Imatinibe pelo plano de saúde: advogado explica regra da ANS para cobertura do medicamento

Imatinib is an oral cancer medication that has already been incorporated into the List of Procedures and Events of the ANS (National Supplementary Health Agency). Therefore, it is part of the mandatory coverage of health plans. Even so, it is still common for health insurance companies to refuse to provide imatinib in some cases, which generates many doubts among consumers about the coverage rules for this medication. To clarify the ANS rules and what the Health Plan Law says regarding the provision of this type of medication, Professor Elton Fernandes, a specialist lawyer in health plans and professor of Medical and Hospital Law at USP Ribeirão Preto, prepared this video. Here, Dr. Elton Fernandes explains, for example, that the ANS has limited the coverage of imatinib to only a few specific cases in its list: ALL - Acute Lymphoblastic Leukemia (Ph+ Chromosome) relapsed or refractory; CML - Myelocytic Leukemia (myeloid, myelogenous, granulocytic) Newly diagnosed Chronic CML Ph+ chromosome chronic phase; blast crisis; accelerated phase; chronic phase after interferon failure; Unresectable or metastatic gastrointestinal stromal tumor (GIST); Adjuvant treatment of high-risk resected cases of gastrointestinal stromal tumor (GIST). Despite this, the Health Plan Law allows for exceeding the ANS (National Supplementary Health Agency) list whenever the medical recommendation is in accordance with Evidence-Based Medicine. Therefore, even outside the ANS list, it is possible to seek the supply of imatinib for treatments that have scientific support. Watch the video to understand better. You can also find out more about imatinib coverage by health insurance plans in this article on our blog: https://www.eltonfernandes.com.br/ima... Learn about the procedure list rule that addresses this issue. Click on Annex II of ANS Resolution 465 (link below) and search for the medication name to directly access the rules. Search for imatinib or the name of your disease: https://www.ans.gov.br/component/legi... #imatinib #roldaans #cancer treatment #healthinsurance lawyer #eltonfernandes The information provided here is general information and does not replace the analysis of the specific case, with its particularities, by a specialized lawyer, so that you are informed about the possibilities and risks of your case. To learn more about these topics, follow our website and social media: ▷ Website: https://www.eltonfernandes.com.br ▷ Instagram:   / eltonfernandesadvogados   The law firm of Elton Fernandes is registered with the OAB/SP (Brazilian Bar Association of São Paulo) under number 16.616, and specializes in lawsuits against health plans, the SUS (Brazilian Public Health System), Medical and Hospital Law, insurance, etc.