Miraculous medicines: How to pay for them and not go bankrupt

The topic of new and expensive medicines will be at the forefront of social debate in the coming years. The amount of resources in the health system is limited, so there must be good mechanisms to allocate these limited resources to different treatments.

This situation is analysed in our publication Miraculous medicines: How to pay for them and not go bankrupt, which can be downloaded here.

The publication has two main parts.

In the first part, we explain the medicines policy in Slovakia is characterised by several aspects:

• Lower absolute spending but higher relative spending on medicines compared to richer EU countries.
• Traditionally, medicines have been targeted by a large (by volume of savings) part of the expenditure review measures, but they have not been implemented.
• Non-compliance with the rules is common, especially by the Ministry - revisions, price referencing, evaluation of conditional categorisation.
• The quality of data on medicine consumption is questionable.
• Nor is there any theoretical preparation for the arrival of new expensive drugs into the system.
• In the coming years, dozens of medicines will come onto the market that will cost hundreds of thousands of dollars per patient.
• There is a lot of social pressure that leads to unsystematic policy interventions, especially in the area of exemptions.

In the second half of the document, we propose a number of tools to change the situation in medicines policy:

• Finding and picking the low hanging and relatively cheap fruit in the form of better communication with the patient, reducing the combined health and social risk of difficult diagnoses, improving palliative care.
• Linking social and health systems at the communication and competence level, but not at the financial and institutional level.
• Better collection and evaluation of data to inform pharmacoeconomic decisions.
• Strengthening the solidarity function (assistance with catastrophic diagnoses) at the expense of the consumption function (‚everyday‘ diagnoses).
• Preparing the regulatory environment for innovative ways of financing expensive pharmacotherapy - Managed Entry Agreements, annuity repayments, etc. 
• We are opening a discussion on the Innovative Treatment Fund, but we are not coming to a definitive conclusion.