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NFZ to Reduce Drug Reimbursement Spending in 2009
28 Jul 08
According to a draft financial plan, presented by Poland's lower house Sejm, the national Health Fund NFZ is to reduce spending on drug reimbursement in 2009 by 1.5% compared to 2008.
Global Insight Perspective | | Significance | Despite NFZ's overall increase of 5.6% on health services funding in 2009, drug reimbursement will be reduced. | Implications | Whereas increases in funding are envisaged for rehabilitation and long-term care, a drop in spending is expected for drug reimbursement. | Outlook | This is bad news for pharmaceutical companies operating in Poland and comes in addition to extra spending that companies had to pay this year for re-registering all pharmaceutical products on the market in line with European Union regulations. |
NFZ to Spend Less on Drug Reimbursement in 2009 According to NFZ chairman Jacek Paszkiewicz, the National Health Fund is intending to raise overall healthcare expenditure in 2009 by 5.6% compared to 2008, of which the highest increases in funding are expected in the areas of rehabilitation and long-term care, whereas drug reimbursement funding is planned to be reduced by 1.5% year-on-year (y/y; see table below). In the second half of 2008, NFZ intends to reform the way it funds primary care where, in addition to capitation fees, payment will also reflect patient health profiles. NFZ projected spending on health services (y/y change %) 2009 | Sanatorium Care | 40.0 | Emergency Treatment and Sanitation | 20.2 | Medical Rehabilitation | 13.9 | Long-Term Care | 13.0 | Mental Care and Addiction Therapy | 10.2 | Primary Care | 8.3 | Orthopaedic Equipment | 5.4 | Prevention | 4.7 | Dental Care | 3.6 | Specialist Out-Patient Care | 3.3 | Separately Contracted Services | 1.7 | In-Patient Care | -0.1 | Reimbursement | -1.5 | Source: PMR, 2008 |
The total amount NFZ intends to spend on healthcare in 2009 stands at 53.6 billion zloty (US$26.1billion), of which spending on drug reimbursement is expected to total 7.2 billion zloty. The latest reimbursement list, as of 16 July 2008, lists for the first time seven parallel imported drugs, including two Parkinson's disease drugs, an antibiotic, epilepsy drug, anti-parasitic drug, cholesterol-lowering medication and infertility treatment (see Poland: 28 May 2008: More Generics Approved for Reimbursement in Poland as Infarma Keen to See Changes). A total of 60 parallel trade drugs are currently available on the Polish market. According to Poland's drugs registration office, URPL, the production of around 1,000 locally-manufactured drugs is expected to be halted in 2009 because of extra expenses associated with re-registration according to European Union standards. Implications and Outlook Extra funding for healthcare services was driven by a higher contribution from mandatory health insurance amid higher employment. It is also part of the Polish government's agenda to reform hospital care in the country where the picture has been frequently dominated by indebted hospitals (see Poland: 13 June 2008: Polish Health Minister Announces Restructuring Plan for Indebted Hospitals). Reduced drug reimbursement funding on the other hand will do little to improve the access of innovative medicines to the reimbursement list, which has traditionally been dominated by cheaper generic medicines (see Poland: 23 June 2008: Polish Pharmacies Enjoy 16% Growth in April as NFZ Increases 2008 Funding by US$23.3bil.) As a whole, the Polish pharmaceutical market is expected to grow 7% y/y in 2008. The outcome of the re-registration of all medicinal products on the Polish market according to European Union (EU) harmonisation requirements is expected to create gaps in certain therapeutic areas. As re-registration for generic medicines will require extra bioequivalence studies, many drug manufacturers are expected to re-register only profitable medicines. The withdrawal of some of these drugs, which may be the cheapest in their respective categories and serve as reference drugs for reimbursement, is expected to push up the price of other drugs, making re-registration worthwhile for certain drug manufacturers.
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