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Parliamentary Group
Assembly of the Republic-Palace of S. Bento-1249-068 Lisbon-Phone: 21391 9233-Fax: 21391 7456 Email: gpcds@pp. parlamento.pt-http://cdsnoparlamento.pp. parliamento.pt
DRAFT RESOLUTION NO. 35 /XI/1ª
IT RECOMMENDS THE GOVERNMENT TO PROCEED TO THE RECOGNITION OF PSORIASIS AS
CHRONIC DISEASE AND CHANGE THE DRUG-COMPARTICIPATION REGIME
INTENDED EXCLUSIVELY FOR PSORIASIS CARRIERS
Exhibition of Motives
" Psoriasis is a chronic cutaneous disease, at times cutaneous-articular, incurable , which
evolves throughout life by periods of improvement and aggravation. Reaches about 1,5-2% of the
individuals of Caucasian race, so it is calculated that there are about 150-200.000
patients with psoriasis in Portugal . Surge most of the times by 2ª-3ª decades of life
in the forms with family tendency, in the 5ª-6ª decades in the unfamiliar ways . (...) Can
reach only limited areas of the skin-elbows, knees, scalp or other
locations (slight psoriasis)-or be much more extensive (may reach all skin),
reach exposed areas, have articular commitment (mild and severe psoriasis). It is said that the
moderate to severe cases and with articular commitment are about 20-30% of all
cases of psoriasis ". (Dr. Francisco Menezes Brandão, former President of the Society
Portuguese of Dermatology and Venereology)
In spite of the widespread concept in the scientific medium, psoriasis has not yet been formally
considered as chronic disease, which increases the difficulties and barriers with which the
patients encounter themselves throughout their lives. However, the Despacho # 20510/2008, of 24
of July, of the Deputy Secretary of State and Health assumes that " rheumatoid arthritis, the
ankylosin spondylitis, psoriatic arthritis, polyarticular juvenile idiopathic arthritis and the
psoriasis in plates are chronic pathologies, responsible for high rates of morbidity
that, in the long term, significantly interfering in the quality of life of patients , being
that the first two pathologies have a prevalence greater than 1% of the population in
general ".
Thus, the fact that, on the one hand, there is not a recognition of psoriasis as disease
chronicle in the diploma that establishes the regime for the comparticipation of medicinal products
(Portaria No. 1474/2004 of December 21) and, on the other, the Despacho No 20510/2008, of 24
of July, which determines a special arrangement of comparticipation for rheumatoid arthritis,
the ankylosin spondylitis, psoriatic arthritis, polyarticular juvenile idiopathic arthritis and the
psoriasis on plaques recognize it as such, generates confusion not only in the doctors as in the
sick.
Being the psoriasis an incurable disease, patients only dispose of a set of
treatments that, when properly carried out, control the development of the
disease. In this set of treatments, they are found medicinal topics that
consists of the application of lotions, creams or ointments on the skin (emollient and
keratolytics; corticosteroids topics; analogs of vitamin D; or others) and the
systemic medications .
The topics and systemic medicines with exclusive indication and use of the carriers of
psoriasis are:
Topics:
-Tacalcitol
-Betametasone + Calcipotriol
-Calcipotriol
-Calcitriol
Systemic:
-Acitretina
It should be noted that, according to the Therapeutic Prontuary, there is no Denomination
International (generic) common for none of the drugs topics above
discriminated by the active substance , which inhibits doctors from prescribing a substance
with the same effectiveness, but with substantially reduced costs for patients.
These therapeutics are comprised only by the Ranking C (37%), implying for each
ill an annual expense close to the € 3,000. According to the President of the Association
Portuguese of Psoriasis, the price of these medications is importable to many
patients . The Association is constantly confronted with reports of forced disruption
of the treatments, due to the financial inability to support the topical therapeutics. In
times of crisis, cases multiply.
Not being a disease that kills, psoriasis is a crippling disease: its visibility
inhibits patients from going out on the street; the inconvenience that causes them the look of third parties draws upon them
self-styled; ignorance in the face of disease discriminates against them. Naturally, the sick of
psoriasis feel excluded by society, which leads to inevitable implications
serious psychological. It is estimated that psoriasis is the third pathology with index more
high of suicide.
The interruption of treatments prevents the control of the disease and may lead to its
evolution and, when psoriasis reaches the serious state , many patients will have to
treatments with biological medication that, according to the Despacho # 20510/2008, of
July 24, of the Deputy Secretary of State and Health, benefits from a special scheme
of comparticipation being, thus, free of charge for the patient and their cost entirely
supported by the State .
This biologic medication is administered for 9 months per year, implying a cost
for the State of about € 1,500 /month, by patient.
According to Professor Manuel Marques Gomes, President of the Portuguese Society
of Dermatology and Venereology, the disruption of the treatments topics has as
consequence that " those patients who do not comply with the treatment evolve in the disease and
go after spending balurdiums [to the state] with the biological " .
The CDS-PP understands, in short, that greater accessibility to topical therapies and
systemic has a double virtue:
-promotes the health, well-being and dignity of psoriasis patients by avoiding the
aggravation of the disease;
-has advantages for the State, as the comstake by the Ranking A of this
medication has fewer costs than biologic medication.
By the exposed, the Assembly of the Republic, pursuant to Article 156º (b) of the
Constitution of the Portuguese Republic, deliberating to the Government:
1-Proceed to the formal recognition of psoriasis as chronic disease.
2-Adopt the necessary measures to assure psoriasis holders the right to
to earn comparticipation by step A, of the keratolitic medicines and
antipsoriatics, intended exclusively for psoriasis carriers.
Palace of Saint Benedict, December 16, 2009.
The Deputies,