1 / 16

LIST OF DRUGS COVERED BY HEALTH INSURANCE FUND OF THE REPUBLIC OF MACEDONIA

This article discusses the positive list of drugs covered by the Health Insurance Fund of the Republic of Macedonia, including generic drugs and reference pricing, aiming to provide high-quality drugs at optimal prices. It also highlights the significance of generic medicines in cost savings and increasing access to affordable treatments. The text emphasizes the collaboration between the HIF and the Ministry of Health for future advancements. -

hedyd
Download Presentation

LIST OF DRUGS COVERED BY HEALTH INSURANCE FUND OF THE REPUBLIC OF MACEDONIA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. LIST OF DRUGS COVERED BY HEALTH INSURANCE FUND OF THE REPUBLIC OF MACEDONIA Ms. Maja Parnardzieva – Zmejkova, MSc, CEO October 2011

  2. Content • Positive list of drugs • Reference pricing of drugs • Some data about amounts for for drugs from the budget of the HIF • Generic drugs • Conclusion and next steps

  3. Republicof Macedonia • Population: 2 040 000 citizens • 1.8 million insurees • Urban population: 66.9% • Area: 25 713 km2 • GDP in 2010: $9.0 billion USD • Government healthcare insurance fund • Mandatory health insurance system • Insurance premium stipulated by law (7.3 % from the gross salary) • Mean life expectancy at birth - Men 71.9 years - Women 76.1 years

  4. Positive list of Drugs (PLD) • Health Insurance Fund (HIF) is a purchaser of health services (2007) • Since 2003 PLD is defined by generic name (INN) • Conflict about the mandate for creating PLD, (HIF vs. MH/ 2009-2011) • New regulation – clear mandate 2011 • For the first time HIF is preparing a rulebook for PLD • PLD to be prepared by a Committee on Positive list, appointed by the Government (13 members) • HIF - secretariat for the Committee on Positive list

  5. Reference pricing of drugs • HIF objective: Health care system to be supplied with high-quality drugs in sufficient quantity and at the best possible prices • HIF established a pricing system for PLD drugs in 2008 (amending the law) • New rulebook based on the comparative methodology for old and new prices for PHC drugs in 2009/2010 • First year - implementation (2010) • Second year – revision (2011) • Pricing process evolves increasing the competition – (positive result for HIF and insurees) • Next step: Revising the Prices for Hospital Health Care drugs from PLD

  6. Comparison of drugs with and without co-payment 2009/2010/2011 • 75% of all drugs with reference price on PHC, are with level of co-payment to 1.5 euro

  7. Expansion at the local pharmaceuticals market Ministry of Health Bureau for drugs 210 manufacturers ( 3 domestic) ~ 250 wholesalers 230 OTC drugs 2700 Rp. /H drugs Total no. of drugs ~ 3000 Pharmaceuticals market in RM

  8. Drugs covered by HIF (2011)

  9. Source: HIF Total No. of Pharmacies in RM in 2011 – 855 (Data Bureau for Drugs) HIF contracted Pharmacies = 750 ( ~90 % ) Primary Health Care: HIF contracted Pharmacies 2008 - 2011

  10. Realization 79 % 90 % 85 % Average 81 % PHC: Comparison of planned and spent amounts (Eur), 2008 -2010

  11. PHC: Effects from the new pricesNumber of prescriptions and amounts 2008-2010

  12. PHC: Consumption by prescriptions / packages / 2008 - 2010 (ATC - third level) A - ALIMENTARY TRACT AND METABOLISM B - BLOOD AND BLOOD FORMING ORGANS C - CARDIOVASCULAR SYSTEM D – DERMATOLOGICALS G - GENITO URINARY SYSTEM AND SEX HORMONES H - SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS J - ANTIINFECTIVES FOR SYSTEMIC USE L - ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS M - MUSCULO-SKELETAL SYSTEM N - NERVOUS SYSTEM P - ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS R - RESPIRATORY SYSTEM S - SENSORY ORGANS

  13. Importance of generic medicines • Offering front-line treatment for key chronic diseases ; • Extending access to affordable quality, safe and effective medicines to more citizens; • Savings in the pharmaceuticals costs, thus enabling free funds to finance innovation; • Incorporating generic medicines with newer formulations and methods of delivery, which in turn provide more available treatments for patients; • Fostering competition in the pharmaceutical market

  14. Conclusions • Generic drugs are dominated on pharmaceuticals market in Macedonia • Creating savings in the pharmaceutical costs, thus providing free sources to finance innovative medications • Transparent procedure for creating Rulebook for PLD for the first time

  15. Next Steps • Close cooperation between the HIF and Ministry of Health • Ministry of Health creates a new methodology for the national limit prices for drugs • New Ministry’s methodology will directly affect the HIF prices and balance out the existing differences

  16. THANK YOU FOR YOUR ATTENTION Ohrid – the city of UNESSCO www.fzo.org.mk majap@fzo.org.mk

More Related