Medical expert committee reviews cancer patients’ care under AB-PMJAY SEHAT

Recommends improvement in oncology package
Medical expert committee reviews cancer patients’ care under AB-PMJAY SEHAT
The suggestions to improve the oncology packages were recommended by the expert committee which was constituted by the State Health Agency (SHA) following certain issues being faced by the cancer patients.[Representational Image] [Screengrab]

Jammu: A medical expert committee has made recommendations for improvement in oncology packages being provided to the cancer patients under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT Scheme in J&K.

The suggestions to improve the oncology packages were recommended by the expert committee which was constituted by the State Health Agency (SHA) following certain issues being faced by the cancer patients.

An official said, “The patients undergoing chemotherapy in metastatic/advanced stage settings need chemotherapy for a long time and sometimes indefinitely. However, the Transactions Management System (TMS) has put a cap on the number of packages for a particular product which often leads to issues among the cancer patients.”

Citing an example, the official further said that for gallbladder cancer treatment, one of the packages is for gemcitabine / oxaliplatin chemotherapy.

“In this case, TMS allows only eight such packages every three weeks and when eight packages are consumed, even if the patient is benefitting and oncologist feels that the patient should continue on the same chemotherapy regimen. However, TMS will not allow this,” the official quoting said

Similarly, if a patient requires the same chemotherapy after one or two years, TMS will not allow it.” The TMS stops us from continuing chemotherapy in such patients even if they are benefitting. Once a particular package is exhausted, the patient will never be able to get benefit of that package in his life, the official added while sharing difficulties being faced by the cancer patients,” he said.

“This is a common problem being faced by the patient in case of relapse of the cancers. The TMS will never allow the oncology centre to use a package which has been consumed in the past. In such circumstances, the relapsed patients will not benefit from the PMJAY scheme, “ he added.

To overcome the difficulties, and provide better facilities to the cancer patients, the official said that the suggestions were made that the capping on packages be removed.

The official said on recommendation of the medical committee, the approval to repeat the same package for a limited number of times be granted if found justified.

The expert medical committee has suggested that the TMS packages most of the time do not include newer oncology drugs/immunotherapy for cancer/targeted oncology therapies. There are numerous newer chemotherapeutic regimens not included in TMS. Most of the recent targeted therapeutic drugs are not included in TMS. Immunotherapy of cancer treatment is not included in TMS.

The committee has suggested creation of a new package for newer targeted therapies, new package for immunotherapy for cancer treatment, and a new package for newer Chemotherapy regimens.

“Amount maximum up to Rs one lakh per cycle to be sanctioned, immunotherapy for cancer treatment amount up to Rs 1.5 lakhs to be sanctioned and newer chemotherapy regimen an amount up to Rs 35, 000 to be sanctioned by medical committee after examining all relevant document related to the case,” the official said quoting recommendations made by the medical expert committee.

The committee has recommended creation of packages for investigations of cancer patients like a basic oncology investigation package costing Rs 25, 000. This will include investigations like CT-Scan, ultrasound, doppler, Xrays, barium studies, biopsy, lab investigations etc.

For advanced oncology investigations, the committee has recommended that Rs 50, 000 will include investigations like PET Scan, nuclear scan, IHC, FSIH Testing, RT-PCR, image guided biopsy etc.

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