Why do the prices of one medicine differ in pharmacies?
As a company, a pharmacy covers its expenses only from the purchase of medicines and other goods. The pricing of medicines is strictly regulated
, in accordance with the Regulations of the Cabinet of Ministers No. 803 "Regulations on the Principles of Pricing Medicines". Why does the state compensation state that 100% is reimbursed but must be paid?
If the patient has been prescribed a non-reference medicinal product included in List A of the reimbursable medicinal product. In this case, the patient pays the difference between the pharmacy price of the relevant group of non-reference and reference medicines (including value added tax).
"Reference group" (medicines of different manufacturers with similar active substances) and a reference price is set for each group - the cheapest drug price in this group. It depends on which active substance the medicine contains and how many components the medicine contains. Within the framework of the state system of reimbursable medicines, the state pays the cheapest analogues in
groups where it is possible to replace medicines, in accordance with the discount percentage provided for the diagnosis. This means that the difference between the most expensive and the cheapest analogue is borne by the patient
. This is necessary so that as many patients as possible can receive discounts on medicines under the national reimbursement system.
If a doctor chooses to prescribe a medicine whose price exceeds the reference price in the relevant group, this must be a medically justified decision. It is the doctor's responsibility to inform the patient and to determine the most appropriate medicine that is commensurate with the patient's capabilities.
List B contains medicines that cannot be replaced by other medicines, so its price is reimbursed by the state in accordance with the amount of reimbursement for the relevant diagnosis. Why pay 0.71 cents at 100% state compensation? The patient pays 0.71 euros
for each prescription when purchasing a medicine or medical device included in the list of reimbursable medicines within the reimbursement category. When making payments with a pharmacy, the National Health Service reduces the amount to be reimbursed by the amount paid by the patient.
· Provides free consultations within the competence of a pharmacist, if necessary, coordinating his actions with a doctor.
· Warns of the need to stop self-medication and seek immediate medical attention.
· Is a specialist with higher or secondary pharmaceutical education, whose profession is an essential part of lifelong learning, which also determines the scope of his competence. An example of how the prices of reimbursable medicines were formed! The Amlodipine Accord 5mg N30 pack
contains a reference medicine.
Reference price = 0.59 euros
Pharmacy price (did not differ in pharmacies) = 0.59 euros
PP1 (PP1 - patient supplement in case of 100% reimbursement) the patient receives 100% reimbursement, where only 0.71 euros is
paid for each prescription. Agen 5mg N30 contains
a non-reference medicine.
Reference price (unchanged) = 0.59 euros.
Pharmacy price (did not differ in pharmacies) = 0.99 euros.
PP1 (PP1 - patient supplement in case of 100% reimbursement) the patient receives 100% reimbursement and pays the difference between the reference medicine and the non-reference, which is 0.40 eur
+ 0.71 euro
for each prescription. Total amount = € 1.11. What does the list of reimbursable medicines consist of?
It consists of:
To what extent does the state reimburse medicines?
- List A, which includes medicinal products of equivalent efficacy;
- List B, in which the drugs included in the IBS do not have drugs of equivalent efficacy.
- List C, which includes medicines, the cost of which for the treatment of one patient exceeds 4268.62 euros per year, and the manufacturer undertakes to cover the costs of reimbursement of the medicine for a certain number of patients from its own resources.
The state reimburses the drug at 100%, 75% and 50% depending on the diagnosis. Children are 100% reimbursed for medicines and medical devices
From 2014, medicines and medical devices for children under 18 years of age are paid 100% from the List of Reimbursable Medicines. In the groups of medicinal products of equivalent efficacy, the cheapest medicinal products of equivalent efficacy will be paid for 100% (reimbursement of the 100% cheapest medicinal products for children does not apply to medicinal products included in List M). If the medicine is prescribed for the first time
It is then expected that the doctor will write the generic name of the medicine for the diagnosis on the prescription if the patient is receiving a reimbursable medicine for a specific diagnosis for the first time. In turn, the pharmacist will dispense the cheapest medicine of the relevant generic name in the pharmacy. If the cheapest medicine dispensed in a pharmacy does not provide the desired therapeutic effect, then the doctor will be able to prescribe other medicines, starting with the next cheapest medicine of the corresponding generic name. Updating the list of reimbursable medicines
Physicians are informed about the changes related to the updating of the list of reimbursable medicines both by sending the prepared information material and patients through the media and the NSS website.
The NSS regularly performs the medication already included in the IBS:
- price analysis in comparison with prices in other European Union countries;
- analysis of effectiveness based on the latest scientific data.
It provides an opportunity to:
Establishment of a list of reimbursable medicines
- to achieve a reduction in prices for medicines already included in the IBS, also reducing the patient's co-payment;
- to provide patients with reimbursement of other costs and more therapeutically effective medicines;
- to reduce the costs of reimbursement of medicines included in the IBS by providing reimbursement of medicines to a larger number of patients.
The basic principle of the development of KZS - the list includes therapeutically and cost-effective medicines that comply with international treatment guidelines.
Any manufacturer or distributor of a medicinal product may apply for inclusion in the list of reimbursable medicinal products, indicating also the price of the relevant medicinal product. The National Health Service evaluates each medicine applied for by KZS:
- comparative efficiency. The effectiveness is compared with the effectiveness of other medicines used to treat a particular disease (based on scientific research data, as well as local and international treatment guidelines);
- price. The price of the medicine is evaluated in comparison with the prices in other European Union countries. The price of medicines to be included in the KZS must not be higher than the third lowest among the countries of the European Union and not higher than in Estonia and Lithuania. In addition, the price is compared with the therapeutic benefits of the medicine.
The procedure for reimbursement of medicinal products in Latvia has been established on the basis of Directive 89/105 / EEC of the European Parliament and of the Council (on the transparency of measures regulating the prices of medicinal products for human use and their inclusion in national insurance schemes). The procedure for reimbursement of medicines is determined by the Regulations of the Cabinet of Ministers of the Republic of Latvia no. 899. (31.10.2006) The purchase of reimbursable medicinal products shall be covered by the following categories of reimbursement:
4.1. Category I - Reimbursement of 100% or the reference price for the relevant group (for List A reimbursable medicinal products and medical devices) if the patient is diagnosed with a chronic, life-threatening illness or disease causing severe irreversible disability which requires use to maintain the patient's vital functions;
4.2. Category II: 75% reimbursement or, in the case of reimbursable List A medicinal products and medical devices, 75% of the reference price for the group concerned if the patient is diagnosed with a chronic disease which makes it difficult to maintain vital functions without the use of the medicinal product or causes severe disability;
4.3. Category III: 50% reimbursement or, in the case of List A reimbursable medicinal products and medical devices, 50% of the reference price for the group concerned if the patient is diagnosed with a chronic or acute illness requiring the use of the medicinal product in question to maintain or improve the patient's state of health, or in the case of reimbursement of vaccines.
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