The Supreme Chamber of Physicians is relentless in its efforts to automate the reimbursement process in Poland, which will free doctors from the obligation to determine the degree of drug reimbursement. This administrative obligation not only takes away time that a doctor could spend with a patient, but also exposes doctors to making mistakes unrelated to the profession, but constantly changing reimbursement regulations. What does drug policy look like in Israel, Switzerland and Malta? What solutions should we follow?
Reimbursement from the machine, or how to free Polish doctors from the obligation to determine the degree of reimbursement
Published July 31, 2023 12:10
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Professor Leonid Eidelman of the Israel Medical Association, former president of the World Medical Association WMA and member of the EFMA Liaison Committee; Dr. Jacques de Haller, former president of the Standing Committee of European Doctors CPME and member of the EFMA Liaison Committee; and Dr. Martin Balzan, vice president of the Standing Committee of European Doctors talk about drug policy in Israel, Switzerland and Malta.
IMPORTANT: In none of the countries mentioned is the doctor involved in determining the degree of drug reimbursement.
We have four organizations that provide health insurance for the entire population. Israel has a "basket" (package) of medicines that is regulated by the Ministry of Health. All drugs that are in the basket are free in hospitals. In outpatient care facilities, they are very cheap; in fact, the price difference is small," says Prof. Leonid Eidelman.
He also adds that the problem with prescribing in Israel is a moral one. This is because the doctor can inform the patient about access to medicines outside of the mentioned basket, which the patient can pay for out of his or her own pocket, or remain only with medicines purchased by the Ministry of Health.
In the Swiss system, doctors are also not forced to make a decision regarding the determination of a drug's reimbursement percentage. Doctors have a function in this process in keeping with their profession.
What we can do is specify on the prescription whether it can be a generic rather than the original formulation, and the quantity. I mean the package size, etc., but this does not apply to reimbursement," admits Dr. Jacques de Haller.
In Malta, the government purchases medicines, which it includes on the official list of medicines available for free to all who live (even temporarily) and work in Malta. For rare diseases for which drugs are not on the list, the so-called Presidential Fund applies.
Unfortunately, there are diseases that are rare and expensive in terms of treatment. If a drug is not on the list, the patient has to buy it out of pocket. This can create a problem with access to medicines. In this case, doctors can draw up a special justification. If it is accepted, we have the so-called president's fund. If the president decides that the request is justified, the patient gets the medicine from the public fund," explained the vice president of the Standing Committee of European Doctors.
More: TU
Source: NIL
