Involvement of patient organizations in reimbursement decisions: Lithuania

1. Involvement of patient organizations in reimbursement decisions: Lithuania Lina Bužermanienė President Lithuanian Council of Asthma Clubs With the help of Eglė Kvedaraitė, Lithuanian Association of Asthma Clubs

2. Reimbursement in Lithuania Elligibility for reimbursement • Certain diseases • Certain social groups 3 lists • List of medications for certain diseases • List of medications (for certain social groups) • List of medical devices 14th EFA Conference, Vilnius

3. Asthma medication in the list (100 percent reimbursement) • Beclomethasonum • Budesonidum • Budesonidum et Formoterolum • Fenoterolum • Fluticasonum • Flunisolidum • Formoterolum • Ipratropii bromidum • Ipratropii bromidum et Fenoterolum • Ipratropii bromidum et Salbutamolum • Natrii cromoglicas • Natrii cromoglicas et Fenoterolum • Natrii montelucastum (kids only) • Natrii nedocromilas • Prednisolonum • Salbutamolum • Salmeterolum • Salmeterolum et Fluticasonum • Theophyllinum 14th EFA Conference, Vilnius

4. Allergic rhinitis medication in the list (children only,80 percent) • Beclomethasonum • Budesonidum • Cetirizinum • Ebastinum – for kids over 12 years old • Fluticasonum – drops for kids over 16 • Natrii cromoglicas • Mometasonum furoatum • Natrii nedocromilas • Loratadinum 14th EFA Conference, Vilnius

5. COPD medication in the list (80 percent reimbursement) • Beclomethasonum • Budesonidum et Formoterolum • Flunisolidum • Fluticasonum • Formoterolum • Ipratropii bromidum • Ipratropii bromidum et Fenoterolum • Ipratropii bromidum et Salbutamolum • Salbutamolum • Salmeterolum • Salmeterolum et Fluticasonum (50 mcg • Salmeterolums and 500 mcg flutikasonum) • Formoterolum • Tiotropii bromidum 14th EFA Conference, Vilnius

6. Dermatitis medication in the list Severe atopic dermatitis (80 percent) • Ac.fucidinicum et Hydrocortizonum for kids • Fluticasonum • Methylprednisolonum • Mometasonum furoatum Moderate atopic dermatitis(80 percent) • Pimecrolimus Prescribed by doctor allergologist, dermatologist,clinical immunologist when corticosteroid treatment is not suitable due to side effects or 3 months treatment by corticosteroids is not effective. Allergic contact dermatitis (50 percent) • Fluticasonum • Methylprednisolonum • Mometasonum furoatum • Prednisolonum tab. and inj. 14th EFA Conference, Vilnius

7. Medical devices (100 percent reimb.) • Spacers for inhaling of asthma medication –for kids up to 7 years old with asthma diagnosis 1 metal spacer or 2 plastic spacers (1 plastic spacer every 3 years). Can be prescribed only by childrens pulmonologist. 14th EFA Conference, Vilnius

8. Planned changes in reimbursement system

9. Problems Only 1 third of population is elligible for reimbursement Part of those who are elligible – have no money to pay the rest of price 14th EFA Conference, Vilnius

10. Council of Representatives of Patients’ Organizations of Lithuania • 26 patients organizations joined an umbrella; 2 asthma patients organizations are members • www.pacientutaryba.lt/ 14th EFA Conference, Vilnius

11. Patients’ representatives at: • Compulsory Health Insurance Council • Disease and Reimbursed Medication List Adjustment Committee • Working Group for Medication Reimbursement Strategy 14th EFA Conference, Vilnius

12. Very little effect, patients opinions very rare taken into account Reform that is executed in the healthcare sector is still not patient-centered No transparency, no trust in health care system Present: more formal way of involving Our wish / future: to be treated as partners and valuable source Result for now Present and future 14th EFA Conference, Vilnius

13. Thank you for your attention! Welcome in Vilnius 14th EFA Conference, Vilnius