Huge costs of reimbursement of prescription drugs, ointment worth PLN 200,000. PLN and other absurdities. The National Health Fund intervenes
In Poland, regulation of prescription markets was recently necessary due to abuses. The aim of the changes was to reduce the huge reimbursement costs. What effect have these changes had?
The prescription drug market can be truly absurd. There were situations when the National Health Fund (NFZ) was obliged to pay up to PLN 200,000 for an ointment prepared in a pharmacy (its equivalents are available for a small part of this amount). Currently, the rules of operation of this market have been regulated, but there are new ways to impose huge costs on the National Health Fund.
The costs of reimbursement of prescription drugs were enormous
In January, the prescription drug market was regulated. Previously, however, there had been serious abuses, with some doctors prescribing “inexplicable” amounts of prescription drugs. As a result, in 2023, the average monthly value of reimbursement of prescription drugs by the National Health Fund was over PLN 64 million. Last year, the National Health Fund spent PLN 758 million on reimbursement of receptor drugs, which was a record amount. Please remember that this is actually the money of each insured person.
In the case we disclosed, the doctor issued up to 500 prescriptions a day for a prescription drug. This is a record holder, because the fine for controlling the prescription of prescription drugs amounted to PLN 900,000. PLN, and in addition, law enforcement authorities are also conducting activities in this matter – said Paweł Florek, director of the Office of Social Communication and Promotion.
Further attempts to financially burden the National Health Fund
Regulation of the prescription drug market involved the introduction of maximum prices for raw materials used to make prescription drugs. When the prescription drug market was regulated, in 2024 a significant decrease in costs was noticed on the part of the National Health Fund. Currently, these expenses are five times lower, amounting to PLN 12.4 million. They could be even smaller, but now the National Health Fund is struggling with the financial burden of packaging prescription drugs.
They would be even lower if it were not for the inflated prices of packaging used to prepare prescription drugs. We have noticed that some pharmacies willingly use this mechanism to maximize profits, thus burdening the Fund's budget with higher expenses – explained Paweł Florek.
In 2024, the National Health Fund paid over PLN 3 million only for bottles and tubes for manufactured medicines. It is worth mentioning that this sum is equivalent to the possibility of paying for therapy for 90 patients with lung cancer. An example of such inflated prices is, for example, a sterile bottle, which costs PLN 4, but the National Health Fund has to pay 30 times more for it. The average price of the National Health Fund reimbursement is PLN 132, while the market price is exactly PLN 4.24. In turn, a sterile container-tube (100/140 ml) costs PLN 12 assuming the market price, and for the National Health Fund it costs PLN 137. However, according to the director of the Office of Social Communication and Promotion, all forms of abuse in this matter have been traced and further actions will be taken in this matter, and the first verification activities are already taking place.
