The Draft Announcement of the Minister of Health on the List of Reimbursed Drugs, Foodstuffs for Special Dietary Purposes and Medical Devices, which will come into effect on January 1, 2024, has been published.
There is a draft January list of reimbursed drugs
Published Dec. 8, 2023 15:00
The presented summary of the draft reimbursement notice No. 73 is not its final version, as administrative work is still underway on the final list of reimbursed drugs, foodstuffs for special nutritional purposes and medical devices effective from January 1, 2024.
Taking into account this draft, in the first list in 2024, public funding will be provided for 19 new
molecule-indications, including:
- 8 molecule - oncology indications,
- 11 molecule - non-oncology indications,
- 10 molecule indications dedicated to rare diseases.
The largest number of new oncology molecule indications in 2023 is observed in hematooncology (5), urological cancers (1) and endocrine cancers (1).
The largest number of new non-oncology molecule indications in 2023 is seen in ophthalmology (2), nephrology (2) and neurology (2).
Good news for patients with retinal diseases
Retinal diseases are one of the leading causes of visual impairment and loss worldwide. The most common diseases include age-related macular degeneration (AMD) and diabetic macular edema (DME). Treatment of retinal diseases is provided through a combined drug program, as the same therapies are used for both conditions. They involve administering the drug by injection into the vitreous chamber of the eye. Such injections are initially given every 4 weeks for 3 months, and then the frequency of injections is adjusted according to the type of condition, the effectiveness of the therapy and the drug used. The usual interval between injections is 4 or 8 weeks. Pharycymab, an antibody for intravitreal administration, has appeared in the draft reimbursement list, which allows to extend the frequency of injections up to 16 weeks.
Information on setting limits on A1, A2 and A3 lists
Due to the enactment of the Law on Amendments to the Law on Reimbursement (the so-called DNUR), the pharmacy algorithm, i.e. the various stages of determining wholesale and retail prices and funding limits, has been significantly simplified:
- sorting the list by CZN/DDD (Article 15(4) ),
- The introduction of a wholesale price (CH, Article 2.5 ) designated as CZN + margin (Article 7.1 ),
- The introduction of a gross wholesale price (CHB, Article 2(5a)), designated as CH+VAT,
- The introduction of new pharmacy margins (Article 7(4 ).
All of the above changes have already been implemented on the notice effective November 1, 2023. Along with the incoming comments, a decision was made to further simplify the algorithm, i.e. to change the method of determining the so-called limit base used to determine the retail margin. From January 1, 2024, the value of x[1] will be calculated as: and rounded to 6 decimal places.
The introduction of the modification in question will result in a penny change in retail prices and patient fees.
[1] Article 7(4) The official retail margin calculated on the gross wholesale price of the drug (...) constituting the basis of the limit in a given limit group shall be set at: <table>, where x is the gross wholesale price of the drug (...) forming the basis of the limit, taking into account the number of DDD of the drug (...) in the package, or the number of unit medical devices, or the number of units of the medical device.
Comments on the project can be submitted until 11/12/2023 (Monday) at 10:00 am.
Project: TU
Source: MZ
