The Israeli Public Committee for Expanding the “National Health Basket” (The Israeli public health remembrance system) has released its recommendations for government funding of medications and medical technologies for 2025. This year, the allocated budget stands at 650 million NIS. A total of 339 indications for medications and technologies were submitted, amounting to approximately 4 billion NIS in requested funding. However, only 117 of these, about one-third, were approved for inclusion in the national health basket.
Budget Allocation Overview
An analysis of the committee’s recommendations reveals that the largest share of the budget, 28%, has been allocated to medications and medical technologies for cancer treatment. The second-largest allocation, 24%, has been dedicated to vaccinations and virology, with the majority (109 million NIS) funding the newly approved RSV vaccine Beyfortus (Nirsevimab). This vaccine, developed jointly by AstraZeneca and Sanofi, is designed to prevent respiratory illnesses caused by the RSV virus in newborns. The third-largest allocation, 11%, is directed towards advanced diabetes treatments and monitoring technologies. Other therapeutic areas received significantly lower funding, ranging from 6% for neurology to just 0.08% for genetic testing.
Per-Patient Budget Analysis
A breakdown of Costs Per Patient-Year (PPY) shows that patients in the fields of allergy and immunology received the highest budget per patient, at 551,733 NIS PPY. The second-highest PPY budget was allocated to hemato-oncology, at 126,410 NIS PPY, followed by ophthalmology, with 117,885 NIS PPY. Conversely, the lowest PPY funding was allocated to nephrology (1,919 NIS), psychiatry (1,653 NIS), vaccinations and virology (617 NIS), and genetic testing (602 NIS).
Inclusion of Innovative Medications
In order to fairly assess the level of innovation in Israel’s national health basket, ten drugs considered to be the most groundbreaking in their respective fields were selected, all of which were approved by the FDA in 2023. The reason drugs approved in 2024 were not considered is that in Israel, new medications can only be submitted for inclusion in the health basket after they have been approved by the FDA or by other leading regulatory authorities such as the EMA of the European Union, the British MHRA, the Swissmedic, the Japanese PMDA, and the Australian TGA.
Out of the ten most innovative drugs approved by the FDA in 2023, five were not even submitted for funding in Israel. Among the five that were submitted—including treatments for Alzheimer’s, lymphoma, Friedreich’s ataxia, ALS, and Duchenne muscular dystrophy—only one, Jaypirca (pirtobrutinib), was approved for national funding. Jaypirca is used for treating relapsed or refractory Mantle cell lymphoma in patients who have undergone at least two prior systemic treatments and are ineligible for CAR-T therapy.
Professor Dina Ben Yehuda, MD, Chair of the Public Committee for Expanding the National Health Basket and Head of the Hematology Department at Hadassah Ein Kerem Hospital, reflected on the committee’s work:
“This year, we have successfully included a broad range of innovative medications and technologies to treat severe diseases, aiming to alleviate patient suffering, improve their quality of life, and even extend life expectancy. We placed particular emphasis on early diagnosis and preventive medicine, including screening tests, continuous monitoring, and vaccinations.”
However, she also acknowledged the limitations of the budget: “Despite our achievements, this is a difficult day for me. There are patients for whom essential technologies could not be included, and my heart aches for those who did not receive the solutions they desperately need. I sincerely hope that next year, we will be able to expand medical solutions further and ensure that Israel’s health basket continues to provide significant and high-quality care to the public.”
Dr. Baruch Weinreb, MD, a leading Israeli Market Access & Medical Affairs consultant says: ”Although the committee is assessing the clinical data separated from the technologies’ cost, along last years, there is a higher impact of the financial aspects. And this has an impact on the medicines and technologies that receive funding in the health basket, with an emphasis to those preventing and reducing hospitalization rates and costs for the health care system. For example, the RSV vaccine, which is funded in a very high cost, prevents morbidity and hospitalization; Ditto treatments for diabetes”.
The Israeli Public Committee for Expanding the National Health Basket
The National Health Insurance Law, 1994, determines, among other things, the medical services the members of the Health Maintenance Organizations (HMO) in Israel are entitled to that are included in the Health Services Basket (the Basket). The expansion of the Basket allows for the addition of new technologies – medications, medical devices, medical equipment, and medical, diagnostic, and therapeutic procedures (Medications and Technologies). It is also designed to enable the continued fulfillment of the objectives underlying the Law, to realize the latent possibilities in these Medications and Technologies and the scientific developments, and to provide patients with a service corresponding to these developments.
The Basket Committee examines new Medications and Technologies and recommends to the Minister of Health, which should be added to the Basket within the given budget. The budget is determined every year in the ongoing discussions between the Ministry of Finance and the Ministry of Health, according to the Government’s State Budget priorities. From 1998 to 2025, a sum of about NIS 10.5 billion was allocated for expanding the Basket (300 M NIS – 650 M NIS each year). The Ministers of Health and Finance appoint the Basket Committee’s members, including representatives from the medicine, ethics, and social fields. Members of the Committee include representatives from the Ministry of Health, the Ministry of Finance, the HMOs, and the public.
