Investigation reveals cancer drug dispute centers on one medication

An investigation by Finnish public broadcaster Yle has found that a recent controversy over cancer drug reimbursements in Finland largely stems from a sharp rise in claims for a single medication, daratumumab, used to treat bone marrow cancer.

Last year, around 600 patients received reimbursements for the drug, which stands out clearly in statistics obtained by Yle from the Social Insurance Institution of Finland (Kela). The dispute began after Kela announced it would stop reimbursing 25 medications starting July 1, shifting the financial responsibility to the country’s well-being services counties, as required by law.

The medications in question are expensive, advanced, and primarily injectable drugs used in outpatient or hospital care. In some cases, patients had been purchasing these drugs from pharmacies and receiving Kela reimbursements, even when the medications were administered within the healthcare system—effectively shifting costs from the counties to Kela.

Kela responded by requiring doctors to specify on prescriptions where the medication would be administered. If a patient cannot self-administer, the cost falls to the well-being services county, not Kela.

The Ministry of Social Affairs and Health (STM) has emphasized that patients’ access to necessary medications has never been at risk. “There is absolutely no cause for concern that people would go without their medications. By law, these drugs are part of treatment and fall under the responsibility of the well-being services counties,” said Anna Cantell-Forsbom, a department head at STM.

The dispute is purely administrative, centering on whether the costs of these drugs should be covered by Kela or the counties. The total cost of the contested medications is estimated at around €100 million annually.

Kela’s decision, implemented with just three weeks’ notice in June, has drawn criticism for its timing during the summer holiday period. Cantell-Forsbom acknowledged that the turn of the year might have been a more opportune time for the change but noted that flexibility could still be applied on a case-by-case basis.

A thorough review of the issue is expected after the summer holidays.