Starting from April 1st, certain quarterly changes in the list of reimbursed products and limit prices are effective.
A new active ingredient – glimepiride (Amaryl) – is included in the list of reimbursed products of the Health Insurance Fund with a 75% reimbursement rate. This will increase the choice of pharmaceuticals available for the treatment of diabetes.
The possibility for prescribing granisetron (Kytril) with a 100% reimbursement rate will be extended – from April 1st it is reimbursed as a first-line therapy for the prevention of nausea and vomiting in case of anticancer therapy with high emetogenic potential. The drug is used for the treatment and prophylaxis of nausea and vomiting.
The possibility for prescribing salmeterol + flutikason (Seretide Inhaler) for the treatment of asthma will also be extended. Now the drug may also be prescribed with a 75% reimbursement rate for adult patients.
The list of reimbursed products is supplemented with 100% and 75% reimbursement rates with several new generic pharmaceuticals approved in Estonia which will increase the choice of available pharmaceuticals :
1) levothyroxin sodium – pharmaceutical used for the treatment of hypothyroidism ;
2) isotretinoin – pharmaceutical used for the treatment of acne ;
3) carvedilol – pharmaceutical used for the treatment of heart failure ;
4) digoxin – pharmaceutical used for the treatment of heart failure ;
5) budesonide – pharmaceutical used for the treatment of bronchial asthma ;
6) formoterol – pharmaceutical used for the treatment of bronchial asthma and chronic obstructive pulmonary disease ;
7) mesalazine – pharmaceutical used for the treatment of ulcerous colitis and Crohn’s disease ;
8) amlodipine – pharmaceutical used for the treatment of arterial hypertension.
The list of reimbursed products is supplemented with a 50% reimbursement rate with the following pharmaceuticals :
1) alendronic acid + cholecalciferol – pharmaceutical used for the treatment of osteoporosis ;
2) methylprednisolone acetate – pharmaceutical used for the treatment of eczema ;
3) glucosamine – pharmaceutical used for the symptomatic treatment of osteoarthritis ;
4) metformin + glibenclamid – pharmaceutical used for the treatment of diabetes ;
5) bisoprolol – pharmaceutical used for the treatment of heart failure ;
6) bisoprolol + hydrochlorothiazide – pharmaceutical used for the treatment of arterial hypertension ;
7) moxonidine – pharmaceutical used for the treatment of arterial hypertension ;
8) ibadronic acid – pharmaceutical used for the treatment of osteoporosis ;
9) meloxicam – pharmaceutical used for the treatment of rheumatic diseases ;
10) metformin – pharmaceutical used for the treatment of diabetes ;
11) sumatriptan – pharmaceutical used for the treatment of migraine ;
12) terbinafin - pharmaceutical used for the treatment of fungal infections ;
13) mometasone + salicylic acid – pharmaceutical used for the treatment of psoriasis ;
14) tolcapone – pharmaceutical used for the treatment of Parkinson’s disease ;
15) drospirenone + estradiol – pharmaceutical used for hormone replacement therapy.
In total 68 packages of pharmaceuticals will be ......
....... excluded from the list of reimbursed products of the Health Insurance Fund due to discontinued supply or expiration of the marketing authorisation of the product. However, this does not have a negative impact on the availability of drugs and does not impair patients’ treatment as generally these pharmaceuticals are not used by Estonian doctors any more.
Changes in limit prices of pharmaceuticals
Starting from April 1st, limit prices will be for the first time calculated for the following pharmaceuticals :
1) isotretinoin – pharmaceutical used for the treatment of acne ;
2) levothyroxin – pharmaceutical used for the treatment of hypothyroidism ;
3) formoterol – pharmaceutical used for the treatment of bronchial asthma and chronic obstructive pulmonary disease.
In association with the inclusion of new pharmaceuticals in the list of reimbursed products, limit prices will be recalculated in the following active ingredient groups :
1) amlodipine – pharmaceuticals used for the treatment of arterial hypertension ;
2) budesonide – pharmaceuticals used for the treatment of bronchial asthma.
New limit prices will also be calculated in groups where pharmaceuticals that were cheaper than the limit price are not marketed any more (e.g. atenolol), or where the prices of the pharmaceutical have either decreased (e.g. valproic acid, lamotrigine, pravastatin) or increased (desogestrel + ethinyl estradiol).
Influence on the patients
In association with the inclusion of new pharmaceuticals in the list of reimbursed products and subsequent decrease in limit prices, patients’ co-payments for certain pharmaceuticals (first of all original drugs) can increase, but generic preparations containing the same active ingredient will still have the same reimbursement rate. All pharmaceuticals approved in Estonia have proven efficacy, safety and quality ; therefore, it should be possible to find the drug with the most suitable price for the patients in close cooperation between the doctor, pharmacist and patient.
From January 1st, 2006 limit prices were established for two active ingredient groups in association with the inclusion of new generic drugs in the list of reimbursed products: atorvastatin (pharmaceutical used to lower high blood cholesterol level) and lamotrigine (pharmaceutical used for the treatment of epilepsy).
After the establishment of limit prices the manufacturers of original drugs lowered their prices, so that the patient pays exactly the same amount for the drug as last year. Co-payments of patients using generic products were even decreased.
In association with the establishment of limit prices for the atorvastatin active ingredient group, the price of the atorvastatin original preparation (Sortis) changed in the following way :
- Sortis 10 mg 30 tablets : price in 2005 – 319,19 EEK, price from January 2006 – 150,30 EEK
- Sortis 20 mg 30 tablets : price in 2005 – 513,20 EEK, price from January 2006 – 286,50 EEK
In 2006, patients’ co-payments for the antiepileptic drug lamotrigine do not exceed 20 EEK per prescription (as it was in 2005).
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