There are currently four drug programs for cardiology patients, but access to them is severely limited due to administrative barriers, systemic shortcomings and uneven distribution of facilities offering such treatment, according to the report "Drug programs in cardiology: actual access vs. patient needs," prepared by the National Association of Patients with Heart and Vascular Diseases "EcoSerce."

The authors, a group of prominent cardiology experts and representatives of patient organizations, not only presented the current situation, but also proposed solutions to the problems blocking accessibility.

- "I hope that this document will be a contribution to a new opening, a discussion, including with policymakers, about what to do so that Polish patients or potential cardiac patients can benefit to a greater extent from the innovative therapies available in drug programs," Agnieszka Volchenko, president of the EcoHeart Association, said at Thursday's press conference.

Patients with cardiac conditions can currently be treated in four drug programs:

B.31 - pulmonary arterial hypertension

B.74 - chronic thromboembolic pulmonary hypertension

B.101 - lipid disorders

B.162 - cardiomyopathy.

The lipid disorders program received the most attention - on the one hand because of its potential reach, and on the other because of the disproportionately small number of program beneficiaries. The report says that 1142 patients were treated in the first quarter of 2024, while, as experts stressed during the discussion, the program was prepared with at least several times as many patients in mind. The scale of the problem is shown by the data from the provinces for 2024: it is true that it can be said that the number of patients covered by the program doubled, but this is mainly due to one province, because in Silesia as many as 362 patients were included. In Mazovia - a province with a similar population - only 76. Silesia, by the way, has been the only province since 2022 where a triple-digit number of patients were included every year (although in 2022 it was "only" 101 patients). This year, 102 patients were included in Lodz province - but for "balance" in one of the largest regions - Małopolska - only 52.

Cardiologists and patients have high expectations for the imminent prospect of including a lipidogram in a six-year-old's balance sheet. This is expected to allow relatively early - even before the occurrence of acute incidents (stroke, myocardial infarction) - to catch cases of genetically determined hypercholesterolemia.

Other problems are related to drug program B.162, concerning transthyretin amyloidosis cardiomyopathy and hypertrophic constrictive cardiomyopathy. In November last year (at the time data for the report was collected) it was being implemented in seven provinces, while some provincial branches of the National Health Fund openly declared that due to the very difficult financial situation the program had been postponed until January 2025. As of November 2024, no patient had a chance to benefit from drugs under this program.

The drug program for pulmonary arterial hypertension (B. 31) benefits 1,527 patients, and the B.74 program (treatment of chronic thromboembolic pulmonary hypertension) has 496 patients. Compared to epidemiological data, the statistics here are good, but physical accessibility is hampered because in some regions the programs are not implemented and patients have to seek treatment outside their province.

According to Prof. Mark Gierlotka, president-elect of the Polish Society of Cardiology, three of these programs (for pulmonary hypertension and cardiomyopathy) should be run by specialized centers. Treatment of hypercholesterolemia, and certainly that occurring in high-risk cardiovascular patients after myocardial infarction, could be done at the level of outpatient clinics, with pharmacy reimbursement. - The only reason it is in the drug program is historical, because the program began with familial hypercholesterolemia, which is a genetic disease and somehow fit into drug programs. The treatment of hypercholesterolemia does not require a drug program," Prof. Gierlotka said, adding that there is time to talk to policymakers about a fundamental change in this area.