The government meeting with one break lasted more than 11 hours on Tuesday, which is the longest meeting of this Cabinet of Ministers so far. The government decided on dozens of questions, devoting about two hours to the question of the drug mark-up model.
The government agreed that it could enter into force on January 1 next year. Previously, it was expected that the citizens would be able to see the changes from November 1 of this year, however, after the objections expressed by the pharmaceutical industry for several months, a compromise step was taken, anticipating the changes coming into force next year.
As the LETA agency was informed by the Ministry of Health (MoH), the new mark-up model envisages abandoning the non-transparent percentage approach in the mark-up mechanism for wholesalers and pharmacies, which can motivate pharmacies to sell more expensive drugs to patients instead of drugs of equal effectiveness, which are cheaper. Instead, there will be one fixed markup for all reimbursable drugs and prescription drugs per package regardless of price for wholesalers and fixed markups in three price bands for pharmacies.
The price of the manufacturer’s medicine may not exceed the price in Lithuania and Estonia, the price in the compensation system must also be provided in the pharmacy for prescription drugs outside of compensation. It will be determined that the manufacturer will be able to make price changes only once every 12 months.
In order to strengthen the pharmacist’s role and compensate pharmacies for the drop in revenue, a prescription service fee will be introduced – it will be 75 cents per prescription for a resident. As previously explained by the Ministry of Health, the 75-cent prescription fee is not set as an additional payment that would make the price of the medicine more expensive. In addition, it does not apply to the number of prescription drugs. This means that the patient pays the specified amount only for the prescribed prescription and not for each medication separately.
On the other hand, the state will cover another 75 cents for each prescription service for large pharmacies, and 1.75 euros for small pharmacies. Rural pharmacies, which also fulfill a social function, have a higher service fee, similar to that of family doctors, in order to promote the availability of services.
The Ministry of Interior emphasizes that regardless of the introduction of the prescription service fee, citizens will still feel a significant decrease in prescription prices.
The Ministry of Justice has also provided property relief for certain groups of persons. It is expected that children up to the age of 18 will be exempt from the patient’s prescription service fee. Indigent persons will also be exempted from patient prescription service charges. In addition, except for the medication in installments, the patient’s co-payment for the prescription will be only the first time.
Health Minister Hosam Abu Meri (JV) emphasizes that the main goal of measures to improve the availability of medicines is to make medicines available to patients – by increasing the amount of compensation by setting at least 75% compensation, expanding the range of compensable medicines and diagnoses, as well as changing the hitherto disproportionate drug mark-up system.
He points out that when the new markup model is introduced, the prices of medicines in pharmacies will generally decrease by 15-20%. In Latvia, they will be similar to the other Baltic countries and equal to the prices in the compensation system.
“The industry will have a simple, transparent and sustainable medicine mark-up model and a strengthened role for pharmacists in healthcare and new services,” emphasizes Abu Meri.
The new pricing model will be effective from January 1, 2025. As the Minister of Health previously stated, specialists will monitor the situation and follow the actual implementation of the changes already now and when the new pricing model comes into effect.
On the other hand, by February 1, 2026, a report will be submitted to the Cabinet of Ministers on the analysis performed and the effectiveness and results of the new drug markup model.
The implementation of the new medicine markup model requires additional funding of 1,580,377 euros for 2024, 9,482,256 euros for 2025 and every year thereafter.
During the government meeting, the industry continued to express the previously expressed concerns, stating that the proposed drug price reform is being rushed, and the consultations with representatives of the healthcare industry are formal, not with the aim of discussing, understanding the specifics of the industry and agreeing on the best solutions in essence.
The industry also reiterated that the reform directed by the Ministry of Health envisages a decrease in the number of pharmacies and the availability of medicines to the population.
Prime Minister Evika Siliņa (JV) emphasized that solutions must be sought, because it is clear that we have to face problems that have not been solved for a long time. She did not agree that the MoI did not listen to the industry, because the ministry nevertheless met the call to extend the transitional phase of the model’s entry into force.
In order not to worsen the situation for rural pharmacies, which the industry has previously expressed concern about, Siliņa called to evaluate whether the implementation of the model will not worsen their situation. Economy Minister Viktors Valainis (ZZS) was also of the same opinion, stating that it would be important to develop guidelines that would determine how to act and how to ensure the existence and continuity of these pharmacies in case of any “aggravations”.
Referring to the concerns expressed by the industry about the fact that the amendments do not assess the importance of the services provided by the pharmacist, as well as the uncertainty about what new services pharmacies will be able to provide, Siliņa informed that the Ministry of Health has invested a lot of work and is ready to work on this issue. It is planned that by the end of the year, the ministry will come up with amendments to regulatory acts that will determine what the new services provided in pharmacies could be.
At the press conference held after the government, the Minister of Health informed that by the end of the year, the Ministry, together with the Latvian Pharmacists Association and the Pharmacy Association, as well as small, individual rural pharmacies, will work on guidelines on how to monitor, so that the new drug markup model does not affect their operation in the future.
He admitted that the cooperation with the industry was not easy, but also that the model was difficult to develop, but Abu Meri is sure that the residents will only be better off.
Source: www.diena.lv
