Israel had added 77 new drugs and technologies to its "basket" of subsidised treatments for 2012, including one drug which is used by just six people in the country.

Novartis’ Afinitor (everolimus), which will now be provided free or at very low cost for the treatment of subependymal giant cell astrocytoma (SEGA) brain tumours, previously cost its six Israeli patients NIS141,000 each per year. It is one of a number of expensive treatments for small patient populations which have been added to the basket for 2012.

Altogether, the 77 newly-covered medications are currently being used by around 70,000 Israelis, and their supply - either for free or at NIS10 per treatment - is set to cost the government around NIS300 million this year. Among the most expensive of the newly-subsidised drugs are two melanoma treatments - Bristol-Myers Squibb's Yervoy (ipilimumab) and Roche/Daiichi Sankyo's Zelboraf (vemurafenib) - which together will cost NIS47 million this year to treat a total of 162 Israeli patients, plus three hepatitis treatments - Johnson & Johnson/Vertex Pharmaceuticals/Mitsubishi Tanabe Pharma Corp's Incivo (telaprevir), Merck & Co's Victrelis (boceprevir) and Gilead Sciences' Viread (tenofovir), which together are expected to cost the government just under NIS44 million annually.

Other drugs which are subsidized for the first time include Eli Lilly/Amylin's Byetta (exenatide) and Novo Nordisk's Victoza (liraglutade), both for the treatment of diabetes type 2, PARI Medical's MucoClear (sodium chloride) for cystic fibrosis, Bayer's anticoagulant Xarelto (rivaroxaban) and Novartis' Gilenya (fingolimod) for multiple sclerosis.  

Altogether, the government will spend NIS6.7 billion on subsidised drugs this year, reports the Israel National News Service, while the newspaper Haaretz says that the government committee on subsidised healthcare made its decision on the new inclusions after 600 requests for new medicines, at a cost of over NIS2 billion, were made.

However, the reimbursement of some drugs already in the basket changes this year; for example, Roche's cancer blockbuster Avastin (bevacizumab) will now be reimbursed only when used as a first-line treatment for non-small-cell lung cancer (NSCLC), and Lundbeck's flagship antidepressant Cipralex (escitalopram) has been dropped from the list.

Commenting on the 2012 additions to the basket, analysts at IHS Global Insight note that the inclusion of orphan drugs and treatments affecting small population groups for reimbursement "is a positive for affected patients who would otherwise have to incur significantly higher costs, and is an indication of Israel's openness to personalised drugs."

They also point out that the number of new additions for 2012 is similar to that seen last year but a considerable drop from the 201 new drugs and technologies which were added in 2010, and also that the NIS300 million provided for supply of the new treatments this year is the lowest allocation in the last six years.