New Drug & Formulary Administration Guidelines
Marek Kos, Deputy Minister of Health, announced on May 22 that the new Reimbursement Act would be subject to external consultations. One of the new things in pharmacy is access to transformative therapies that used to be limited to drug programs. The new rules relax financing caps, rearrange the distribution of utensils and mixtures of finished drugs, renew pharmacy margins and roll out an official drug formulary.

One important difference relates to prescription drugs presented for refund from finished products. This is only available as flat rate if the prescibed dose is lower than the smallest DPC-oriented oral dose. The updated version eliminates that restriction and applies it to all drug products. Limits for financing raw materials will also go up from the 15th to the 25th percentile. This modification is intended to ensure that patients are safeguarded, and to strike a balance in costs for patients and the healthcare payer.

Margins on pharmaceuticals are now to be calculated using non-aseptic-related preparation costs, not aseptic. The Minister of Health will also establish a national formulary to standardizing prescription practices, to aid less experienced physicians and to ensure the consistency of prescriptions.

Less Complex Pharmacy Procedures and Less Administration Burden
The project SZNUR offers solutions for the return of products once expiring the right of reimbursement. Pharmacies will be able to return medicines only when a reimbursement change applies to drugs purchased not more than nine months earlier. This is to avoid buildup of unused medications over the long term.

The NHF will also have more flexibility. Should minor post-inspection recommendations not be adopted by a pharmacy, the NHF may opt to decide not to terminate the contract with the pharmacy immediately in order to avoid denial of the public's access to reimbursed medicinal products.

Office workers in the hospital Pharmacy are expected to have a wider access to the Target Import Service System (SOID), and effectively update and finalise all the requests issued. Pharmacies will no longer be required to provide written explanations when declining to fill orders for some hard-to-come-by medicines, either. Denials will instead be processed through the backend ZSMOPL system.

These changes are a significant step forward in the reduction of the pharmacy operational burden and patient access to critical treatments.