The crisis is intensifying, as is the outbreak of the disease, as neither time is the ally of cancer patients, nor is money within the reach of many of them. The drug crisis oscillates between “temporary solutions” and the greed of drug importers and agents who control the necks of patients in Lebanon. Subsidized and unsubsidized drugs are very expensive, cancer treatments of all types are very expensive or unavailable, and cancer grows more in the body of breast cancer patients.
Instead of writing about research findings and experiences in developing modern and advanced breast cancer treatments, we write about the cries of hundreds of cancer patients asking for their medications and their right to their treatment, which they now demand. the sale of what is “above and below them” to receive, or simply abandon the treatment sessions indefinitely.
The journey of agony begins from the first moment the patient decides to undergo a mammogram to detect cancer early or prevent the risk of infection. Two years ago, due to the Corona pandemic and then the economic crisis, the Ministry of Health stopped launching awareness campaigns to reduce the cost of mammograms and encourage women to detect breast cancer early.
The head of the “Barbara Nassar Association for Cancer Patients Support”, Hani Nassar, confirms that the cost of a mammogram varies from 60 to 120 dollars, depending on the center or hospital, after its cost has not exceeded 40,000 pounds. Lebanese. Today there is talk of a figure that fluctuates between 2 million and 4 million Syrian pounds, which may not be able to bear a good part of women, which leads more to the spread and growth of cancer due to the impossibility of detect is early.
From the image to the confirmation of the infection, a woman with breast cancer begins her long therapeutic journey, the beginning of which is a partial or complete surgery to remove the tumor and the breast. The cost of a non-restorative mastectomy is about $ 3000-3500, “according to Nassar, and this surgery is necessary and inevitable for women with first, second and even third degree breast cancer. its removal, the cost reaches 6,000 dollars, which has been paid Many women are encouraged to abandon this idea, especially since the Lebanese state, with its guarantors, does not recognize the restoration process as a cosmetic procedure.
As a result, patients were forced not to perform reconstructive surgery because they were unable to bear the high cost in light of the lack of health coverage for this type of medical intervention, knowing that removing the breast without repairing it significantly affects health. psychological of women.
As for the greatest catastrophe, it lies in the chemical treatments to deal with this malignant, and only those who have found themselves on this therapeutic journey will be able to imagine the magnitude of the numbers.
Nassar accompanies patients on their journey, knows what is happening and the suffering that accompanies them on the journey to find medicine or to secure the cost of a single session.
Nassar points out that the cost of radiation therapy varies between $ 1,500 and $ 4,000, depending on which side of the breast is affected. If the right breast is approved, the cost is 1500 dollar While the cost doubles to 4000 dollar If the tumor is in the left breast and the mass is close to the heart, it requires the use of a more accurate technique that does not cause burns in the treated area. The guarantors are still covering the cost at £ 1500 per dollar, or £ 3900, and the patient has to pay the difference.
The biggest pain is chemotherapy and, as Nassar says, “there is crying and grinding of the teeth.” When the Ministry of Health withdrew the subsidy on some types of drugs and kept the subsidies on other types, this was to streamline the subsidy and keep two types of subsidized drugs for each type.However, the problem was that the drugs didn’t matter. the types of subsidized medicines and the import of non-subsidized medicines.
After having worked with the ministry, compiled a list of medicines and found a solution for each category, the best solution was the goods of the Indian company “Cipla” registered in Lebanon, which would arrive in Lebanon at the end of August. We were waiting for all the drugs for subsidized chemotherapy to arrive, but the ministry informed us that the expected goods would not arrive in Lebanon. Therefore, today we lack any vision or alternative for any subsidized chemotherapy drug available on the market.
What is the difference between a supported and an unsupported session?
Nassar explains that the hospital average per session is about 200. dollar Any amount above this amount is included in the cost of unsubsidized medicines. For example, a patient takes a drug called Gemzar, the formula of which is subsidized gemcitabine and Gemtabin manufactured by the Lebanese company Benta, and all other medicines are unsubsidized.
In the Lebanese market there are only unsubsidized medicines, which cost around £ 6 million or more, depending on their type. The cost of the Taxotere drug is about 15 million pounds, as is the Taxol drug, which costs about 7 million pounds. Therefore, the cost of the treatment will be between 9 million Lebanese pounds and 20 million Lebanese pounds per session. Note that there are patients who undergo three sessions per month and not one session every three weeks.
As a result, a huge number of cancer patients have given up on treatment due to the high cost. Today it can be said that the ministry has revoked the subsidy for chemical anticancer drugs that are administered in hospitals because subsidized drugs do not exist. In this regard, says Nassar, “Benta should provide the market with a brand name, subsidized Gemcitabine, which is one of the 10 chemotherapy drugs we need, and its quantity is limited and sufficient for the needs of the market.
And in the end, given that women with breast cancer, chemotherapy in the hospital is not supported, what about the result? Lack of treatment for the affected woman leads to the development of the disease in her body and the transition to the fourth stage. The difference between the first, second and third stages of cancer is that the patient is able to recover and carry out her life normally, while the fourth stage is doomed to death, but thanks to the treatments that are administered today, the patient’s life can be extended to five years or more.
These treatments, such as Ibrance, Verzenio, or Kisqali pills, are all cut-offs and, if available, will be available for one month and in very small quantities (meets the needs of half the patients) before they resume for two months. As for morphine for pain relief, it is also cut into its 10, 60, and 100 calibers, and patients have to wait two months or more for another shipment to arrive.
But what about hormone treatments?
Nassar confirms that these treatments are given to the patient who has finished the treatment and that she has to take this treatment for years (ranging from 3 to 10 years depending on each patient for the cancer not to come back). There are 4 types of drugs for hormone therapy, namely:
1- Tamoxifen is cut in Lebanon and its price was around 13 thousand pounds, today it has become around 200 one thousand.
2- Exemestane has been removed the support For one guy (it cost two million and 200 thousand pounds), while for the other guy the subsidy was kept, and the two don’t exist.
3- The drug Femara, from which the subsidy has been withdrawn, and its price is about one million and 860 thousand pounds.As for the subsidized Femazol, which is produced by the benta company, its price is about 450 thousand pounds . While the interested parties are waiting for the company “Hikma” to deliver a shipment of subsidized medicines, the price of which does not exceed 40,000, and the limited quantity will be delivered to the Ministry of Health.
4- Arimidex has a price of about one million and 800 thousand pounds As for Victeve, which should be subsidized, and its price does not exceed 45 thousand pounds, the manufacturer has stopped producing it and the agent refuses to import it to causes problems with the Banque du Liban.
After this detailed refutation of the therapeutic path for breast cancer patients, what do we say to patients today in Lebanon? Either sell everything you have for treatment or wait for the subsidized drugs to be available on the market. According to data from the Ministry of Health for the year 2016, personality In Lebanon 2500 new cases per year in breast cancerIn addition to the cases that are still being treated.
