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Parliamentary Group

DRAFT LAW NO. 83 /XI

Includes in the Step A de-comparticipation the medicines

keratolytic and antipsoriatic intended for patients with

Psoriasis

Exhibition of Motives

Psoriasis is a hyperproliferative disease of the skin, of unknown etiology. This

pathology, incurable and non-contagious, shows a wide variety in the severity and the

distribution of the skin lesions that are characteristic to you.

Men and women are hit in the same way. Most of the diagnostics of

psoriasis occurs in the age range between the ages of 20 and 40, and may, however, arise in

any phase of life, including in children. There are cases in which it emerges before the 15

years (27%); before the 10 (10%); before the 5 (6.5%) and before the two years (2%). The

psoriasis usually affects several members of a same family. About 30% of the

patients have relatives who are also carriers of psoriasis. This chronic disease

affects 1% to 3% of the population. In Portugal, it is estimated that about 250 thousand people

suffer from psoriasis. All over the world, psoriasis affects more than 125 million people.

As it is a disease that affects the skin, being quite visible, it has profound effects

psychological. Often the patient gets traumatized with his / her aspect and with the reaction

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of the others to your appearance. In fact, lesions on the skin, which can have the aspect of

scales, reddish stains or pústulas, often lead to the people

have feelings of revulsion towards the sick. This reaction is a consequence, in the

majority of occasions, from the unawareness and lack of information.

The stigma associated with the disease affects the social, familial, emotional and psychological life, and

professional of patients, conditioning their daily lives. The manifestations that are

characteristics of this disease contribute to increased stress and other disorders

emotional which, in turn, aggravates the physical situation of the patient.

The aspect, extent, evolution and severity of the manifestations associated with psoriasis are

very variable. These manifestations preferentially affect the elbows, knees,

lumbar region and scalp. However, in the most serious cases, these lesions may

cover large surfaces of the body, including the face. They arrive to reach more than 90% of the

body.

About 10% of patients develop psoriatic arthritis, which has very symptoms

similar to those of rheumatoid arthritis. Psoriatic arthritis translates into pain and

deformity, whether of small as of large joints. This type of pathology

cause, at times, notoriously invalidating situations.

According to the first national study on the impact of psoriasis on quality of life

of the patients, promoted by the Portuguese Association of Psoriasis (PSOPortugal), more than

a quarter of patients have other associated diseases, such as diabetes, high cholesterol,

hypertension and depression.

There are several types of Psoriasis. In a same patient, and at different heights of your

life, can appear the different types of psoriasis.

Despite the psoriasis being incurable, the quality of life of patients improves

considerably due to the correct treatment of the disease, which is fundamental to

reduce or inhibit the development of symptoms and prevent secondary infections. No

there is a definite cure for psoriasis, but a diverse set of treatments. The

therapeutic to be adopted depends on the type of diagnosed psoriasis and the characteristics of the

own sick.

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The sum expended on the purchase of medicines and creams, lotions and called for

treatment of psoriasis is quite considerable, coming in to snore the 2,000 annually and,

in some cases, surpassing even the 3,000 €. Add to these values the amount of money spent

with food, which is key in the case of these patients.

The most widely used medicines to treat Psoriasis, used in more than 70% of the

cases, are attended by the ranking C (37%), while the creams, lotions and champosed

do not enjoy any kind of comstake. By way of example, a bisnaga of

Betametasone + Calcipotriol of 60g, for which there is no generic medicine of the

active substance in the Therapeutic Prontuary, costs 48.93, while a blister of 50

acitretina units of 25mg costs 60.24 €. Both medications are,

currently, attended to 37%.

According to the representative of the Portuguese Association of Psoriasis (PSOPortugal), John

Cunha, " every day arrives reports of desperate people because they can't

buy the medicines ". Many patients have been interrupting treatment, the

that causes a worsening of their disease, because they have no capacity to cope with the

costs inherent in therapeutics.

The comparticipation of antipsoriatic drugs of topical application and action

systemic to 95% (step A) is a matter of social justice and public health. And,

inclusive, of economic reasonableness.

The therapy with organic medicines, the expenditure of which amounts to 1500 monthly, and which is

applied for a minimum of nine months per year, is comprised at 100% by the

State, which implies a high cost for the public purse.

The comparticipation of the antipsoriatic drugs of topical application and action

systemic to 95% will represent a rather lower expense for the state. This measure

will, including, ensure the timely and rigorous treatment of psoriasis that by its

time, whether it will translate into the improvement of the health conditions of patients. Soon, you will register

a decrease in the number of cases of patients with an aggravated health situation and,

consequently, the decrease in the number of patients who need to turn to the

biological medicinal products.

It is unacceptable to stall this measure, under the risk of perpetuating a situation of deep

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discrimination and to contribute to the deterioration of the quality of life of these patients, the

par with the increase in the expenditure of the public erarium.

Thus, under the applicable constitutional and regimental provisions, the

Deputies and the Deputies of the Left Bloc, present the following Project

of Law:

Article 1.

Subject

The present diploma falls in the Step A de-comparticipation the medicines

queratolytics and antipsoriatics, of topical and systemic application, when destined for the

sick holders of Psoriasis.

Article 2.

Comparticipation of medicines in the Step A

They are attended by the Ranking A, as provided for in the Decree-Law No. 118/92, of 25

of June, in its current wording, provided that the prescribing physician mentions

expressly in the recipe the present diploma, and are prescribed for Psoriasis (L40),

in accordance with the International Statistical Classification of Diseases and Problems of

Health (CID-10), the following medications:

a) keratolytic and antipsoriatic drugs of topical application;

b) keratolytic and antipsoriatic drugs of systemic application.

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Article 3.

Entry into force

The present diploma comes into force with the approval of the State Budget

subsequent to their publication.

Lisbon, Palace of Saint Benedict, November 26, 2009

The Deputies and Deputies of the Left Bloc,