Czech government's move to cut drug costs sparks protests
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《英国医生杂志》
Doctors?and patients?representatives say they fear that psychiatric care in the Czech Republic could be seriously hampered by a new health ministry directive seeking to restrict the range of available drugs.
Access to second generation antipsychotic drugs for patients with schizophrenia will be limited under measures promoting the use of cheaper generic drugs over brand name drugs for some types of treatment from January. The Czech doctors?union Lok supports the move, because of the need to save money, but groups representing psychiatrists are opposing it.
"Restricting the entire range of newly developed medication is not fair to patients. People and their diseases are very different, and it should be down to doctors, in consultation with patients, to judge which medicines are most suitable," said Professor Norman Sartorius, professor of psychiatry at the University of Geneva and a council member of the World Psychiatric Association.
"In many cases it takes a long time to find the most effective treatment, and taking that away poses a risk that a patient抯 condition could deteriorate. It will cost the state 10 times more than if the patient is receiving the best medication and leading a normal life."
Susan Kirkwood, spokeswoman for the European Federation of Associations of Families of People with Mental Illness, said many patients experienced serious side effects from some drugs.
"It is important that people have the drug that suits their particular condition. Restricting available treatments will damage the lives of people with mental illness and reduce their ability to lead fulfilled lives and to integrate into society, as well as adversely affecting the health of relatives coping with them. The longer term social and economic cost could be much higher than any planned short term saving," she said.
The federation, which receives funding from several drug companies, has written to the Czech health minister, Milada Emmerova, saying that millions of people could be affected. The federation says newer drugs have fewer side effects and can dramatically improve patients?quality of life.
Ms Emmerova has been criticised in the Czech press for agreeing a deal with the Czech generic drug producer Zentiva—where her son is a senior manager—whereby Zentiva would lower the price of some drugs and the ministry would increase reimbursements on Zentiva products while reducing those of competitors. The minister also disbanded the expert committee that decided which drugs were fully covered by public health insurance.
Professor Cyril H鰏chl, president of the Czech Psychopharmacological Society, also raised concern about limiting drug availability.
"Schizophrenia is a heterogeneous group of disorders, and therefore psychiatrists and patients need unrestricted access to almost all second generation antipsychotics to find individually the most suitable treatment," he wrote in a letter to international colleagues. "We are afraid that economic aspects are going to replace professional ones in the treatment decision making process."
But Dr Milan Kubek, chairman of the Czech doctors?union Lok, welcomed the bid to cut drug expenditure.
"We must cut the unnecessarily high expenditure on medicine, which accounts for 27% of healthcare costs, more than other countries. Patients will have the option of paying for more expensive alternatives, while doctors can ask health insurance companies to fund more expensive medicine in exceptional cases," he said.
Lubos Olejar, president of the Czech Association of Patients, said patients must become accustomed to using "Skodas" rather than "BMWs." "The quality is just as good; it抯 merely a different brand," he insisted.(Prague Katka Krosnar)
Access to second generation antipsychotic drugs for patients with schizophrenia will be limited under measures promoting the use of cheaper generic drugs over brand name drugs for some types of treatment from January. The Czech doctors?union Lok supports the move, because of the need to save money, but groups representing psychiatrists are opposing it.
"Restricting the entire range of newly developed medication is not fair to patients. People and their diseases are very different, and it should be down to doctors, in consultation with patients, to judge which medicines are most suitable," said Professor Norman Sartorius, professor of psychiatry at the University of Geneva and a council member of the World Psychiatric Association.
"In many cases it takes a long time to find the most effective treatment, and taking that away poses a risk that a patient抯 condition could deteriorate. It will cost the state 10 times more than if the patient is receiving the best medication and leading a normal life."
Susan Kirkwood, spokeswoman for the European Federation of Associations of Families of People with Mental Illness, said many patients experienced serious side effects from some drugs.
"It is important that people have the drug that suits their particular condition. Restricting available treatments will damage the lives of people with mental illness and reduce their ability to lead fulfilled lives and to integrate into society, as well as adversely affecting the health of relatives coping with them. The longer term social and economic cost could be much higher than any planned short term saving," she said.
The federation, which receives funding from several drug companies, has written to the Czech health minister, Milada Emmerova, saying that millions of people could be affected. The federation says newer drugs have fewer side effects and can dramatically improve patients?quality of life.
Ms Emmerova has been criticised in the Czech press for agreeing a deal with the Czech generic drug producer Zentiva—where her son is a senior manager—whereby Zentiva would lower the price of some drugs and the ministry would increase reimbursements on Zentiva products while reducing those of competitors. The minister also disbanded the expert committee that decided which drugs were fully covered by public health insurance.
Professor Cyril H鰏chl, president of the Czech Psychopharmacological Society, also raised concern about limiting drug availability.
"Schizophrenia is a heterogeneous group of disorders, and therefore psychiatrists and patients need unrestricted access to almost all second generation antipsychotics to find individually the most suitable treatment," he wrote in a letter to international colleagues. "We are afraid that economic aspects are going to replace professional ones in the treatment decision making process."
But Dr Milan Kubek, chairman of the Czech doctors?union Lok, welcomed the bid to cut drug expenditure.
"We must cut the unnecessarily high expenditure on medicine, which accounts for 27% of healthcare costs, more than other countries. Patients will have the option of paying for more expensive alternatives, while doctors can ask health insurance companies to fund more expensive medicine in exceptional cases," he said.
Lubos Olejar, president of the Czech Association of Patients, said patients must become accustomed to using "Skodas" rather than "BMWs." "The quality is just as good; it抯 merely a different brand," he insisted.(Prague Katka Krosnar)