LEAs update, will women with endometriosis really be able to get treatment for free?

THE’update of the LEAsthe essential levels of assistance that the National Health Service must guarantee to all citizens everywhere, has included some treatments and therapies paid for by the system (or upon payment of a copay) starting next December 30th. Endometriosis, a pathology which affects one in ten women of childbearing age and is often underestimated or diagnosed late, had already been recognized for years as disabling. But very little risks changing, in concrete terms. We’ll see that in a moment.

Together with these treatments, the State-Regions Conference has updated the nomenclature to include, among others, the services necessary for the diagnosis and monitoring of the celiac disease (private individuals are also moving on this point: the Glovo platform has, for example, introduced the possibility of purchasing products at home with the regional celiac budget, this has just started in Milan), the strengthening of newborn screening which will be extended to pathologies, such as spinal muscular atrophy (Sma), currently present only in 13 regions, the inclusion, among modern advanced diagnostics, also ofenteroscopy with ingestible microcamera and other diagnostic imaging technologies, has added a hundred pathologies to the list of rare diseases and has also included the provision of hospital services in public coverage medically assisted procreation.

As for endometriosis, theBEE. the Endometriosis Project Association (which has been at the forefront in Italy for 17 years to raise awareness of the disease and support patients’ rights), has raised – not unique among other things – several doubts: this update would not in fact correspond «to the real resolution of the care needs of those who suffer from the pathology, 10% of the female population. News that risks becoming misinformation. In addition to the delay in the implementation of the decree relating to LEAs, approved in 2017, there are no substantial improvements in the current situation».

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Let’s see the reasons. To date, the protections provided only concerned cases of moderate and severe endometriosis (III and IV stages)and included check-ups, three different types of ultrasound and barium enema. It is expected from December 30th some more performance “but anyone who does not have a stage III or IV diagnosis (diagnosis that comes thanks to histological examination and therefore only to those who undergo surgery) he is not entitled to return to the LEAs» explains the association. In fact, little changes in cases not recognized at the most advanced stages but still disabling. It should be remembered that more than 170 million women worldwide and over 3 million in Italy suffer from endometriosis.

The president of the association Annalisa Frassineti explains that, therefore, there will be no substantial changes: «Arguing that women will be able to get treatment for free corresponds to very serious misinformation, which will lead the population to believe that soon those who suffer from endometriosis will no longer have to pay for visits and therapies – says Frassineti – first of all, it would be important that women with stage I and II endometriosis could access treatments and therapies recognized by the LEAs. It’s fundamental prevent the worsening of the diseasewhich can get worse over time. Furthermore, they are not present in all regions centers specialized in endometriosistherefore women find themselves forced to undertake journeys of hope in order to carry out semi-annual/annual check-ups. It is added that medical training on endometriosis is delegated to the doctor, who can therefore decide whether or not to delve deeper into the topic, and because of this, trained doctors are insufficient and therefore have increasingly long waiting lists.”

In short, they are quite virtual and limited LEAs. It will not be enough, as in theory it should be, to go to the nearest hospital and ask for the services provided, at least in the most serious cases. «These protections, in fact, to be effective should be implemented in public centers specialized in the diagnosis and treatment of endometriosis – recalls a note from the APE – since the ability to treat endometriosis is closely related to the experience of the gynecologist, gained through a large number of cases managed and the ability to interact with a multidisciplinary medical team”.

«The APE will continue to work so that every woman with endometriosis can not only be protected, but also followed in a path that welcomes and respects every aspect of her life that the disease involves – adds Frassineti – it is necessary for the State to find funding for the training of healthcare personnel, the drafting of clinical guidelines, support for specialized reference centers, and support for the costs of interventions, without forgetting the promotion of information, prevention, awareness and research campaigns on endometriosis”.

Source: Vanity Fair

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