Israeli NHI Ombudswoman's complaints report

In her latest biannual report (2004-2005), Ombudswoman Kami Jabotinsky-Rubin of the Israeli National Health Insurance details how the sick funds manage to avoid providing patients with therapies, surgery and drugs even though they are included in the NHI basket of reimbursable health services and are in accordance with any relevant Ministry of Health guidelines.

The report, presented to the Chairwoman of the Knesset and to the MoH, relates to 13,000 complaints made by sick fund members over 2004/5. The largest source of these relate to non-receipt of medical services that the funds are required by law to supply to their members. The report shows that during both 2004 and 2005 there were substantial increases in complaints by the public regarding drugs. This is most likely due to the almost total freeze in updating the basket during the years 2003 and 2004, and the delay in implementing the substantial update that eventually took place in 2005.

The drugs for which there were the most complaints in descending order were: Plavix (clopidogrel; easily number one) - to extend its indication to include reimbursement for more than one month after stent, and in combination with aspirin where aspirin alone failed; Avastin (bevacizumab), Herceptin (trastuzumab), Erbitux (cetuximab), Arimidex (anastrozole), Lipitor (atorvastatin), Remicade (infliximab), Risperdal (risperidone), Mabthera (rituximab), Ocsaar/Plus (losartan and hydrochlorothiazide), Omr-IgG-am (immunoglobulin G antibodies) and Temodal (temozolomide)