”

She also thanked the other committee members for “their professional discussions. The members of the committee came from a wide range of disciplines - medical, managerial, public, social and ethical. All of them were reflected in the committee's considerations. Despite the differences, I felt in all the discussions that there was something that united us all in the decision-making process and that is compassion.”

Ben-Yehuda added that “we were able to achieve a diverse and most advanced update to the publicly funded health basket for Israeli citizens. For the first time, eyeglasses were included for children up to the age of seven; we added vaccines for preventive medicine, diagnostic technologies and innovative treatments for serious and complex diseases.

“For me, this is also a sad day for those patients for whom we were not able to include new technologies. But I am all hopeful that the technologies for them will be included in next year’s medicine basket.”Moshe Bar Siman Tov, a former Treasury economist who was appointed Health Ministry director-general by Health Minister Arye Deri, said: “We maintain and implement one of the most important principles in the State Health Insurance Law: mutual guarantees. We guarantee the availability of the most advanced technologies universally to all residents. The increase of the basket to NIS 650m. is real news. Next year, we will increase by another NIS 100m., but already, this is the biggest addition ever made to the basket.”

Moshe Bar Siman Tov, the former Treasury economist who was returned as Deri's Health Ministry director-general, commented: “We maintain and implement one of the most important principles in the State Health Insurance Law –mutual guarantees. We guarantee the availability of the most advanced technologies universally to all residents. The increase of the basket to NIS 650 million is real news.

“Next year, we will increase by another NIS 100 million, but already, this is the biggest addition ever made to the basket.” He added that “we know the Israeli basket is one of the most extensive and advanced in the world.”

Dr. Osnat Luxenburg, the longtime head of the ministry’s Medical Technologies, Information and Research Division, who coordinates the committee’s work, said: “Our recommendations are the last step in a process that continues throughout the year, in which professional work is carried out among the best in the world to locate the most important drugs and technologies for the public in Israel.”The Israel Cancer Association called for a permanent update of the drug basket with an annual increase of 2%. Such a demand has been made by various groups for several decades, but it has always been turned down by the Treasury. 

The committee’s work was done in view of the weight of the responsibility and public mission placed on our shoulders and in view of the needs of the patients and what each and every one of the technologies mean to them, Luxenburg added. “We thank the health minister and the Israeli public who put their trust in us that we will make every effort to maximize the budget for its expansion to promote the health of the population in Israel.” 

Meanwhile, the Israel Cancer Association called for a permanent update of the drug basket with an annual increase of two percent in order to prevent distress from the patients. Such a demand has been made by various groups for several decades but has always been turned down by the Treasury. 

“We congratulate the members of the public committee for the expansion of the health services basket for introducing medicines and advanced technologies to the basket for the benefit of cancer patients,” the Israel Cancer Association said. “At the same time, we thank the health minister who reached agreements with the finance minister on increasing the basket the drugs by an additional NIS 100 million. However, unfortunately, every year there are still important new drugs that remain outside the basket due to a lack of budget.” 

Anger and frustration about the Basket Committee’s recommendations were also expressed by the Obesity Research and Treatment Society. Prof. Dror Dicker, its chairman, said: “I would like to congratulate the members of the basket committee for their complex, sensitive and not simple work. However, it is a pity that the State of Israel ignores a quarter of its population that suffer from the disease of obesity. There is no economic sense in the state’s preference to spend a total of NIS 20 billion per year on medications that are the consequences of the obesity epidemic on the economy and society, rather than allocating a budget in the basket to treat obesity. The results of obesity cost a fortune, but there is almost no investment in their treatment,” he declared.

In January, when the internal wards are full of patients beyond capacity, with an exhausted staff, we see how much a separate basket of resources is needed to improve the ability to provide proper medicine to the citizens of the country.”

Prof. Sigal Ben-Yehuda, dean of the Hebrew University of Jerusalem Faculty of Medicine and a leading hematologist at Hadassah-University Medical Center, who served as chairman of the committee, said: “This was one of the most complex challenges in the health system.... We were able to achieve a diverse and most advanced update to the publicly funded health basket.... For the first time, eyeglasses were included for children up to the age of seven. We added vaccines for preventive medicine, diagnostic technologies and innovative treatments for serious and complex diseases.

The list of all the additions to the 2023 basket will be posted (in Hebrew) on the Health Ministry’s website at https://www.gov.il/he/departments/ministry_of_health/govil-landing-page.