Table of contents:
- Coverage of drugs in an EU comparison
- Different criteria for assumption of costs
- The Austrian reimbursement system in an EU comparison
Video: Coverage Of Drugs In An EU Comparison
2024 Author: Wallace Forman | [email protected]. Last modified: 2023-12-17 11:08
Coverage of drugs in an EU comparison
The assumption of costs for pharmaceuticals by social insurance or the public sector is regulated differently in the 28 EU countries. The deductibles - that is the proportion of the cost of a drug that must be borne by the patients themselves - are structured differently.
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- Different criteria for assumption of costs
- The Austrian reimbursement system in an EU comparison
Austria is one of the few EU countries in which the costs for reimbursable medicinal products prescribed by a doctor are fully covered. Austrians only have to pay a flat-rate deductible in pharmacies in the form of the prescription fee. An exemption from the prescription fee is possible under certain conditions.
Different criteria for assumption of costs
In most EU countries and also in Austria, the reimbursement of costs depends on the type of drug in question. In some countries, however, the reimbursement works differently.
Examples: In the three Baltic states Estonia, Latvia and Lithuania, the reimbursement of costs depends on the underlying diagnosis. There are lists of "reimbursable diagnoses". In Denmark and Sweden, the level of reimbursement depends on the patient's previous expenses for medication. Medicines are not reimbursed below a certain amount of expenditure per year. In addition, the reimbursement rates rise and the share of the deductible falls.
The patient's own contribution to the cost of reimbursable drugs is different in the EU countries. The models include reference price systems, percentage deductibles and flat-rate contributions. In practice, the models are partially combined within the framework of a country's reimbursement system.
Reference price systems:Reference price systems have been introduced in numerous EU countries (e.g. Germany, France and Hungary). Reference price systems generally include medicinal products that are grouped together with an identical active ingredient or in therapeutically similar groups. A fixed reimbursement amount, the reference price, is set for these drugs. Usually the reference price corresponds to the cheapest drug in the group. For the other drugs in the group, patients must add the difference to the reference price.
Percentage deductible: For certain drugs, only part of the costs are covered, e.g. France, Finland.
Flat rate contributions from patients:Flat-rate prescription fees are used in 13 of 28 EU countries - including Austria. They are usually paid per prescription and are between around 50 cents and ten euros. In very few EU countries the flat rate is capped annually as in Austria (upper limit for prescription fees).
The Austrian reimbursement system in an EU comparison
Along with Germany, Great Britain, Ireland, Italy and the Netherlands, Austria is one of the few countries in which the costs for reimbursable pharmaceuticals - with the exception of the prescription fee - are fully covered. In the Netherlands there is also a comprehensive reference price system. In the other EU countries, drugs for the treatment of non-life-threatening or non-serious diseases are only partially paid for.
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