REVIEW – January 2013

Reimbursed prescription medicines: patient cost-sharing and efforts to reduce it

Authors: Erki Laidmäe

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Mandatory health insurance covers part of the cost of reimbursed prescription medicines in Estonia. Patients also participate in cost sharing. Part of cost sharing can be called unavoidable as it includes two components: the so called prescription fee and mandatory co-payment. The remaining part of cost sharing can be fully avoided as it consists of the cost of medicines which exceeds the reference price. Some studies have shown that patients’cost-sharing is relatively high in Estonia. Several regulatory measures directed to wholesalers, retailers and prescribers have been introduced in recent years. Also, the Estonian Health Insurance Fund has run extensive public information campaigns directed to patients aiming to promote generic medicines and to aid better informed choice in pharmacy while buying prescription medicines. In combination, these measures have been productive as patients’co-payment decreased 17.3% in 2012 (€6.65 per prescription) in comparison to €8.02 per prescription in 2009.