Haemophilia Care in Poland
On 7th September 2010 an international conference “Haemophilia Care in Poland – Current State of Affairs” took place in Warsaw, Poland. The conference was jointly organized by the Polish Haemophilia Society and the EHC, and the Polish Minister of Health Ewa Kopacz was its official patron. The speakers included Dr Paul Giangrande, haematology consultant from Oxford Radcliffe Hospital, Brian O’Mahony, President of the Irish Haemophilia Society, Dr Joanna Zdziarska, a haematologist from the University Hospital in Cracow, Poland, and Bogdan Gajewski, President of the Polish Haemophilia Society. Also representatives of people with haemophilia and some parents of children with haemophilia had a chance to express their opinions. The debate was efficiently moderated by journalist Malgorzata Wisniewska.
The speakers underlined that the introduction of prophylactic treatment for children in 2008 was a very significant step forward in haemophilia care in Poland. However, there remained many problems to be solved. The most important were:
- lack of comprehensive haemophilia care, including problems with access to physiotherapy;
- lack of secondary prophylaxis for adults with serious joint changes;
- wrong costing of medical procedures by the National Health Fund, which was the reason that hospitals often lost money when treating patients with haemophilia;
- no comprehensive treatment for patients with inhibitors;
- necessity of continuing the existing National Programme of Haemophilia Treatment, which will expire in 2011;
- no access to recombinant factor concentrates.
When referring to the latter point, Dr Giangrande stressed the fact that prices of plasma-derived and recombinant factor concentrates had become comparable, and in the most recent tender organized in the United Kingdom plasma-derived factor concentrates (bought only for patients with von Willebrand disease as otherwise British patients rely on recombinants) were more expensive than recombinants.
Dr Giangrande pointed also out that switching over from plasma-derived factor concentrates to recombinants did not cause any increase in inhibitor frequency.
Praising the progress made in Polish haemophilia care, Brian O’Mahony added that still further steps were necessary to fulfil the European Principles of Haemophilia Care. He underlined that patients should have access to all kinds of concentrates, including the safest ones, i.e. recombinants; such concentrates form 100 per cent of supply in Ireland and 40 per cent in Hungary. Patients should also have a chance to participate in making decisions concerning the state health policy as far as haemophilia was concerned.
During the debate parents and journalists asked about reasons for the existing delays in introducing a modified version of the programme of prophylaxis for children. Representatives of the National Health Fund and the Ministry of Health explained that the delay had been caused by organization problems and that soon the new version should be implemented.
The conference found a large echo in the media, with articles published in several magazines and some materials, including an interview with Dr Giangrande and Brian O’Mahony, broadcast by state television.
There was also a direct gain for people with haemophilia in Poland as the National Health Fund decided to revise its costing of endoprosthetic surgery in haemophilia. This in turn resulted in a change of the attitude of hospitals. Currently up to eight such surgeries a month are made in the Institute of Haematology and Transfusion Medicine in Warsaw, and some more are made in Cracow.
Adam Sumera
Vice-President, Polish Haemophilia Society