Moving to another country can be scary. Moving to another country and having to take new medication, can be terrifying.
One of the questions I always ask my clients moving to Israel, is what medications are you currently taking? Because Israel has a wildly different health system than the United States, and what you’ve been prescribed by your doctor in the U.S., may not jive with the healthcare system here in Israel.
Case in point: Eliquis- A recentish addition to the medley of cardiovascular medications that is used to prevent blood clots.
In Israel, it is considered a second tiered medication. What do I mean by that? It is a drug that needs to be initially prescribed by a specialist (in this case a cardiologist), for specific reasons. For Eliquis, these are the specified reasons:
1) Prevention of thromboembolism after hip replacement surgery.
2) Prevention of thromboembolism after knee replacement surgery.
3) Prevention of stroke and systemic embolism in patients with atrial fibrillation treated with
warfarin who have experienced a clinically manifested CVA or TIA within the
4) Prevention of stroke and systemic embolism in patients with atrial fibrillation who are treated with warfarin and have a documented high INR.
5) Prevention of stroke and systemic embolism in patients with atrial fibrillation without
valvular disease and a Vasc CHADS2 score of approximately 2 or higher.
6) Short-term treatment for the prevention of stroke and systemic embolism in patients with
atrial fibrillation without valvular disease and a CHADS2 score of
approximately 0 or 1 after rhythm reversal and ablation operations in
7) Treatment and secondary prevention of deep vein thrombosis (Deep Vein Thrombosis – DVT).
8) Treatment and secondary prevention of pulmonary embolism(Pulmonary Embolism – PE)
So if you fit one of those definitions, then the cardiologist can prescribe. If not, don’t despair, you have to ask for special permission, using a form (29gimel) that your doctor completes and submits. The doctor will need to specify why you need Eliquis specifically. So bring documentation from your home country when you come, explaining exactly why this medication (and try to bring a 3 month supply, so you won’t feel stressed about the bureaucratic delays).