Access to Medicines

Pharma Israel is taking action to increase the public access to medicines, vaccines and innovative medical technologies that are contributing to the eradication of diseases and epidemics, to curing diseases and to turning incurable diseases into chronic diseases, thereby significantly improving quality of life and increasing life expectancy.

In Israel, the public health system operates by virtue of the National Health Insurance Law, 1994. All Israeli residents are entitled to a national health services basket that is one of the most advanced and extensive in western countries. Additional channels also exist that enable expanded access to medicines that are not included in the national health services basket.

Main channels providing the Israeli public with access to medicines, vaccines and medical technologies:

100% of residents of Israel are entitled to the health services basket that was established by virtue of the National Health Insurance Law and is updated annually by the Public Committee for Expansion of the Health Services Basket, which is locally called “the Basket Committee” for short. This committee issues recommendations to the Minister of Health about which medicines and technologies should be included in the basket considering the budgetary constraints. The Israel Medical Association, hospital directors, the HMOs, patient NPOs, pharmaceutical companies and anyone who so desires, can submit proposals to the Basket Committee to include critical technologies in the basket.

In recent years, we have been witnessing a gap between the limited budget allocated for updating the basket and the medicines and medical technologies that the Basket Committee has ranked as being the most critical for Israeli residents. Members of the Basket Committee have shared the enormous difficulty in prioritizing one medicine over another.

77% of Israelis have supplementary healthcare services (“Shaban”) that are provided by the HMOs in Israel. Any member of the HMOs may join a Shaban plan at any time and at any age (i.e., without underwriting or policy conditions that depend on the insured’s existing conditions or state of health). Since a Shaban plan gives its members access to medical services and medicines that are not included in the national health services basket, Shaban is a supplementary program that expands healthcare and services coverage for its members.

35% of Israelis have private health insurance policies, which are marketed by private companies and offer various plans of coverage for medicines and medical services, some of which are not included in the national health services basket or covered by a Shaban plan.

Additional channels providing the Israeli public with access to medicines, vaccines and medical technologies under particular circumstances:

HMOs’ exceptions committees are committees that accept special applications from patients to receive a treatment or medicine that is not included in the national health services basket. The exceptions committee may approve public funding of a patient’s treatment that has been proven to be vital for the patient, according to medical and budgetary considerations.

Compassionate treatments by the pharmaceutical companies that are provided to patients when there is no registered treatment or registered medicine that is suitable for their disease. Compassionate treatments are provided by the pharmaceutical companies with the approval of the Ministry of Health and at the request of the treating institution, provided that the medicine will be available throughout the entire course of treatment and provided that the treating physician monitors the patient’s medical condition. Compassionate treatments are provided only in instances when the treating physician believes that the potential benefit of administering the treatment exceeds the risk involved. The treatment is provided at no cost to the patient and requires the patient to sign an informed consent form. Physicians and pharmaceutical companies are under no obligation to provide these treatments, the value of which has been estimated to total between hundreds of thousands of shekels to millions of shekels per patient.

Participation in clinical trials is another way for patients to gain access to treatments or medicines that have not yet been registered, when there is no other suitable alternative for their medical condition. Patients may participate in a clinical trial at no cost to them and subject to signing of an informed consent form.