THE ACCESSIBILITY OF PHARMACEUTICALS REIMBURSED FROM THE COMPULSORY HEALTH INSURANCE FUND BUDGET IN TERMS OF PRICES IN 2009 −2015

Ligita Vaičaitytė, Gintarė Petronytė

Abstract


This article focus on the accessibility of pharmaceuticals reimbursed from the compulsory health insurance fund (CHIF) budget in terms of prices in 2009–2015. Data on CHIF budget expenditure on reimbursed pharmaceuticals and patients co-payment for pharmaceuticals were obtained from the database of the National health insurance fund under the Ministry of Health.
The major part of CHIF budget expenditure (45–48%) was used to cover the cost of pharmaceuticals for oncology and cardiovascular diseases at 100% and 80% reimbursement level in 2009–2015. CHIF budget expenditure on reimbursed pharmaceuticals and reimbursed per prescription, patients co-payment for pharmaceuticals decreased in 2009–2011, however, these indicators increased in 2012–2015. Patients’ co-payment for reimbursed pharmaceuticals was 26.91% of CHIF budget expenditure in 2009–2015. The highest patients co-payments were paid for cardiovascular diseases pharmaceuticals at 80% reimbursement level whereas the lowest co-payments for oncology pharmaceuticals at 100% reimbursement level. The highest co-payments for reimbursed pharmaceuticals were paid by the patients of working age (18–65) and retirement age (65+). Furthermore, the majorpart of CHIF budget expenditure (95%) was used to cover the cost of reimbursed pharmaceuticals for both patients groups, especially for working age patients.
Although the state government and other government institutions, in implementing the pharmaceutical reimbursement policy, applied various measures to improve accessibility for reimbursed pharmaceuticals, however, the accessibility of reimbursed pharmaceuticals for patients (especially for those of the retirement age of 65+) was ensured in the short term (2009–2011).

Keywords


pharmaceutical reimbursement policy, regulatory measures for reimbursed pharmaceuticals pricing, economic accessibility of reimbursed pharmaceuticals

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DOI: http://dx.doi.org/10.13165/SPV-18-1-10-05

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"Health Policy and Management" ISSN online 2029-9001 / ISSN print 2029-3569