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Financing of expensive therapy

Financing of expensive therapy. Michaela Gajdošová Gabriela Kliešková Ministry of Health Slovakia. Spendings on drugs in % ATC groups. Trend of average reimbursement for one pack size in Sk. Reimbursement of orphan drugs (OD). EU legislation on OD 1999

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Financing of expensive therapy

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  1. Financing of expensive therapy Michaela Gajdošová Gabriela Kliešková Ministry of Health Slovakia

  2. Spendings on drugs in % ATC groups

  3. Trend of average reimbursement for one pack size in Sk

  4. Reimbursement of orphan drugs (OD) • EU legislation on OD 1999 Patients suffering from rare conditions should be entitled to the same quality of treatment as other patients

  5. Types of reimbursement • Drugs in type A Drug which is mainly used in doctor´s ambulance as a part of a doctor´s service and it is accounted from a doctor to the health care insurance companies on a special receipt. Doctors get the drugs from a pharmacy, they pay for them,they administer them to patients and then it is payed back to them from health care insurance companies

  6. Types of reimbursement • Drug in type F Financially demanding drug, mainly „ad manus medici“, mainly drug which costs more than 100 EUR. • For such a drug margins are different: Wholesaler – 4% Pharmacy – 6%

  7. Wholesaler margin 11% Pharmacy margin 21% Wholesaler margin 5% Pharmacy margin 7% Margins Reimbursed drugs type A Vaccines

  8. Types of reimbursement

  9. Reimbursement of orphan drugs (OD) • If reimbursed – with very strict indication limitation • Mainly administred to patients only via specialized centres for expensive treatment

  10. Conclusion • Orphan drugs have no specific strategy of reimbursement • Mainly reimbursed are those drugs which can be administrated by patients

  11. Thank you for your attention

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