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The regulations that prevented the treatment of 54-year-old Janina Orczyk, who died of kidney cancer, are still in force. Oncologists call for clear and fair criteria for authorizing non-standard chemotherapy.
Janina Orczyk, who died of kidney cancer, sued the Ministry of Health and the National Health Fund before her death. She demanded 150 for refusing treatment. PLN compensation and redress and 18 thousand. PLN for the purchase of drugs, the reimbursement of which was refused by the National Health Fund. The trial in this case started on August 8 last year, the woman died on February 15 this year.
Ineffective interferon treatment
The patient was first treated with the cheaper drug interferon. With no effect. Doctors wanted to use another expensive preparation, the financing of which must be approved by the National Health Fund. Unfortunately, Janina Orczyk could not obtain such consent for six months.
– The National Health Fund terrorizes doctors by creating absurd categories of including patients in the drug program. Patients avoid these regulations and only a doctor in difficult situations can make the right decision. How can the medical director of the National Health Fund question the opinion of a provincial consultant who is a professor, which means that he subjected his knowledge to multiple verification – wonders prof. Wiktor Jędrzejczak national consultant in the field of hematology.
Oncologists emphasize that their hands are tied by the regulations of the National Health Fund. – There are no regulations that in such exceptional situations – such as the case of Janina Orczyk – would allow the consent of the National Health Fund to be omitted, and would allow a quick decision to be made by a provincial consultant or by a specially appointed therapeutic committee. Currently, the consultant only issues an opinion that is in no way binding for the National Health Fund – believes prof. Krzysztof Krzemieniecki Małopolska consultant in the field of oncology.
Custom chemotherapy
Janina Orczyk obtained the consent of the National Health Fund for the use of an expensive drug only after the media became interested in her trial. – Chemotherapy is an expression of cronyism, because the drug is available to the most resourceful, who can launch the media and publicize their problem – says prof. Jacek Jassem, consultant in the province Pomeranian Voivodeship in the field of oncological radiotherapy. In addition, access to therapy depends on where you live. – Although the Constitution of the Republic of Poland guarantees equal access to non-standard chemotherapy, the differences between the provinces are huge. In some voivodeships, the NHF branch gives everyone consents for treatment, in others not at all – says Krzysztof Łanda, an expert on the medical market.
– Clear eligibility criteria for the non-standard chemotherapy program are needed to ensure equal access to it in all voivodeships – emphasizes Wojciech Matusewicz, president of the Agency for Health Technology Assessment.
Palliative care in neoplastic diseases
The Ministry of Health explains that drugs for kidney cancer are very expensive and that is why regulations regarding their use must be in force, if only to have enough money for patients who cannot be treated with other preparations. Besides, these drugs will not cure the sick person, they only extend their life. And the average survival time of patients, calculated from the date of initiation of therapy with these preparations, is approximately 250 days. – Many patients see non-standard chemotherapy as their last resort, although these are most often palliative therapies – says Prof. Jassem. Janina Orczyk fought to extend her life and believed that she had the full right to do so. – Either let’s be honest that we can’t afford it and we have to pay for chemotherapy from additional insurance, or let’s change the system so that there are clear qualification criteria – says prof. Jacek Jassem.
High cost of chemotherapy
The health ministry treats cancer as a priority – emphasizes Minister of Health Ewa Kopacz and adds that spending on very expensive chemotherapy used only after obtaining an individual consent of the National Health Fund increased sevenfold compared to 2005 and amounted to PLN 1. zloty.
Janina Orczyk testified in court that when the National Health Fund refused to finance her such treatment, she was offered to participate in clinical trials in which she could receive an expensive drug. She refused, however, because she heard on TV that the health ministry was assuring that kidney cancer patients should be treated on the slogan “rescue”, which means they will get the drug immediately and there will be no problems with financing. The reality turned out to be different.
Recipes that make cancer treatment difficult
Kidney cancer is a rare cancer. It accounts for 2 to 4% of all malignant neoplasms. It ranks 10th in the list of the most common malignant neoplasms in women and 9th in men. Janina Orczyk died eighteen months after the diagnosis of the disease. During this time, she fought for the right to treatment. During the trial, she emphasized that she felt incredible regret and humiliation. Unfortunately, the rules that made it difficult for her to access treatment have not been changed. During the meeting on the Day of the Sick, Minister of Health Ewa Kopacz appealed to patients to demand that pharmaceutical companies reduce the prices of drugs. – Support us in our policy and be messengers from the minister to the pharmaceutical company, appealing to lower the price of this drug. And then, using this option, we will enter it on the list of reimbursed drugs – she said.
Text: Halina Pilonis