Changes regarding the Spanish Common Package of Benefits

Earlier this year, the Commission of Benefits, Insurance, and Financing made several agreements in cardiovascular and endocrine fields, which were subsequently approved by the Interterritorial Council of the National Health System (CISNS). On October 28, 2022, several Resolutions of the General Directorate of the Common Package of Benefits of the National Health and Pharmacy System in this regard were published concerning the use of the system for percutaneous repair of the mitral valve with clip, prioritization of patients with type 2 diabetes mellitus for the provision of glucose monitoring systems, the use of glucose monitoring system with sensors (flash type) for type 1 diabetes mellitus in childhood and adolescence.

The following key conclusions were provided in these Resolutions respectively:

• It was outlined that the system for percutaneous repair of the mitral valve with clip should be kept in the Common Package of Benefits of the National Health System under the same conditions as in the monitoring study protocol. The Resolution outlined the patient criteria that must be met, as well as the information on the minimum requirements the hospitals should meet to be eligible to perform this service. This decision was based on the monitoring study by the Basque Office for Health Technology Assessment (OSTEBA);
• Prioritization criteria for patients with type 2 diabetes mellitus that undergo intensive insulin therapy and require at least six digital punctures per day for self-monitoring of blood glucose, to whom it is necessary to provide glucose monitoring systems were outlined for the following periods: the second half of 2022 and the first half of 2023 (with the commitment to start in the second half of 2022), the first half of 2023, the second half of 2023, throughout 2024. As an example, for the first period mentioned above, the following patient categories are specifically included: patients with visual impairment, functional limitations, disability, dependence, or cognitive impairment that limits or prevents them from performing digital punctures or recognizing, expressing, or acting in a situation of hypoglycemia; patients with a history of severe hypoglycemia defined as those that require health care or help from a third person for its solution (one episode or more in the last two years); patients under 18 years of age; pregnant women or women in the process of pregnancy planning;
• Suffering inadvertent hypoglycemia is no longer considered an exclusion criterion for the provision of glucose monitoring systems using sensors (flash type) for type 1 diabetes mellitus in childhood and adolescence. Other inclusion and exclusion criteria for this indication have not changed.

The full details in Spanish can be found here.

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