Basket of guaranteed services: robotic surgery in two more cancers

To date, endometrial and colorectal cancer treatment services using the robotic system.have not been available to patients under publicly funded healthcare services.

The introduction of provisions on the new guaranteed benefit in the Ordinance of the Minister of Health of November 22, 2013 on guaranteed benefits in the scope of hospital treatment (Journal of Laws of 2023, item 870 and 978) was based on the process of qualifying health care services as guaranteed benefits and implements the proposed solutions contained in the recommendation of the President of the Agency for Health Technology Assessment and Tarification.

The proposed regulation aims to improve treatment outcomes and quality of life for patients with malignant endometrial cancer and malignant colorectal cancer by providing patients with access to surgical management using a robotic system for the treatment of these cancers. Assuming that the benefits: surgical treatment of endometrial cancer with a robotic system and surgical treatment of colorectal cancer with a robotic system would be performed mainly in centers that currently have a robotic system and/or report procedures under L31R Radical Prostatectomy with a Robotic System*, it is estimated that performance of the benefit would be feasible (depending on the volume criterion required of centers) in:

- 11-19 centers within the C18-C20 diagnoses,

- 2-6 centers within the C53-C55 diagnoses.

The introduction of the above-mentioned services to the list of guaranteed services is the implementation of the demands contained in the opinion of the President of the Agency for Health Technology Assessment and Tarification dated May 23, 2017, which indicated the legitimacy of financing the above-mentioned treatments with public funds. Following the recommendations of the President of the Agency No. 254/2014 and 256/2014 of December 15, 2014, a review of the scientific evidence was carried out again by order of the Minister of Health. An analysis of scientific reports published after the date of the recommendations indicated that performing procedures using the robotic system compared to conventional surgery leads to statistically significant differences for some of the primary endpoints. In addition, statistically significant differences in favor of robotic system surgery were noted with regard to parameters related to the duration of surgery, the length of the patient's hospital stay and the occurrence of intraoperative adverse events.

Paragraph 2 of the draft regulation establishes a transition period for providers who intend to provide the guaranteed benefit "Surgical treatment with robotic system for malignant prostate cancer" that do not meet the requirements set forth in lp. 58 of Annex No. 4 to the regulation amended in Paragraph 1, in part:

1) "Personnel" in column 4 in point 1 regarding the minimum quality criteria for medical personnel;

2) "Organization of the provision of services" in column 4 in point 1 regarding the minimum experience of the center.

In the previous state of the law, healthcare providers had a deadline of January 1, 2023 to comply, but it is reasonable to extend this deadline due to the need to adapt to existing factual conditions. Providers are in the period of adjustment to these conditions, while the deadline of January 1, 2023 proved to be too short, so the deadline for compliance was extended to December 31, 2023.

Source: RCL