Limited treatment: What do patients say about drug programs?

Reading the report "Availability of drug programs as assessed by patients," prepared by the We Patients Foundation, provides unique insights into what stakeholders themselves think about the functioning of drug programs.

The first threshold for accessibility is information itself. The report, based on interviews with representatives of more than a dozen patient organizations, leaves no doubt on the matter: "patients are often unaware of available drug programs and the eligibility process is sometimes opaque and fraught with bureaucracy"; "many are not even informed that there is such a thing as a drug program or that they could be included in it at another center."

Another obstacle is regional exclusions (or impediments). It is an open secret that in - depending on the program - there are better chances for treatment in some provinces, and in others, less. There are also differences between centers, even within a single province. Patients: "In one facility the program works well, in another it's impossible to get the drug. The differences are huge."

Natural, inherent in the nature of drug programs (created as a tool for controlling and limiting access to some therapies) are the eligibility criteria, which was strongly emphasized by experts during the discussion of the presented report, which took place on Wednesday, November 19, in Warsaw. Patients are well aware of this: "the eligibility criteria are structured in such a way that many patients drop out in advance," "with female cancers the patient has to be practically at the end of the road to qualify."

There is no doubt that at the moment the main problems with accessibility are the result of the financial situation of the National Health Service - and patients are aware of the consequences. And they are increasingly afraid of them. "The management doesn't receive money for medicines," "the facility has debts and can no longer afford to credit the NHF," "oncology patients are very worried that there will be problems."

The concerns of patients - not just neurological patients - are not unfounded. Prof. Alina Kulakowska, national consultant in neurology, said during the expert debate that this year contracts for drug programs in the area of neurology have been reduced by 16 percent nationwide, but these reductions vary from province to province. As she stressed, she is convinced that the centers implementing the programs will not "kick out" patients from them, but they will have to decide whether and how many new patients to accept, putting their center at risk of losing financial liquidity. In turn, Dr. Jakub Gierczynski, a health care expert, stressed that without ensuring stable financing - this year's realized subsidy from the state budget is about PLN 32 billion, it should be a good PLN 9 billion higher - it is impossible to implement expensive, though necessary because effective, therapies in a stable manner.