An intermediary hiring some insurers called Aurel Health-Bienzobas is pressing oncologists who work for these private companies so that they do not prescribe to patients cancer treatments with a high price that are commonly used in public health, according to ABC has revealed this Mondaythat has had access to dozens of reports that exchange the doctors with “oncological advisors” of this company dedicated to administer part of the management tasks of this medical area.
When this company is hired, oncologists who work for insurance companies must ask these advisors “to authorize the treatment they consider most suitable for the patient.” The problems appear, according to ABC, with treatments such as monoclonal antibodies (avastin or panitumumab) that are administered intravenously and that are common in the national health system.
The arguments to reject authorization can be several: that “it is not effective cost”, that European guides consider other cheaper therapies or that are not in clinical card, that is, approved by the Spanish Agency for Medicines and Health Products (AEMPS) more efficient, always according to what is published by this means.
The Spanish Society of Medical Oncology (SEOM) is “concerned” about published information and considers it a “problem of maximum relevance for patients who are affected by decisions.” Its president, César A. Rodríguez, has assured in a statement that there is a working group in progress since 2021 whose priority task was to analyze this “problem” although there are still no “conclusions.”
Health is pronounced
For the Ministry of Health, which has ruled on this information, “this is the nth example of how the interference of a private entity with profit in the field of health care ends up harming specific patients.” “We have said it by active and passive: eliminating profit in the provision of health care is the fundamental element to eliminate the existence of less legitimate interests,” said the Secretary of State of Health, Javier Padilla, to questions from Eldiario.es.
Minister Mónica García has also spoken through X. “That companies press oncologists in private so as not to prescribe certain treatments is not health, it is business,” he said adding that the Ministry “defends public health”, in which “doctors decide according to scientific evidence and not according to economic benefits.”
The reports that ABC has accessed show cases of DKV, Sanitas, Adeslas and Cigna, although there are more insurers who have hired their services. They all deny knowing the pressures that oncologists report. Auntl Health-Bienzobas defends that it is doctors who have the last word about treatments.
Among the patients of these companies there are also public officials who choose private health through MUFACE, who has just renewed their contract with public administration Con a substantial up of the premiums. Until now they provided this DKV, Asisa and Adeslas service, although the first one has been off the next three years.
Health insurance does not always cover all treatments. eldiario.es has collected cases of companies that denied the latest generation therapies against cancer with a high price to their patients, which finally ended up being treated by public health. A report from the Ministry of Health warned a few months ago from this practice consisting of deriving economically non -profitable patients to the public system. He referred to public officials who had chosen MuFace and were attended by private health.
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