Patient welfare vs drug policy

During the debate, the issue of child nutrition was raised in terms of the so-called undue reimbursement of food products and related penalties imposed on doctors, including the high-profile case of prescribing milk replacers. It was emphasized, among other things, that doctors ordering non-reimbursed preparations acted in accordance with the latest medical knowledge, solely for the benefit of the patient, and did not exploit the situation for their own benefit. - The National Health Fund did not suffer losses, instead our patients avoided complications and hospitalizations, unnecessary suffering and treatment costs," stressed speakers Andrea Horvath and Aleksandra Kindracka, representing doctors penalized for undue reimbursement.

- We don't see any reason for us to be responsible for the minister's decisions, which are not really understood," said NRL Vice President Klaudiusz Komor, commenting on the doctor's obligation to specify the degree of reimbursement on prescriptions. He presented the unalterable position of the medical self-government on the reimbursement system in Poland, in which it was pointed out, among other things, that the scale of the problem clearly shows the need for the organizers of the health care system to take quick and decisive action to lift this obligation from doctors, through the automation of the reimbursement determination system already advocated by the medical community.

In his lecture, Prof. Grzegorz Grześk, a member of the Drug Policy and Pharmacotherapy Team of the Supreme Medical Council, pointed out that current drug policy is sometimes at odds with patient welfare. - As doctors, we are obliged to treat well, to treat effectively, and the patient must have access to modern solutions so that we can also treat in accordance with current medical knowledge, he said.

Patients and representatives of patient organizations stressed, above all, the importance of trust in the doctor-patient relationship, and that they do not want to go to doctors who, through legislative restrictions, will consider the possible legal or financial consequences of treatment, rather than the treatment itself. The discussion concluded that reimbursement criteria need to be changed because they are too complicated, in view of which it is easy to make mistakes or misunderstandings.

Conclusions:

• It should not be the doctor's duty to mark the degree of reimbursement on the prescription. The Minister of Health should fulfill the obligation from the agreement with the OZZL Residents' Agreement of February 8, 2018 2018 (paragraph 16).
• The degree of computerization of health care processes now allows the reimbursement determination process to be automated.
• A doctor should not be afraid to issue a prescription for a drug that a patient needs. Difficulties in determining the level of payment should not further hinder this decision.

Postulates:

• Establish a panel of experts to objectively and substantively evaluate medical recommendations for continuing treatment of children with allergies with milk replacer not covered by reimbursement indications.
• Deciding to rescind the fines and interest imposed on doctors when the panel confirms the medical legitimacy of the measure. An assessment that is independent of the influence of NHF officials would help dismiss unfair accusations of alleged fraud against doctors, as well as better understand the situation of patients.
• Any checks on the correctness of the prescription should be carried out promptly and efficiently, so that the protracted inspection process does not result in the accumulation of wrongful interest and the unconscious repetition of the error.
• Support for the appeal by representatives of the Medical Council (Appeal No. 2/23/P-IX of the Presidium of the Supreme Medical Council of February 10, 2023 to the Minister of Health to exempt doctors from the obligation to specify the level of reimbursement on their prescriptions) regarding the complete exemption of doctors from the obligation to indicate the scope of reimbursement for drugs and special medical purposes. Administrative issues should not and cannot divert doctors from their primary duty to provide medical services and take up a doctor's time that could be devoted to the patient.

Source: NIL