Na léčivé přípravky existuje celá řada, často odlišných, požadavků. Ze strany lékařů a pacientů je zde snaha o individualizovanou farmakoterapii, co nejvýhodnější pro zdravotní stav pacienta. O maximálně efektivní využití svých finančních prostředků se snaží jak zdravotní systém, tak výrobci léčivých přípravků. A proto se může stát, zejména na tak malém trhu jako je Česká republika, že některé léčivé přípravky nejsou pro naše pacienty běžně dostupné. Existují však cesty, jak je zajistit. Stručná pravidla pro použití neregistrovaných léčivých přípravků a způsoby jejich zajištění jsou uvedeny v tomto článku včetně praktických příkladů.
There are diverse demands influencing the availability of medicinal products. Physicians and patients search for the best available individualised pharmacotherapy. Health care systems as well as medicine producers search for the most effective ways of resource allocation. Those are reasons why, especially in the case of a small market such as Czech Republic, some pharmaceuticals may not be directly available. However, there are ways to acquire such medications. This article describes a legal framework for the use of non-authorised medicinal products in the Czech Republic and some examples from every day practise.
OBJECTIVES: To describe and compare price regulation and reimbursement in the Czech Republic and Sweden. METHODS: Legal documents, government reports, statutory information, annual reports and scientific articles were searched using the keywords: pharmaceutical market regulation, drug policy, drug pricing, drug reimbursement and patients' participation in costs concerning both countries. Approaches to regulation and regulatory steps concerning prices were compared between the countries. MAIN OUTCOME MEASURE: (i) Institutional responsibilities in pricing and reimbursement of pharmaceuticals; (ii) principles of patients' participation in costs on pharmaceuticals. RESULTS: Substantial differences were found in terms of pricing. In the Czech Republic, the Ministry of Finance sets maximal prices for pharmaceuticals whereas in Sweden there is a process of price regulation combined with reimbursement decisions taken by the Pharmaceutical Benefits Board. Together with a system of state-owned pharmacies, this ensures that drug prices in Sweden are fixed at the same level throughout the country. In the Czech Republic, prices may differ, since only maximal price levels are set. In both countries, decisions about reimbursement are taken at the national or state level whereas insurance funds or county councils are responsible for covering costs. The private share of pharmaceutical expenditures is substantially lower in the Czech Republic, even though there is no maximal level for patient's co-payment, as there is in Sweden. CONCLUSION: Differences in price setting and some other regulations of the pharmaceutical market were found. Both systems are designed to promote rational use of pharmaceuticals; and are based on social solidarity.
- MeSH
- ekonomické soutěžení organizace a řízení MeSH
- ekonomika farmaceutická MeSH
- financování organizované MeSH
- kontrola nákladů zákonodárství a právo MeSH
- léčivé přípravky ekonomika zásobování a distribuce MeSH
- lidé MeSH
- náklady na léky zákonodárství a právo MeSH
- podíl na nákladech zákonodárství a právo MeSH
- pojištění farmaceutických služeb zákonodárství a právo MeSH
- poplatky farmaceutické MeSH
- programy národního zdraví zákonodárství a právo MeSH
- prospektivní platební systém MeSH
- rozhodování MeSH
- úhrada zdravotního pojištění zákonodárství a právo MeSH
- výdaje na zdravotnictví zákonodárství a právo MeSH
- zákonodárství lékové MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Švédsko MeSH
Objectives: Analysis of participation in drug costs by seniors in the Czech Republic in connection with seniors' access to pharmacotherapy. Materials and methods: Quota-sampled guided interview with 450 respondents visiting pharmacy; ratio of men and women approximately 1:2; age over 60 years; 3 regions of the Czech Republic. Results: Respondent's income was retirement pension in 80 %. More than 55% of respondents did not reach the official state average. Respondents used altogether 1,650 medicines on physician's prescription in the last four weeks. Overall co-payment for medicines was 38,778 CZK, i.e. 86 CZK per patient. Only 27% of respondents used fully reimbursed products. Respondents used together 273 OTC drugs (over-the-counter drugs, e.g. non prescription drugs) in value of 16,540 CZK, i.e. 37 CZK per patient. Average respondent spent on medicines 123 CZK in the last four weeks, i.e. 1.5% of the official state average income. There were respondents, about 10%, searching for the level of co-payment in several pharmacies and more than 8% of respondents had to refuse dispensation of medicines due to co-payment. Conclusions: Our study demonstrates that there are patients who may fail to gain access to medication due to co-payment in the Czech Republic. The financial participation in health care costs is generally low in the Czech Republic (8.8% of total health expenditures) but there were differences in co-payment levels in patients ranging from 1 CZK to thousands CZK. In our opinion problem might be in the absence of any instrument limiting the highest individual participation as it is for example in 12-month period in Sweden. In our study co-payments were lower in smaller communities that may be due to better communication between physicians and patients or physicians and pharmacists. We found a critical ethical problem in different levels of co-payment of concrete product.
- MeSH
- dostupnost zdravotnických služeb ekonomika zákonodárství a právo MeSH
- financování organizované využití MeSH
- interpretace statistických dat MeSH
- náklady na léky statistika a číselné údaje trendy zákonodárství a právo MeSH
- poplatky farmaceutické normy statistika a číselné údaje zákonodárství a právo MeSH
- poplatky lékařské statistika a číselné údaje zákonodárství a právo MeSH
- senioři statistika a číselné údaje MeSH
- Check Tag
- senioři statistika a číselné údaje MeSH
- Publikační typ
- rozhovory MeSH
- Geografické názvy
- Česká republika MeSH
