The Lithuanian Ministry of Health has announced that newly adopted amendments to the Government Resolution on Reimbursable Medicines price calculation along with the Reimbursable Medicines Pricelist, which come into effect in July, will help patients and the Compulsory Health Insurance Fund (CHIF) save around €20 million and €9 million per year respectively. The Lithuanian Parliament has also approved the use of ‘mystery shopping’ in pharmacies, thus ensuring the quality of services and patients’ right to full information on medicines is met. We hope that work on increasing trans
parency within the sector will continue, whilst the relaxed funds from decreased generic medicine prices will be used in a far-sighted way, fostering much needed innovative medicines within the Lithuanian healthcare system.
The new reimbursable medicines pricelist
The newly adopted Reimbursable Medicines Pricelist contains 1,991 medicines of which 1,059 have already gone down in price to the new required level. This level demands that the manufacturers’ declared price in Lithuania doesn’t exceed 10 percent of the average of the cheapest comparable medicines (of the same molecule) in reference countries.
The decreased prices are said to be advantageous not only to patients – the introduced level drastically reduced patients’ co-payments for reimbursable medicines – but also to the state, which will save somewhere in the region of €9 million. The Lithuanian Ministry of Health states that this money can be used in reimbursing more innovative medicines for patients with oncological, heart and other complicated diseases who are currently unable to receive much needed treatment. It’s estimated that the inclusion of innovative medicines would be beneficial for thousands of patients.
More issues to address in order to stimulate innovation within the Lithuanian healthcare system
It’s worth noting that until now access to innovative medicines in Lithuania was among the worst, whilst generic and out-of-patent medicines were among the most expensive in Europe. Moreover, in 2016 almost 50 percent of the entire CHIF budget was spent on these medicines alone.
As Lithuania’s population, among many others in the West, continues to decrease and age, fostering innovation in the Lithuanian healthcare system becomes a must, not a luxury. It’s estimated that in 40 years time, healthcare will cost at least two percent than the average GDP, therefore policy makers need to focus on innovative treatment methods, especially in the field of medicine, which bring better treatment results, shorter treatment duration and greater medicine safety which later helps save funds and reduce expenditure.
Pharmaceutical innovators are still facing many obstacles in Lithuania which need to be addressed by both the current Ministry of Health and the Government.
First, decision making on including innovative medicines in the Reimbursable Medicines Pricelist has to be improved and shortened. Although the Law on Pharmaceutical Activities determines a 180-day period for adopting these decisions, in reality it often fails to comply with it, leaving Lithuania dragging far behind Europe’s more advanced reimbursement technologies.
Second, inefficient use of the budget needs to be tackled by a) revising reimbursable medicine lists and subsequently removing ineffective medicinal products, b) ensuring objective, reasonable and clear CHIF budget planning which will eventually help to use funds more efficiently, attract investment and increase savings and c) solving health insurance tax revenue collection to the CHIF budget problem.
Third, only a fully transparent and open system can provide much needed innovation by way of a) governmental decisions becoming more transparent and open, b) a need for the government to cooperate and include pharmaceutical manufacturers in drafting future policies and c) fostering the development of biomedical research, which is fundamental in the development of further innovations.
There are more issues to address and questions to answer for the Ministry of Health in order to further promote innovative and accessible healthcare. The Ministry’s position with regards to long-term, strategic innovative medicine policy remains unclear, as do plans on how to accelerate decision making on the subject of reimbursing innovative medicines. Moreover, the Ministry’s plans regarding the Reserve List, as well as their plans regarding the planning and use of CHIF budget, remain vague.
Rūta Pumputienė, Founder of the Law Firm | RP Law Firm