High Court: health insurance funds will not be able to automatically reject requests for medicines costing 14 million shekels

We are talking about the drug Elevidys for children with Duchenne muscular dystrophy. The cost of one therapy is about 14 million shekels. According to Calcalist, there are about 300 patients with this diagnosis in Israel, of which approximately 20 could potentially meet the criteria for receiving such treatment.

After proceedings in the Supreme Court, the exclusion commissions of health insurance funds will not be able to reject such requests automatically, without consideration on the merits. This does not mean that health insurance funds are obliged to finance the drug for every patient, but they will have to carry out an individual review and justify their decision.

Duchenne muscular dystrophy is a rare genetic disorder that primarily affects boys and results in progressive muscle weakness. Elevidys is a gene therapy designed to target one of the causes of disease. The drug remains the subject of debate in the medical community due to its cost, limited data, and questions of effectiveness.