On July 1, the Health Insurance Fund expanded the availability of medicines, improving treatment options for a number of serious and rare diseases. The new subsidized medicines help prolong life, improve quality of life, and support people coping with serious illnesses.
According to Social Minister Karmen Joller, adding to the list is always positive news, especially when a drug for treating rare diseases is added to the list of subsidized drugs. "In general, drugs for rare diseases are very expensive, and until now, patients had to pay for these drugs themselves or rely on donations," said Karmen Joller. She cited the example of the active ingredient vosortide, which is used to treat achondroplasia and has been reimbursed by the Children's Foundation until now. "From now on, the drug will be available with a 100% discount to seven Estonian children who really need this treatment," she added.
Since July, the list of cancer drugs reimbursed by the Health Insurance Fund has also been significantly expanded. "We added the active ingredient abemaciclib to the list, which is used in the treatment of hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer. The drug is used in combination with hormone therapy and helps to slow the progression of the disease and improve quality of life," explained Getter Hark, Head of the Health Insurance Fund's Drug Reimbursement Service.
Another important cancer drug added to the list of medicines is the active substance alectinib, which is used to treat early-stage ALK-positive non-small cell lung cancer after complete removal of the tumor. The aim of the treatment is to reduce the risk of recurrence and improve patient survival. "We are also expanding treatment options for prostate and colorectal cancer. We are expanding the reimbursement of the active substance olaparib—in addition to its current use, it can now also be used in cases of metastatic castration-resistant prostate cancer. Encorafenib is now available for the treatment of colorectal cancer and is used in patients whose disease has progressed after previous treatment," added Hark.
One of the main innovations in the list of medicines is trientine (medicine Cuprior), which is the first medicine reimbursed through the list of subsidized medicines in Estonia for the treatment of Wilson's disease. "This is a rare, hereditary disease in which the body's copper metabolism is disrupted, causing copper to accumulate in the liver, brain, and other organs. When the disease manifests itself, the liver may enlarge, which in extreme cases can lead to acute liver failure. On the other hand, the disease can cause neurological disorders such as dysarthria, tremors, and gait disorders. Unfortunately, neurological symptoms are accompanied by psychiatric disorders such as sleep disorders and cognitive dysfunction," explained Hark. There are up to 12 known patients suffering from the disease in Estonia.
The list also includes the active ingredient cilostazol, which is intended for the treatment of one symptom of peripheral circulatory disorders – intermittent claudication. The drug dilates blood vessels and improves blood circulation in the body, thereby reducing pain when walking and the risk of blood clots. The active ingredient benralizumab, used to treat rare eosinophilic granulomatosis, will also be added to the list of subsidized drugs. An estimated six patients in Estonia require this treatment. Starting in July, the active ingredients benralizumab and mepolizumab, which are indicated for asthma, will also be available through the list of subsidized medicines in addition to hospital treatment. The medicines can now be purchased from retail pharmacies, with the aim of improving the availability of treatment close to home.
One important change is the addition of treatment options for patients with osteoporosis, or bone thinning. Until now, treatment subsidies were only available to those who had already suffered a bone fracture, but starting in July, the subsidy will also be extended to patients at high risk of bone fracture. The change is based on the latest treatment guidelines, according to which treatment should be started before a fracture occurs. Thanks to these changes, up to a thousand new patients will receive osteoporosis treatment each year, improving their quality of life and reducing the risk of fractures.