Changes in the treatment of patients with plaque psoriasis

The National Health Fund introduced unannounced changes in the treatment of people with the most severe forms of plaque psoriasis. Patients and doctors believe that this will not increase the number of patients who have access to the most effective biological drugs.

However, we are afraid that this may block the introduction of a therapeutic program, which is the only way to increase the number of the most severely treated biologically patients with psoriasis, told PAP national consultant in the field of dermatology, Prof. Andrzej Kaszuba, who has been fighting for the implementation of such a solution for several years. As he noted, his draft was sent to the Ministry of Health at the end of July 2010, and final amendments were made to it recently. Now it should go to the Health Technology Assessment Agency (AOTM).

In a letter sent to PAP on April 1, the spokesman of the Ministry of Health, Piotr Olechno, assured that the ministry was working on a therapeutic program for the most severely affected by plaque psoriasis. On Friday, the spokesman confirmed that the information was up-to-date.

The creation of the program was promised in October 2010 by the then Deputy Minister of Health, Marek Twardowski. Unfortunately, he did not manage to fulfill it, because he resigned at the end of the year.

This promise was repeated by Minister of Health Ewa Kopacz on February 10, 2011, when on the occasion of the World Day of the Sick, she met with representatives of patients with psoriasis. The minister showed great understanding for the situation of the most severely affected by this disease and awakened our hopes for improving the availability of therapy, said Wojciech Wilkowski, president of the Union of Psoriasis Patients’ Association.

Psoriasis – a chronic inflammatory disease – affects not only the skin but many other organs. In its most severe forms, skin lesions occur all over the body, and often affect joints, leading to disability. The disease causes physical and mental suffering.

Statistics show that in Poland access to biological medicines for patients with psoriasis is the worst in the European Union. In our country, about 1 million people suffer from various forms of psoriasis, but the number of patients who require immediate application of biological drugs is estimated at about 800 people.

Currently, the treatment of patients with the most severe forms of psoriasis is financed under the so-called Homogeneous Patient Groups (JGP) on the basis of the order of the President of the National Health Fund. Therefore, funds for expensive biological drugs come from the money contracted by a given hospital or dermatological department for all psoriasis patients.

The amendment to the ordinance of the President of the National Health Fund of April 6, 2011 will allow the settlement of biological drugs in such a way that doctors will be able to use all four recommended preparations, differing either in the mechanism of action or dosage. The existing solution allowed to use only one of them.

According to PAP, the spokesman for the National Health Fund, Andrzej Troszyński, by introducing new changes, the National Health Fund wanted to ensure financing of services related to the treatment of severe psoriasis on a more favorable basis than before.

Unfortunately, this will not increase the number of biologically treated patients, because our contracts, which are definitely too low, will not allow it. As a result, modern treatment of even a few severe psoriasis patients can lead to debt and ward closings. Not to mention the fact that the rapid depletion of funds will not allow less severe patients to be treated, and may also be the reason for discontinuing biological therapy – lamented prof. Kashuba. As he emphasized, no one from the National Health Fund or the Ministry of Health consulted with him on this change.

Work is currently underway on a therapeutic program for patients with psoriatic arthritis. They are more advanced. But if severe forms of plaque psoriasis were treated effectively from the outset, many cases of articular psoriasis and young people with disabilities could be prevented. Ultimately, it would bring the state clear savings – emphasized Kaszuba. (PAP)

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