The Ministry of Health plans to negotiate lower prices with pharmaceutical companies under the state-funded drug program, according to statements from the health ministry. The program, which marks its 10th anniversary and was expanded in 2023 to include children and adolescents under 18, pregnant women, and adults aged 65 and over, currently accounts for over 9 billion zlotys in state spending and covers roughly 94 to 96 percent of all drugs on the reimbursement list.
Under the upcoming changes, the state plans to invite pharmaceutical manufacturers to reduce their prices. According to the health ministry, if a drugmaker refuses to negotiate rates, its product could be removed from the free-of-charge list provided that equivalent generic alternatives exist. Products may remain on the list if manufacturers propose adequate pricing. Deputy Health Minister Katarzyna Kacperczyk stated that this shift will restore normality and competitiveness to the system.
Impact on Patients and Substitution Rules
Patients utilizing the program will receive the active pharmaceutical substance rather than a specific branded product to which they might be accustomed. According to the Ministry of Health, individuals may receive medications in different packaging or with alternative brand names containing the exact same active ingredient. Patients seeking to retain their specific preferred brand may be required to pay out of pocket.
When a prescribed medication loses its place on the free-list, patients will not need to secure a new prescription if their current document remains valid. Pharmacists are authorized to dispense a generic substitute without extra administrative steps. However, returning to a doctor’s office becomes necessary if the prescribing physician includes a “do not substitute” note on the prescription.
Implementation Timeline and Savings Targets
The first modifications are slated to take effect on October 1, coinciding with the launch of the new reimbursed drug list. The Ministry of Health estimates that the pricing adjustments will generate savings of approximately one billion zlotys, funds that officials intend to allocate toward financing new medical therapies.
Regarding restrictions on prescriptions, the ministry emphasizes that physicians should only utilize the “do not substitute” note for valid clinical reasons, such as patient allergies to specific ingredients, rather than simple brand preference. Officials state that doctors will be required to explain their clinical recommendations to patients, even when those choices involve financial costs for the individual.
Did You Know? The state-funded drug program in Poland has been active for 10 years and covers approximately 94 to 96 percent of all medications currently included on the official reimbursement list.
Frequently Asked Questions
Who is currently covered by the state-funded drug program?
The program covers children and adolescents under the age of 18, pregnant women, and individuals aged 65 and older, following its expansion in 2023.
What happens if a pharmaceutical company refuses to negotiate prices?
According to the Ministry of Health, if a manufacturer declines to negotiate rates, its product may be removed from the free list, provided that equally effective generic substitutes are available.
Do patients need a new prescription if their medication is removed from the free list?
No, if the existing prescription is still valid, a pharmacist can dispense a substitute medication without requiring the patient to obtain a new document from a doctor.
How will these upcoming pricing negotiations and substitution rules affect your regular visits to the pharmacy?
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