Patients save millions, but there is a deficit in the medicine budget

As of April 1 this year, the procedure for prescribing state reimbursable medicines has been changed – the doctor now indicates the name of the active substance instead of a specific medicine in the prescription, while pharmacies dispense reimbursable medicines with the lowest price from medicines with the same effect. They are equally high quality, effective and safe, according to the State Agency of Medicines. The Minister of Health Ilze Hänķele admitted to the Independent that the decision to carry out this reform in the spring of this year, when the new coronavirus epidemic began in Latvia, was correct, because by postponing the introduction of the new procedure indefinitely, there were fears that it would never be implemented. According to the Minister, the benefits are obvious, as patients’ co-payments are significantly reduced by purchasing medicines of the same effectiveness, but without overpaying. The savings generated by this new system will allow patients to save, but at the same time the savings generated on the national side will make it possible to add new medicines to the list of reimbursable medicines. The Minister of Health admits that also this year a budget deficit is developing in the “wallet” of reimbursable medicines, because more and more patients need and the right to receive state-reimbursed medicines.

The co-payment is halved

The State Agency of Medicines has compiled data on the new procedure for prescribing medicines. The main conclusion is that patients save more than one million euros every month in co-payments for state reimbursable medicines. In total, since April 1, patients have saved 5.05 million euros in co-payments, but patients’ co-payments for one prescription have decreased on average by 1.60 euros.

Patients’ average additional payment or co-payment for one prescription decreased by 45 percent in June, by 46 percent in July, and by 48 percent in August..

For example, ain August, it has decreased from 3.60 euros to 1.88 euroscompared to August 2019. Patients’ co-payment for one prescription has decreased on average by 1.60 euros between 1 April and 1 September this year.

“When it became known that the new procedure for prescribing reimbursable medicines would come into force on April 1, the manufacturer reduced the price of 250 reimbursable medicines, including 50 medicines that already had the lowest price, ”says Dita Okmane, a specialist of the State Agency of Medicines. On 1 May 2020, prices were reduced for a further 18 medicines, on 1 July for a further 75 medicines and on 1 September for a further 45 medicines.

Deleted but also included

During the period from 1 February 2019 to 1 July 2019, 81 medicinal products were removed from the list of reimbursable medicinal products before the change of the system, but after the change of the system during the period from 1 February 2020 to 1 July 2020, 99 medicinal products. In turn, 70 new medicines are included in the list of reimbursable medicines. Consequently, concerns that the new regime will lead to the removal of medicines from the list of reimbursable medicines have not been confirmed. On the contrary, it has contributed to lower drug prices and the availability of lower-priced medicines.

The State Agency of Medicines has also received more reports of adverse drug reactions. No Between 1 April and 30 June 2020, 175 doctors and pharmacists and 20 patients reported adverse drug reactions. This is indeed at least twice as much, as in 2019 in total, the State Agency of Medicines received only 61 adverse reactions from doctors and pharmacists and 48 patients. “Analysis of the reports shows that the reported side effects are already indicated in the summary of product characteristics and package leaflet as mainly minor side effects, ie they are already known and intended,” says D. Okmane. “Although the number of reports has increased, Adverse reaction reporting activity in Latvia is still low compared to countries such as France, Denmark and the Netherlands, where the number of adverse reaction reports per 1,000 inhabitants is several times higher than the annual number of reports received in Latvia. ”

That’s why

The State Agency of Medicines and the Ministry of Health continue to invite the population to report any observed side effects that may have been caused by the medicinal product to both a doctor or pharmacist and the State Agency of Medicines.

and recalls that, if medically justified, a doctor can still prescribe a specific reimbursable medicine in 30% of cases, indicating the trade name of the medicine.

90% follow the new order

Statistics also show that in April, May and June this year, medical practitioners used active substances or international non-proprietary names in prescriptions for reimbursable medicines prescribed in almost 90 percent of cases. By comparison, in March 2020, when the new procedure had not yet entered into force, the name of the active substance was used in only 16% of cases when prescribing medicines under the reimbursement procedure.