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Financing of expensive therapy

Explore the evolving landscape of financing expensive therapy in Slovakia, with a focus on reimbursement of orphan drugs and the impact of EU legislation. Learn about the types of reimbursement and the challenges faced in ensuring quality treatment for patients with rare conditions.

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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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