Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T15:44:48.608Z Has data issue: false hasContentIssue false
  • English
  • Français

The process of updating the National List of Health Services in Israel: Is it legitimate? Is it fair?

Published online by Cambridge University Press:  21 July 2009

Dan Greenberg ,
Miriam I. Siebzehner  and
Joseph S. Pliskin
Dan Greenberg
Affiliation:
Ben-Gurion University of the Negev
Miriam I. Siebzehner
Affiliation:
The Gertner Institute for Epidemiology and Health Policy Research
Joseph S. Pliskin
Affiliation:
Ben-Gurion University of the Negev
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The Israeli National Health Insurance Law stipulates a National List of Health Services (NLHS) to which all residents are entitled from their HMOs. This list has been updated annually for almost a decade using a structured review and decision-making process. Although this process has been described in detail in previous papers, none of these have fully addressed legitimacy and fairness. We examine the legitimacy and fairness of the process of updating the NLHS in Israel.

Methods: We assessed the priority-setting process for compliance with the four conditions of accountability for reasonableness outlined by Daniels and Sabin (relevance, publicity, appeals, and enforcement). These conditions emphasize transparency and stakeholder engagement in democratic deliberation.

Results: Our analysis suggests that the Israeli process for updating the NLHS does not fulfill the appeals and enforcement conditions, and only partially follows the publicity and relevance conditions, outlined in the accountability for reasonableness framework. The main obstacles for achieving these goals may relate to the large number of technologies assessed each year within a short time frame, the lack of personnel engaged in health technology assessment, and the desire for early adoption of new technologies.

Conclusions: The process of updating the NLHS in Israel is unique and not without merit. Changes in the priority-setting process should be made to increase its acceptability among the different stakeholders.

Keywords

Resource allocationAccountability for reasonablenessTechnology assessmentDecision makingFairness
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 255 - 261
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Cairns, J. Providing guidance to the NHS: The Scottish Medicines Consortium and the National Institute for Clinical Excellence compared. Health Policy. 2006;76:134–143.Google Scholar
2. Daniels, N, Sabin, J. The ethics of accountability in managed care reform. Health Aff (Millwood). 1998;17:50–64.Google Scholar
3. Daniels, N, Sabin, J. Setting limits fairly: Can we learn to share medical resources. New York: Oxford University Press; 2002.Google Scholar
4. Daniels, N, Sabin, JE. Setting limits fairly: Learning to share resources for health. New York: Oxford University Press; 2008.Google Scholar
5. Gibson, JL, Martin, DK, Singer, PA. Priority setting for new technologies in medicine: A transdisciplinary study. BMC Health Serv Res. 2002;2:14.Google Scholar
6. Golan, O. Ethical criteria for prioritization of medical services. J Health Law Bioeth. 2008;1:22–64.Google Scholar
7. Guttman, N, Shalev, C, Kaplan, G, et al. What should be given a priority - costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel. Health Expect. 2008;11:177–188.Google Scholar
8. Hammerman, A, Greenberg, D. Estimating the budget impact of new technologies added to the National List of Health Services in Israel: Stakeholders' incentives for adopting a financial risk-sharing mechanism. Health Policy. 2009;89:78–83.Google Scholar
9. Israeli State Controller and Ombudsman. Annual report for the year of 2003 and financial year of 2002 (Report 54b). Jerusalem: State of Israel; 2004.Google Scholar
10. Jansson, S. Implementing accountability for reasonableness-the case of pharmaceutical reimbursement in Sweden. Health Econ Policy Law. 2007;2:153–171.CrossRefGoogle ScholarPubMed
11. Kapiriri, L, Norheim, OF, Martin, DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy. 2007;82:78–94.Google Scholar
12. Luxenburg, O. Technology assessment and setting priorities for the adoption on a national level: The Israeli experience. http://www.fresh-thinking.org/docs/workshop_070208/commentary_luxenburg_070208.pdf (accessed April 9, 2009).Google Scholar
13. Menon, D, Stafinski, T, Martin, D. Priority-setting for healthcare: Who, how, and is it fair? Health Policy. 2007;84:220–233.Google Scholar
14. Mitton, CR, McMahon, M, Morgan, S, Gibson, J. Centralized drug review processes: Are they fair? Soc Sci Med. 2006;63:200–211.CrossRefGoogle ScholarPubMed
15. Morgan, SG, MacMahon, M, Mitton, C, et al. Centralized drug review processes in Australia, Canada, New Zealand, and the United Kingdom. Health Aff (Millwood). 2006;25:337–347.Google Scholar
16. Neumann, PJ, Kamae, MS, Palmer, JA. Medicare's national coverage decisions for technologies, 1999–2007. Health Aff (Millwood). 2008;27:1–12.Google Scholar
17. PBAC. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/pbac-outcomes-by-meeting (accessed November 15, 2008).Google Scholar
18. Peacock, S, Ruta, D, Mitton, C, Donaldson, C, Bate, A, Murtagh, M. Using economics to set pragmatic and ethical priorities. BMJ. 2006;332:482–485.CrossRefGoogle ScholarPubMed
19. Rabinovich, M, Wood, F, Shemer, J. Impact of new medical technologies on health expenditures in Israel 2000–2007. Int J Technol Assess Health Care. 2007;23:443–448.Google Scholar
20. Rocchi, A, Menon, D, Verma, S, Miller, E. The role of economic evidence in Canadian oncology reimbursement decision-making: The lambda and beyond. Value Health. 2008;11:771–783.Google Scholar
21. Rosen, B. In: Thompson, S, Mossialos, E, eds. Health care systems in transition: Israel. Copenhagen: European Observatory on Health Care Systems; 2003.Google Scholar
22. Schlander, M. NICE accountability for reasonableness: A qualitative study of its appraisal of treatments for attention-deficit/hyperactivity disorder (ADHD). Curr Med Res Opin. 2007;23:207–222.CrossRefGoogle ScholarPubMed
23. Schreyögg, J, Stargardt, T, Velasco-Garrido, M, Busse, R. Defining the “Health Benefit Basket” in nine European countries. Evidence from the European Union Health BASKET Project. Eur J Health Econ. 2005;(Suppl):2–10.CrossRefGoogle Scholar
24. Shalev, C, Chinitz, D. Joe public v. the general public: The role of the courts in Israeli health care policy. J Law Med Ethics. 2005;33:650–659.CrossRefGoogle ScholarPubMed
25. Shani, S, Siebzehner, MI, Luxenburg, O, Shemer, J. Setting priorities for the adoption of health technologies on a national level – the Israeli experience. Health Policy 2000;54:169–185.Google Scholar
26. Shemer, J, Morginstin, T, Hammerman, A, Luxenburg, O, Shani, S. [Promoting medical technologies in the national list of health services: 1995–2000]. Harefuah. 2003;142:82–86.Google Scholar
27. Shmueli, A. Survival vs. quality of life: A study of the Israeli public priorities in medical care. Soc Sci Med. 1999;49:297–302.Google Scholar
28. Siebzehner, MI. Priority setting in medical technology-evaluation of the Israeli model. PhD thesis. Beer-Sheva: Ben-Gurion University of the Negev; 2004.Google Scholar
29. Steinbrook, R. Saying no isn't NICE- the travails of Britain's National Institute for Health and Clinical Excellence. N Engl J Med. 2008;359:1977–1981.Google Scholar
30. Tamir, O, Rabinovich, M, Shani, M. Year 2006 update of the Israel National List of Health Services. Isr Med Assoc J. 2006; 8:595–600.Google Scholar
31. Victoria Israeli and others vs. PNAC and others High Court of Justice Judgment of 11 June 2006: 2974/06. Available from: http://www.courts.co.il/Google Scholar