No more ointments for as much as 200k each. The prescription drug market will be regulated

Prescription drugs are one form of treatment funded by the NFS. They are preparations prepared in a pharmacy based on a prescription. They most often come in the form of ointments and solutions for external use. The patient pays a small fee of about PLN 18 for prescription drugs. The lion's share of the cost of these preparations is paid for by the National Health Fund, which in practice means every insured person. It turns out that these reach even tens of thousands of zlotys.

The prescription drug is prepared by the pharmacist. The composition of the drug is stated on the prescription. The pharmacy then issues an invoice for the prescription drug, which is paid by the National Health Service. The ingredients used to prepare prescription drugs are not innovative substances. They have been known for years,. Paradoxically, however, their price, instead of falling, is increasing uncontrollably. A prescription drug for several thousand zlotys in some situations does not differ in composition from a ready-made drug that the patient will buy locally for a maximum of several dozen zlotys.

For a quarter gram of hydrocortisone contained in an ointment prepared for one prescription, the National Health Service would have to pay more than PLN 300. If we order an ointment of similar composition from an online pharmacy, its total cost (not only hydrocortisone) would be about 30 PLN in total.

Prescription drugs have been of interest to the NHF's Inspection Department for years. The main concern is: prescribing prescription drugs despite the presence of ready-made drugs on the market to protect patients with the same clinical conditions. Another issue is also the use of small-weight packaging despite the availability of larger and cheaper packaging, which artificially raised the price of the prescription drug.

Between 2020 and 2023, the NFZ conducted a total of nearly 180 pharmacy inspection proceedings and about 20 proceedings in the area of medical prescription (against 57 doctors). All of them concerned prescription drugs. The total financial impact from the detected irregularities amounted to more than PLN 18 million.

- Most pharmacies that fill prescriptions for prescription drugs work well, but there are "black sheep" here, too. Some pharmacies have turned prescription drugs into a profitable business for themselves, for which we all pay. We also notice inexplicable amounts of prescription drugs prescribed by some doctors. It is worth noting that a prescription drug should be treated as a unitary service, unique and individualized in terms of the clinical condition of a particular patient, the NFZ inspectors admit.

The Health Ministry, seeing irregularities in the area of prescription drugs and an uncontrolled increase in the prices of raw materials necessary for their preparation, decided to regulate this market. That's why the amendment to the Reimbursement Act includes provisions on setting maximum prices for ingredients used in prescription drugs. A list of raw materials along with their prices will be published by the National Health Fund. The changes will take effect on January 1, 2024.

Regulation of the prescription drug market does not mean that the National Health Fund will stop funding them altogether. However, it will make it possible to make prices and expenses more realistic, which today are borne by the Fund, and in fact by everyone who pays a health premium.