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On March 22, A. Dulkys modified the order by adding the drug Levonorgestrel to the list of reimbursable drugs.
According to him, levonorgestrel coils can be prescribed “to 18 to 20-year-old girls who consult a gynecologist for contraception” and to “15 to 17-year-old girls according to the procedure established by the Ministry of Health.”
Photo by Julius Kalinskas / 15min / Arūnas Dulkys
According to the Ministry of Health (SAM), a separate procedure is needed to guarantee the protection of the well-being and interests of sexually active patients of this age and due compliance with the provisions of the legislation already in force.
A separate administration procedure will appear
The Minister has not yet established this procedure, but it will be done, according to SAM.
“It is not yet ready, but requirements for the provision of outpatient OB / GYN personal health care services will be prepared. <...> draft amendment establishing the procedure for the administration of the drug levonorgestrel (Fleree intrauterine device 13.5 mg) to sexually active girls between 15 and 17 years of age ‘, 15 minutes specified by the Ministry.
Until then, levonorgestrel will only be available as a compensatory product for adult girls ages 18-20.
But even that will have to wait: the Minister will have to change the 2021 price list for reimbursable drugs.
Until a new active substance is included in the price list, patients cannot buy it from pharmacies as reimbursement.
“Until a new active substance is included in the price list, patients cannot buy it from pharmacies as reimbursement. Therefore, it is not appropriate and appropriate for doctors to prescribe the drug until the prescription date is clear, since the prescription is only valid for 10 days.
Levonorgestrel (Fleree 13.5 mg intrauterine system) will be available to patients once it is ready for entry into force in 2021. Q2 a change in the price list to include the drug in question, ”SAM said.
There was resistance
The order, which included the drug Levonorgestrel on the list of reimbursable drugs, was signed by former Health Minister A. Veryga on April 21, 2020.
According to him, levonorgestrel coils were supposed to be given to “girls between the ages of 15 and 20 who consulted a gynecologist for contraception,” but politicians and NGOs opposed it.
Sigismund Gedvila / 15min photo / Aurelijus Veryga
Conservatives Vilija Aleknaitė-Abramikienė, Antanas Matulas, Raimundas Martinėlis, Audronius Ažubalis, Laurynas Kasčiūnas and Rasa Petrauskienė demanded that the decision be reversed, and the Free Society Institute and other organizations declared it unfounded.
A.Veryga and He stated that with the decision to prescribe the hormonal coil to adolescents he was rushed.
He stressed that the drug will not be included in the price list of Reimbursable Medications for some time, so doctors will not be able to prescribe it and patients will be able to buy it in pharmacies as reimbursement.
Consent and patient care
Minister A.Veryga formed a working group to assess the appropriateness and necessity of levonorgestrel compensation for sexually active girls between the ages of 15 and 20.
The working group was chaired by the Lithuanian Bioethics Committee. The conclusions were formed on January 4 of this year.
Apparently SAM took them into account.
SAM chose the opinion formed by the majority of the members of the working group.
“The Working Group presented all the alternative proposals that were made and the SAM chose the opinion expressed by the majority of the Working Group that levonorgestrel, an intrauterine delivery system, could be reimbursed without additional conditions for girls aged 18 to 20 years and for sexually active girls between 15 and 17 years old, “taking into account the ethical, legal and social aspects highlighted by the working group,” the ministry said.
These aspects, which the Minister intends to define in his procedure, are the following:
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consent requirement before introducing a levonorgestrel intrauterine coil;
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special requirements for the provision of information;
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Requirements for patient care after administration of an intrauterine levonorgestrel system.
The offer came from the Society of Obstetricians and Gynecologists.
The proposal to include the hormonal coil in the list of reimbursable drugs was put forward some time ago by the Lithuanian Society of Obstetricians and Gynecologists.
According to her, most adolescents who have sex start between the ages of 16 and 17, every five years, at 15 years or less, and the hormonal spiral is one of the most effective and safest means of preventing pregnancy.
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