a-6761 (ACC-BLR-6761)
Nach einer Recherche in unserer Länderdokumentation und im Internet können wir Ihnen zu oben genannter Fragestellung Materialien zur Verfügung stellen, die unter anderem folgende Informationen enthalten (Zugriff auf alle Quellen am 20. Mai 2009):
„Limited availability of PEG-IFN+RBV treatment
• Not provided in Romania, Belarus“ (EHRN, 24.-25. November 2007, S.
„Availability of antiviral treatment for HCV
In accordance with international guidelines, all 13 countries offertreatmentbygenotype,and, with the exception of Belarus and Romania, indicate availability of treatment with pegylated interferon (PEG-IFN) and ribavirin (RBV).“ (EHRN, 2007, S. 15)
„Overall limited availability of HCV diagnostics and treatment
ThecostofHCVtreatmentinmostoftheworldisrelativelyhigh.InthenewEUMemberStates and neighboring countries a 53-week course costs an average of EUR 12 600. As a result, cost is one of the primary barriers to treatment not only for IDUs but also for the general population.
Thepracticesofreimbursementbythestatevaryfromcountrytocountry.In9(outof13) countries the treatment costs are fully covered by the state, most oftenbyhealthinsurance.However, the ability and readiness of states to reimburse treatment remains limited. For example, in Bulgaria only 50–60 people can get state-financedtreatment.Treatmentispartlycoveredbystatein two countries - Belarus and Latvia. However the standards of treatment provided and covered by the state may significantlydifferfromtheEuropeanstandards,forexampleinBelarusdoctorsstillprescribe interferon monotherapy. Modern combination therapy is not covered by state in Russia or Ukraine.“ (EHRN, 2007, S. 16)
„In Belarus, antibody and qualitative RNA tests are free of charge if a patient is referred by a GP; but quantitative RNA and genotype tests are only free in exceptional cases, such as if a hospital decides to cover them from its internal resources. For example, there is free genotype testing at a children’s hospital in Minsk, and the RNA test is used in an infectious disease hospital in Gomelsk, though it is oftenlimitedforotherpeople.InBelarus,thegenotypeofinfectioninmostIDUsisunknown, and liver biopsy is rarely performed. […]
5.2.5.2 Availability of HCV treatment and reimbursement
International guidelines, such as those from EASL and WHO, recommend PEG-IFN and RBV treatment as the most effectiveHCVtreatment,whichisavailableinmostcountriesintheregion, with exception of Belarus and Romania (see Table 14). […]
Clearly, the cost of treatment and whether or not it is paid for by clients themselves, the government or an external source, are important factors in determining the accessibility of HCV treatment for drug users. HCV treatment in the region ranges from EUR 2 000 for the least expensive drugs registered in Belarus, to EUR 22 800 in the Czech Republic, an average cost of EUR 12 600 for a standard year-long course (53 weeks) of treatment. In most countries, people must have health insurance to receive help paying for HCV treatment, and the majority of IDUs do not have it (the Chech Republic, Estonia, Hungary, Poland, Romania, Slovakia, Slovenia). Partial coverage by the state is available in Latvia. In Belarus, insurance does not cover HCV treatment, the Government can cover only up to the firstthreemonthsoftreatment;thereafter,thepatientmustpay.“ (EHRN, 2007, S. 56)
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„Sickness and Maternity
Regulatory Framework
First law: 1955.
Current laws:1992; 1993 (health), with amendments; 1995 (social insurance); 1997 (pregnancy and childbirth); 1996, with 1998 amendment; 1999; and 2002 (families with children).
Type of program:Social insurance (cash benefits) and universal (medical benefits) system.
Coverage
Cash sickness and maternity benefits: Persons in covered employment or in military service; and registered unemployed women (maternity benefits only).
Medical benefits:All persons residing in Belarus.
Source of Funds
Insured person: See source of funds under Old Age, Disability, and Survivors.
Self-employed person:Not applicable.
Employer:See source of funds under Old Age, Disability, and Survivors.
Government:The cost of medical benefits. Maternity benefits for members of the armed forces, the interior service, and students are paid for out of the state budget.
Qualifying Conditions
Cash sickness benefits:Paid for insured workers, including foreign citizens and persons without citizenship working in Belarus.
Cash maternity benefits: There is no minimum qualifying period.
Medical benefits:There is no minimum qualifying period.
Sickness and Maternity Benefits
Sickness benefit:The benefit is equal to 80% of the insured’s average earnings for the first 6 days of incapacity; thereafter, 100%.
The monthly maximum benefit is equal to 300% of the national average wage in the month before the incapacity began. The benefit is also paid at 100% of the insured’s average earnings to provide care for a sick child younger than age 14 for up to 14 days, or for periods of hospitalization as recommended by a doctor. […]
Workers’ Medical Benefits
Medical services are provided directly by government health providers and include general and specialist care, hospitalization, prostheses, medication, and other medical care services.
Dependents’ Medical Benefits
Medical services are provided directly by government health providers and include general and specialist care, hospitalization, prostheses, medication, and other medical care services.
Administrative Organization
Social Protection Fund of the Population (
http://www.ssf.gov.by) of the Ministry of Labor and Social Protection finances sickness and maternity benefits.
Cash benefits are provided directly by the enterprises, as well as by local offices of social protection, as specified by law.
Ministry of Health (
http://minzdrav.by) and local health departments provide general supervision and coordinate medical care.
Medical services are provided through government clinics, hospitals, maternity homes, and other facilities and are administered by the Ministry of Health and local health departments.“ (US SSA, 31. August 2008, S. 43 f.)
