Antonis is 38 years old; he was diagnosed with morbid obesity, is being treated by an endocrinologist, and has managed to lose 50 kilograms using the injectable medication Mounjaro, a treatment he is now forced to discontinue pending the review of his request for coverage through the General Healthcare System (GESY), as he has been receiving it privately until now, bearing a significant financial burden himself.
Speaking on the “Alpha News” program, he publicly denounced both the delay in reviewing his request and the way he was treated by officials at the National Health Insurance Organization (OAU).
ΣΧΕΤΙΚΑ ΑΡΘΡΑ
“Since July 6, I have submitted a formal request through my doctor for the Mounjaro medication. My doctor has personally informed me that applications from as far back as last October are still being reviewed. OSAK informed me last week that they are still reviewing cases from October. (…) I personally have filed a request for expedited processing because I’ve been on treatment for 14 months. My endocrinologist won’t let me stop treatment because I’ll experience symptoms.”
He also complains that he was met with “sarcasm” for choosing to begin treatment privately, noting that it saved his life. “Should I apologize for saving my own life?” he asks pointedly.
“And for the social worker—who has no medical training, who isn’t a doctor—to come to the conclusion that my reason for seeking urgent care wasn’t serious.”
He filed a complaint with the OAU, reference number 136106.
“In other words, I’ve lost 50 kilograms with so much effort, and now the OAU is asking me to gain it all back until they approve me.”
He points out that the treatment costs 500 euros a month, emphasizing that he contributes to the National Health System (GESY) and that his condition requires prompt action.
“I’m supposed to give them time. My body isn’t giving me any time. What are we supposed to do now? Let my insulin levels rise, let me gain weight, and develop rheumatic conditions?”
The drug Ozempic is already covered by the National Health System (GESY); however, its prescription is subject to clear restrictions, as explained by Sophia Petridou, a Senior Officer at the National Health Insurance Organization (OAY).
Approximately 2,800 patients are currently receiving the medication through the system, while the National Health Insurance Organization (OAY) receives about 500 new requests per month, according to Ms. Petridou. Nearly 8 out of 10 applications (80%) are approved, while the few that are rejected are usually due to incomplete information provided by doctors, with the option to resubmit.
According to Ms. Petridou, the National Organization for Medicines (OAY) has revised the Ozempic protocol. Although the drug will remain exclusively for diabetic patients, the criteria are expected to be relaxed soon, allowing more patients with diabetes to gain access to the treatment.
Unlike Ozempic, Mounjaro is officially approved for both diabetes and clinical obesity; however, the drug has not yet been fully included in the GESY formulary.
Currently, it is administered through the extremely time-consuming process of individual requests. The treating physician submits a request through the IT system, and a special committee of the National Health Insurance Organization (OAY) reviews the requests one by one based on the international literature.
This process has resulted in a massive backlog. Nearly 1,800 nominal requests have been submitted, yet only 430 have been evaluated so far. Approximately 240 applications have been approved, while about 1,400 requests remain pending, with some patients waiting for months or even a year.
The rejection rate for Mounjaro is significantly higher than for Ozempic, as many applications are rejected because they involve weight loss for cosmetic reasons rather than for serious medical problems related to obesity.
The enormous delay in reviewing applications has left many patients in despair. According to complaints received by the Observatory of the Federation of Cyprus Patients’ Associations (OSAK), many are forced to discontinue their treatment.
The cost of purchasing medication privately outside the General Health System (GESY) is prohibitive, ranging from 450 to 500 euros per week. For a patient with a genuine medical need, paying these amounts out of pocket is impossible, putting their health at risk due to the forced interruption of treatment.
Ms. Petridou acknowledged that the pressure on the system is unprecedented, noting that “what is happening right now with these two medications is without precedent.” To address the delays, the agency has contracted out services to increase the number of staff reviewing applications and speed up the processing. A circular was sent to doctors with guidelines on how to properly complete the applications, so that no time is wasted seeking additional information. A permanent solution to the problem is expected once Mounjaro is fully included in the GESY drug list, which will eliminate the bureaucracy associated with individual approvals. Negotiations with the manufacturer regarding prices and quantities are in their final stages.
Despite strong complaints, the National Health Insurance Organization (OAU) emphasizes that Cyprus is one of the first countries in Europe to choose to include and reimburse medications for treating obesity through the national health system. “We ask for a little more patience,” says Ms. Petridou, assuring that all patients who meet the medical criteria will ultimately receive their treatment.
