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Dublin: 18 °C Thursday 2 October, 2014

Health insurance company under fire for not offering cancer drug

Senator Professor John Crown said that the decision by GloHealth means private patients are having to be put into public health care.

HEALTH INSURANCE COMPANY GloHealth has come under fire for not allowing customers to avail of a cancer drug.

Senator Professor John Crown told the Seanad today he has an “urgent request” for the issue to be brought to the attention of the Minister for Health, James Reilly.

Access

Crown spoke about one drug in particular, Ipilimumab, which is given to people battling cancer.

He said that there is “uneven access” to cancer treatments, which is apparent for patients who have private insurance, depending on which company they are with.

This has led to “spin off problems for the public health service” as patients who require a particular form of treatment, and “who have been paying a premium all their life to their insurance company in the expectation that legally approved treatment available in the public system” would be available to them are finding they are being denied such treatments, said Professor Crown.

He said that their doctors, after a failed process of appeal to the health insurance company, have to discharge the patient and bring them into the public system – “where their treatment is given at the taxpayer’s expense”.

GloHealth

Crown singled out health insurer GloHealth, saying it will not cover its patients with treatment for Ipilimumab, and neither will the the Garda Síochána’s insurers, the St Paul’s insurance scheme.

The drug has been approved for routine use and Professor Crown described it as “an extraordinarily exciting drug”, that gives huge benefits to a small number of patients, “patients who ordinarily would have a fatal income”.

He said that the drug was made available by Health Minister Reilly and that this was a “compassionate and humane decision”. He said he does not know what pressure the minister can bring to bear in terms of insurance approvals.

Said Senator Crown:

People have choices and anybody who is opting to take private health insurance, I believe should think long and hard before they sign up to GloHealth.

GloHealth confirmed to TheJournal.ie that its current policies do not cover the drug Ipilimumab, which it says is in a similar manner to other insurers.

This decision was taken on the basis of economic grounds and will be reviewed on an on-going basis. In 2011, the National Centre for Pharmaeconomics in Ireland stated that they could not recommend reimbursement of the drug at the submitted price.

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