In this post, we have gathered for you what are the items included in mandatory coverage of health plans and the purposes of each one so that your operator can adapt to the new rules.

The National Supplementary Health Agency (ANS) recently included 5 medicines and 2 tests in its List of Health Procedures and Events.

In addition, it also announced that 4 other medicines are being included as mandatory coverage.

To stay up to date with what has changed, continue reading until the end:

5 new medicines included in the List of Health Procedures and Events

Approved by the ANS directors at the 9th Extraordinary Meeting of the Collegiate Board, five new drugs targeting different types of cancer and psoriasis were included in supplementary health coverage.

These inclusions were submitted by FormRol, an electronic platform that provides an interface for presenting proposals for updating the list, and discussed by the Permanent Committee for Health Care Regulation (COSAÚDE) and through public consultations.

The following medicines were approved:

• Brigatinib: used to treat non-small cell lung cancer (NSCLC) that is locally advanced or metastatic;
• Venetoclax: used to treat chronic lymphocytic leukemia;
• Trifluridine + tipiracil hydrochloride: used to treat metastatic colorectal cancer;
• Trifluridine + tipiracil hydrochloride: used to treat metastatic gastric cancer, including adenocarcinoma of the gastroesophageal junction;
• Risankizumab: indicated for the treatment of moderate to severe psoriasis.

2 new tests are also included in the List

In addition to medicines, 2 other technologies were also incorporated, following a positive recommendation from Conitec (National Commission for the Incorporation of Technologies into the Unified Health System) to the SUS.

Are they:

• Oral provocation test (OPT) for cow's milk protein allergy detection, with diagnosis and monitoring for patients up to 24 months of age;
• Fecal pancreatic elastase test for diagnosis of exocrine pancreatic insufficiency in cases of cystic fibrosis.

All seven of these technologies, 5 medicines and 2 tests, will have mandatory coverage within a maximum period of 60 days after implementation in the SUS, as provided for by law 14,307/2022.

It is important that your operator is aware of this deadline and starts offering these technologies in its coverage in the appropriate period to comply with the ANS requirements.

4 medicines are included as mandatory in supplementary health

In addition to these 7 technologies, as we said at the beginning of this text, the inclusion of more six therapies aimed at oral cancer treatments.

From the moment the decision is published in the Official Gazette of the Union, operators will have a period of 10 days to adapt and offer treatments to their beneficiaries as provided for by legislation.

There are 4 medicines incorporated:

• Acalabrutinib which has three indications for use: treatment of adult patients with chronic lymphocytic leukemia (CLL), in the first line of treatment; treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL); and treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.
• Apalutamide: treatment of patients with metastatic castration-sensitive prostate cancer (mCPSC);
• Enzalutamide: also recommended for the treatment of patients with metastatic castration-sensitive prostate cancer (mCPSC);
• Lorlatinib: treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) that is positive for anaplastic lymphoma kinase (ALK), in first line.

These four medications serve six therapies and will soon become mandatory.

And, just like the already incorporated technologies mentioned above, these were also submitted to the ANS via FormRol, in a process of continued analysis and incorporation by the Agency.

COSAÚDE also participated in the discussion and evaluation of these technologies, along with involved social participation.

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