Prescription drugs. Health Ministry estimates scale of abuse

In reference to the results of the National Health Fund's inspections of prescription drug reimbursement abuses, which showed the huge scale of irregularities in this area, the Minister of Health and its subordinate bodies have taken action - both control and legislative - to eliminate improper phenomena in this area.

"It should certainly be considered an irregularity, as the payer points out in its communication*, for one authorized person to issue 500 prescriptions per day for prescription drugs, the cost of which is borne by all citizens who pay public premiums," reads the MZ website.

As indicated by the National Health Fund, in 2023 it spent a record over PLN 758 million on reimbursing prescription drugs. The amount indicated is not solely the result of irregularities, as there is a certain group of patients who, due to the very individual course of certain disease entities, require the use of a drug prepared in a pharmacy based on a doctor's prescription, i.e. a prescription drug. However, the sharp increase in the amount of reimbursement in this regard and the numerous irregularities identified raise objections from both the Minister of Health and the public payer, whose task is to optimize the use of limited funds dedicated to health policy.

"Against such practices should be every citizen who is aware that even the smallest amount depleting health care systems - with a purpose other than to meet the actual and not non-existent needs of patients, limits access to services including diagnostics, prevention, rehabilitation, drug therapies or all other types of services aimed at improving the health of society or preventing diseases and adverse health phenomena. Unfortunately, there is a group of people - balancing in their actions on the border of the law, abusing public trust and acting to the detriment of all fellow citizens," according to the health ministry.
In the first stage of the measures taken, the Minister of Health introduced, similar to the rules in effect for finished medicines, regulations on the maximum cost of pharmaceutical raw materials used in the preparation of prescription drugs, which brought the expected benefits in the form of a decrease in medically unjustified public spending.
In the initial stage, unfortunately, also patients actually requiring the use of prescription drugs, incurred increased costs (resulting from the need to incur surcharges in the case of raw materials purchased at prices above the established limit) associated with the need to normalize the situation described. In this regard, the situation has normalized by adjusting prices to the applicable raw material limits by manufacturers.
Unfortunately, the dishonesty of those carrying out the described abuses has led, in response, to artificially inflating the prices of packaging used to store manufactured prescription drugs and increasing the cost of finished drugs used in prescription practice. As cited by the National Health Service in its announcement:

"a bottle of sterile costs more than 4 zlotys, the National Health Fund paid for it 31 times more
&
for a pack of Linomag (liquid) the National Health Fund pays 302 zlotys, while the market price of an identical preparation is just over 17 zlotys."

The analytical and inspection teams of the National Health Funds are constantly monitoring the situation and taking appropriate action, as well as referring cases to other State Services when warranted.
In view of the above, the Minister of Health has decided to take further legislative and regulatory action to introduce a limit on public spending on packaging and ready-made medicines - used in the preparation of prescription drugs.
The Minister of Health hopes that both the increase in public awareness in this area, the actions taken - both control and legislative - will lead to the normalization of the described situation, which will allow public funds to be spent to meet the real health needs of citizens.

compiled based on: MZ