The price of the reimbursed medicines is identical everywhere

The fixed prices of reimbursed medicines, and fixed margins – these are the major rules of the so-called Reimbursement Act, in force since 1st January 2012.

According to the Department of Health, it provides equal access to medicines. Prior to the Act, some chemist’s shops used various promotions enabling clients to purchase medicines at a preferential price. Such promotions were available only in bigger cities, whereas clients from smaller centres could not take advantage of the discounts.

HOW IS THE PROMOTIONAL LIST OF REIMBURSED MEDICINES PREPARED?

The price and conditions of medicine reimbursement undergo negotiations between the Ministry of Health, represented by the members of Economic Commission, and the pharmaceutical companies. The Commission consists of 17 members (12 representatives of the department and 5 representatives of the National Health Fund (NFZ)). The members of the Commission sign declarations of no conflict of interest, which are then examined by the Central Anti-Corruption Bureau.

The Economic Commission is guided by, amongst other things, recommendations by the Agency for Health Technology Assessment (AOTM), and the price of each medicine used in the latest year before the application for reimbursement was filed.

Applications for the inclusion of a medicine on the reimbursement list are filed by the medication manufacturers themselves. If a pharmacological company fails to respond to the department’s call for the opening of negotiations on the price of the medicines, or to reach an agreement with the Economic Commission on a medicine price, it has to be aware of the fact that the said medicine will not be entered into the new list of reimbursed medicines.

The list of medicines co-financed by the State is updated every second month.

WHAT DOES A MEDICINE PRICE FOR A PATIENT DEPEND ON?

The cost of a reimbursed medicine a patient will be faced with in a chemist's shop depends not only on the fixed official price established by the department and a manufacturer, but also on other factors, like the remuneration group applying to the medicine, the limit on the price, the type of disease, and other patient entitlements.

There are four price categories that patients can take advantage of: free of charge, for a flat-rate fee (PLN 3.20), or with 30% or 50% of the price paid by the patient.

Moreover, the reimbursed medicines are divided into four groups. There is one medicine in each group that sets the limit price. The said price defines the amount up to which the NFZ co-funds medicines from each group. If the price of a medicine exceeds the limit, a patient is left to cover the difference between the limit and the medicine’s retail price.

Some medicines are eligible for discounts only in the case of a chronic disease. However, this fact has to be included in a prescritpion drawn up by a doctor. Also there are groups of patients with special rights, who are entitled to free medicines, e.g. disabled soldiers, and individuals who were victims of repressions.

The fixed margin for chemist’s shops and pharmaceutical wholesale stores is charged additionally to the official price of a medicine.