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Monitoring of doctor´s prescription in the Czech Republic. Tomas Sechser Daniela Rrahmaniova Ministry of Health Czech Republic. CR PPR 29.10.2007 tosc@volny.cz. Agenda. a) Stabilisation of Public Budgets Act No 261/2007 Coll. - new legislation valid since 2008
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Monitoring of doctor´s prescriptionin the Czech Republic Tomas Sechser Daniela Rrahmaniova Ministry of Health Czech Republic
CR PPR 29.10.2007 tosc@volny.cz Agenda a) Stabilisation of Public Budgets Act No 261/2007 Coll. - new legislation valid since 2008 b) Amendment of Public Health Insurance Act – part 44 c) New Drug Law in 2008 d) Regulatory fees e) Pharmacy f) Generic Substitution g) Rational Pharmacotherapy
CR PPR 29.10.2007 tosc@volny.cz New Drug Law(since the beginning of 2008) • The term of generics „officially“ introduced • vaccines distributed directly to physicians (distributors, manufacturers) • implementation of the EU rules • data on drug consumptions available publicly • drugs prescription for GP, emergency service • introduction of the term OTC – without prescription and specially listed • affordable also outside of pharmacies • without prescription but limited, pharmacist decision
[New Drug Law 2008] CR PPR 29.10.2007 tosc@volny.cz Decree on drug presciption • a limited number of packages (max 3) (exceptions) • electronical prescription (standard receipts only with opiates) • mobile phone of the patient given in the recept • main diagnosis • symbol (!) in the listed cases • higher reimbursement in case of need • necessary and immediate care • covered (paid) by patient • repetition of the prescription
[New Drug Law 2008] CR PPR 29.10.2007 tosc@volny.cz Regulatory Fees • With regulatory fee 30 CZK per receipt • Without regulatory fees • Annual limit 5000 CZK per patient included 30 CZK regulatory fees (not included fees for stay in hospital) (60 CZK per day per patient) • Co-payment (lower than 12%)
[New Drug Law 2008] CR PPR 29.10.2007 tosc@volny.cz Pharmacy • Role of Pharmacy - collection of the regulatory fee, receipt for patient when asked - information of insurance funds - penalties (administrative, disciplinary)
[New Drug Law 2008] CR PPR 29.10.2007 tosc@volny.cz Generic Prescription • Generic substtitution - in case of patient´s asking - the same substance - the same way of administration - the same dosage form - lower co-payment • - symbol „R” change is not allowed
45% 40% 35% 30% 25% 20% 15% 10% 5% 0% CR GB SR I D B DK F ESP NL A CH S PG [Svihovec, Suchopar, 2002] CR PPR 29.10.2007 tosc@volny.cz Role of generics comparison with other European countries (finance)
[Svihovec 2007] CR PPR 29.10.2007 tosc@volny.cz
CR PPR 29.10.2007 tosc@volny.cz Rational pharmacotherapy • Will be precised in a national drug policy • Use the therapeutic interventions the most effective the most safe the cheapest alternative
Clinical Practice Guidelines • Systematically developed statements to assist practitioner and patient decision about appropriate health care for specific clinical circumstances
[citace] CR PPR 29.10.2007 tosc@volny.cz Determination of limits • limit for reimbursement to certain medical specialisations • for a certain health conditions of the patient • determination of the method of reimbursement - on medical prescription - on requisition - by a lump-sum payment
CR PPR 29.10.2007 tosc@volny.cz Conclusion • Health care reform starts at the baseline • Role of health care providers will be cultivated • It seems to be very important feed-back of prescription information • Not only qualitative but also quantitave aspectc of drug prescriptions