Although there are modern and innovative treatments in Romania, oncological patients, namely those suffering from liver cancer, have no chance of benefiting from them. The National House of Health Insurance does not settle these therapies, and this for several reasons. Radu Gănescu, the president of the Coalition of Patients with Chronic Diseases, explained for the “Truth” where the money and what interests are hidden behind the refusal of the Romanian state to save lives.
Romanian patients do not benefit from revolutionary oncological therapies unless they pay for them
Although we live in the 21st century, in full technological development, when progress and innovation are galloping, and artificial intelligence is already part of our daily lives, the Romanian patient is still treated with universal panacea. And not because it would not have access to revolutionary therapies, but because the Romanian state does not settle them. It is about thousands and even tens of thousands of euros, money that a simple Romanian does not have, and the Romanian state does not offer. “Hepatic cancer remains one of the most serious oncological conditions, with a high mortality rate and limited therapeutic options”, Explains Dr. Liliana Gheorghe, gastroenterologist at the Fundeni Clinical Institute. However, the specialist continues, radio-boltal therapy with radioactive microspheres loaded with Yttriu-90 opens new perspectives for patients. “However, the problem of settling these treatments through the National Health Insurance House (CNAS) remains a sensitive one”, shows the doctor.
According to the doctor, early detection of liver cancer is essential for therapeutic success. The specialist emphasizes that the disease is commonly associated with viral infections (hepatitis B, C, delta), non-alcoholic steatohepatitis (NASH) and metabolic disorders such as diabetes, obesity and high blood pressure. Unfortunately the symptoms appear delayed, which complicates the diagnosis: “Therefore, regular screening for transaminases, bilirubin and viral status are vital for the early detection of the disease. Modern imaging methods, such as liver elastography and MRI with contrast substance, also contribute to the early detection of suspicious liver lesions, offering higher chances for effective treatments. ”
How much does a man’s life cost? 18,000 euros!
However, if we refer to innovative therapies, the therapy with radioactive microspheres is noted. This minimally invasive procedure involves injecting radioactive microspheres directly into the arteries that nourish the tumor, destroying the cancer cells and limiting the increase of the disease. “We have achieved formidable results with radio -bolization. The patient treated in November has recovered excellent. Three months after the intervention, the improvement was net superior ”said the doctor. This method not only extends life expectancy, but is essential in the “bridging” phase, giving patients the chance to remain eligible for liver transplant. In addition, compared to other treatments, radio-balance has lower side effects and a shorter recovery period, allowing patients to maintain a better quality.
But there is a big problem: we are dealing with a revolutionary, but very expensive treatment. Specifically, the amount on which a patient should pay to benefit from this therapy is 18,000 euros. Therefore, the access of Romanian patients to treatment is limited, in the absence of CNAS. “It would not be a formidable financial effort for the state, but there is always a reluctance from the administration. There is false fear that if this door opens, there will be too many requests. ” emphasizes the doctor Liliana Gheorghe. But things are not so, because the number of patients who would need this therapy is relatively small. “We are talking about a maximum of 300 patients in a year and about a financial impact managing by the state”, the doctor continues.
Dr. Liliana Gheorghe believes that in order to improve the access to radio -bolization, an approach is required by the medical community, patients and institutions. It is necessary to update the national oncology program to include this innovative procedure, thus ensuring a real chance to Romanian patients fighting liver cancer.
Radu Gănescu, President of the Coalition of Patients with Chronic Diseases
“CNAS has no money to set up common drugs, what about modern therapies!”
Radu Gănescu, the president of the Coalition of Patients with Chronic Diseases, explained for “Truth” that this therapy is known and appreciated for its beneficial effects: “I have heard about the existence of this treatment that is already given at European level, settled. ”
Indeed, from the information we have obtained, Romania is the only European country that does not settle radio-boltal therapy with radioactive microspheres. “Last year, the people from Fundeni did several interventions, and the first of them was financed by the company that brought the treatment in Romania. The other patients paid their own treatment, each as he could ”, said Radu Gănescu.
CAS received for 2025 a larger budget than the one allocated last year, but some of this money will go on extinguishing some debts: “Cas entered in 2025 with a debt of almost 2.5 billion lei, a debt to be paid. Decreased from the budget allocated this debt, the house has no money left even for the settlement of some drugs already on the list of settled drugs. Most likely in the autumn it will be a new budgetary reallocation ”.
However, until we think about money, there are other steps to take to bring to the Romanian market for modern therapies: “The policy of the drug must change. And it will certainly change, because not only in Romania, but also in other European countries, evolution is very fast in the field of medicine. We will have to keep up. “ But the process is extremely complicated, because the power to change something for the better is in the hands of several institutions in the system: “We are not only talking about CAS but also about the National Medicines Agency, about local authorities, hospitals, doctors, etc. ”.
How to evaluate a medicine to be put on the market or not
The evaluation of a particular drug, to determine whether or not it will be placed on the market, implies, first of all, a cost assessment. “We all want the lowest costs, but the very good products are very expensive. Then we have to decide if these high costs are renting. For example, before, with a relatively cheap medicine you treat patients from a whole community. Now things have evolved, therapies are targeted by types of diseases, they are specific. You no longer have a wide margin of population you treat, you have a lower margin but the costs are higher. And sometimes it is not worth it. I mean, I pay 40,000 euros and I have 500 healthy people, or do I pay 1,000,000 euros and I have 3 healthy people? ”, Sput the representative of patients.
Why is not the market in Romania attractive for foreign drug producers
The Romanian state has never been very good at this chapter, to bring innovative drugs in Romania: “It was only in recent years that we started, slowly, slowly, to recover from the lost land. Ever since a medicine appeared on the western market and until it reached Romania, up to 1,000 days. Now, waiting times have been shortened: only 700 days. “ The reasons? Price policy and bureaucracy specific to our country. Radu Gănescu explains that the Romanian legislation, designed how 10-15 years requires a very low price. The smallest. “When they come with a medicine in Romania, our legislation practically puts them on the run. What do we do, exactly? An assessment of prices practiced in other countries and setting a lower price. However, when I impose this price, the manufacturer loses. This is why he does not come to me anymore, he goes to countries where he earns money ”, shows Radu Gǎnescu.
The second reason why many of the innovative treatments in the West are missing in Romania is the bureaucratic harassment in which the health system is sunk:“The process of putting a new drug on the market itself is very time to eat us. Any therapy that enters the national program and later becomes reimbursed by the National Health House, goes through a rather complicated bureaucratic process. An evaluation is made, a score is calculated according to costs but also according to the number of countries that reimburse the treatment. For example, in order to obtain a maximum score, among others, the product must exist on the market of at least half of the European countries. ”
In Germany, for example, things are not. The product, evaluated by EMA, enters the European market, arrives in Germany, here is put on the market in three days, and its evaluation is done at the same time with its administration. However, Radu Gănescu stated that this year things will be simplified in the country: “Starting in 2025 the European law has changed, and now the countries will no longer evaluate the drug products, therapies and treatments separately. There will be a single evaluation, at European level. And then, someone will want that medicine, will order it directly. The first products considered will be even oncological ones ”.
Regarding the radio -boltal therapy with radioactive microspheres, which would prolong the life of liver patients, reporters “Adevărul” tried to get a reaction from CNAS representatives. We will publish the answer after we receive it.
