The determination of the level of reimbursement requires simplification

– The current system of reimbursement of medicines, foodstuffs for particular nutritional uses, according to which the person issuing the prescription is responsible for determining the level of payment, is dysfunctional! – warn doctors in a letter to Adam Niedzielski, the Minister of Health, Healthcare Employers' Agreement. The PPOZ doctors also turned to Bartłomiej Chmielowiec, Patient's Rights Ombudsman, and Łukasz Jankowski, President of the Supreme Medical Council, for support in sorting out an important topic. – Determining the amount of drug reimbursement requires simplification and automation! – justify in the letters sent.

– Currently, this obligation forces physicians (and other prescribers) to time-consuming verification of payment levels. In the event of a shortage of medical staff, such a situation is unacceptable: it is in the interest of patients that the doctor should be able to devote more time to treatment, and not to unnecessary bureaucracy. In addition, the complicated system of determining payment is conducive to various interpretations, which result in imposing excessive penalties on healthcare providers. Unclear criteria for determining reimbursement levels and high prices finally mean that in the case of drugs available in more than one reimbursement level, patients try to sometimes unjustifiably persuade doctors to prescribe a drug with a specific reimbursement, often using pharmacists' hints. A doctor's refusal results in unnecessary tensions between the patient and the doctor, which may adversely affect the effectiveness of treatment. Once again, we strongly emphasize that the role of a doctor in the health care system is to treat the patient, to provide him with the necessary medicines by issuing a prescription, while the payment for medicines is the problem of the patient and the insurer (collecting premiums) – points out Bożena Janicka, president of PPOZ.

Not without significance in taking decisive action to modify the reimbursement system are numerous inspections carried out by provincial branches of the National Health Fund and the Head Office of the National Health Fund, repeated requests from doctors regarding the prescribed drug and its reimbursement, as well as the imposition of penalties and demands for reimbursement of amounts resulting from prescriptions issued to the patient with reimbursement.

- With a view to providing patients with the best treatment conditions by providing them with the necessary medicines, we believe that joint actions should be taken as soon as possible to modify the drug reimbursement system for patients with various diseases, and thus abolish the obligation to specify on prescriptions, the level of payment by doctors - , justifies Bożena Janicka, adding that the simplification of the reimbursement system and its maximum automation should primarily consist in transferring the obligation to determine the level of reimbursement from medical facilities to other institutions, perhaps pharmacies.

- Pharmacies often advise patients about a different reimbursement, so they may be the ones who, after obtaining information from the patient, are able to quickly and without the risk of mistakes determine the availability in which the drug should be dispensed. The stable staff situation on this market also means that such an obligation will not have a negative impact on other services provided by pharmacies. A good opportunity to introduce changes is the Draft Act Amending the Act on the Reimbursement of Medicines, Foodstuffs for Special Nutritional Purposes and Medical Devices, currently being processed, to which we submitted just these remarks – comment PPOZ doctors.

- We hope that our arguments are convincing enough to make changes urgently. Lack of action on the part of the ministry will force doctors to stop determining the reimbursement. None of us agrees with the unjust imposition of fines and the demand for reimbursement of the amounts for the drugs prescribed to patients - stresses the president, Bożena Janicka.

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