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 LAW NO. 106 /XI/1ª

REGIME FOR THE COMPARTICIPATION OF MEDICINES

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)

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

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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.

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In these terms, it is considered to be matter of public interest to be awarded the

Ranking A of the medicines referred to in the numbers 13.3.1 (de

topical application) and 13.3.2 (of systemic action)-keratolitic Medicines and

antipsoriatics-from Group 13 of the Tier C of the table attached to the Portaria No. 1474/2004, of 21

of December with subsequent amendments, when prescribed for carriers of

psoriasis.

For the exposed, under the applicable constitutional and regimental provisions, the

Deputies of the undersigned CDS-PP present the following Draft Law:

Article 1º

The medications referred to in numbers 13.3.1 (topical application) and 13.3.2 (of action

systemic)-keragitic and antipsoriatic Medicines-of the Group 13 of the Ranking C of the

table attached to the Portaria No 1474/2004 of December 21 with the subsequent amendments

go on to be attended by the Ranking A.

Article 2º

1-To benefit from the comparticipation provided for in the previous article, the patient must

present supporting documentation of which it suffers from psoriasis.

2-The prescriptive doctor must always make express mention of the present diploma in the

recipe.

Article 3º

This Law shall come into force with the approval of the State Budget subsequent to its

publication.

Palace of Saint Benedict, December 16, 2009.

The Deputies,