What: The “health basket” committee published a list of technologies added to the 2023 National Health Insurance (NHI) basket of services (Ministry of Health, 2023a). New additions include drugs, procedures, medical equipment and medical devices. The government has allocated a record amount of additional budget to cover the new services.
Why: Israel has a positive basket of benefits that lists all services and technologies covered by the NHI. New treatments are reviewed and added to the “health basket” every year. Once a budget has been set for the new treatments, a public committee reviews potential new treatments and technologies. Committee decisions are limited to the budget allocated and new treatments are added to the “health basket” once approved by the Minister of Health (Ministry of Health, 2023b).
How: The total budget for additional services and technologies is the highest ever – 650 million NIS. The 2023 expansion to the health basket includes over 120 new treatments that will benefit approximately 350 000 people.
Since 2014, equal representation of women amongst the members of the committee is a requirement. This year was the first time that the head of the committee was a woman. The improved gender balance has influenced the type of treatments recommended; More treatments that are connected to women’s health and reproductive health have been included in the basket in recent years.
Examples of the new medicines and technologies, available through the NHI as of 2023:
- Cancer treatments: around half of the added budget is dedicated to cancer treatment, for example comprehensive genomic profiling of tumours for therapy guidance, personalized drugs, immunotherapy for breast, kidney, skin cancer and more.
- Prevention and public health: eyeglasses for children up to 7 years old; vaccination Shingrix (against shingles) and Prevenar (against lung infections) for people over 65 years old.
- Chronic diseases: “Tezspire” treatment for asthma; expanded eligibility for children with juvenile diabetes for a continuous hybrid system for sugar monitoring and insulin infusion; speech and language therapy for people with stuttering.
- Reproductive health: Dilators for women suffering from genito-pelvic pain; expanding age eligibility for screening tests during pregnancy and for abortions; expanding eligibility for IVF for men conceiving a child via surrogacy.
The committee discussions on the expansion of the “health basket” last for months, as the expert members need to consider many proposed treatments. The most expensive medicine approved this year is “Darzalex” (85 000 NIS for 1700 patients). This drug can increase the life expectancy of myeloma patients from 3 to 10–15 years. One of the treatments that was not included in the new NHI list this year is the meningococcal B vaccine for babies. There are around 20 cases a year of this type of meningococcal infection that lead to neurological damage or even death in this age group, which could be prevented by this vaccine.