DISTRIBUTION OF PHARMACEUTICALS REIMBURSED AT A 50% RATE BY ANATOMICAL THERAPEUTIC CHEMICAL (ATC) GROUP IN ESTONIA, 2023-2026: AN ANALYSIS USING ESTONIAN HEALTH INSURANCE FUND (EHIF) DATA
Author(s)
Guvenc Kockaya, MSc, PhD, MD1, Yagmur Faiz, BSc2, Nurseda Akgül, BSc2, OZNUR SEYHUN, BSc, MFE, MSc1, Selin Okcun, MSc3.
1Econix Research, Tallin, Estonia, 2Econix Research, İstanbul, Turkey, 3Health Economist, Econix Research, İstanbul, Turkey.
1Econix Research, Tallin, Estonia, 2Econix Research, İstanbul, Turkey, 3Health Economist, Econix Research, İstanbul, Turkey.
OBJECTIVES: In Estonia, pharmaceutical reimbursement rates of 50%, 75%, and 100% are determined by diagnosis, disease severity, therapeutic value, and patient eligibility, with higher reimbursement generally applied to essential medicines for serious or chronic conditions. This study aimed to evaluate the distribution of pharmaceuticals reimbursed at a 50% rate across ATC groups using EHIF data.
METHODS: A descriptive reimbursement analysis was conducted using ‘EHIF Medicine Reimbursement List’ from 2023 to 2026, with data compiled in Excel and analyzed at the package level using *ravimikood* as the unique package identifier. Duplicate records were excluded for package-level counts; however, reimbursement categories were analyzed as non-mutually exclusive, since a single package may be reimbursed at different rates depending on indication or reimbursement criteria.The number and percentage share of pharmaceuticals reimbursed at 50% were calculated by ATC group and year, with emphasis on the ATC groups representing the largest shares.
RESULTS: Among pharmaceuticals reimbursed at a 50% rate, the total number of pharmaceuticals was 1,256 in 2023, 1,305 in 2024, 1,273 in 2025, and 1,305 in 2026. For the years 2023 through 2026, the number of pharmaceuticals in ATC group C was 311; 328; 303; and 315, respectively, corresponding to 24.76%; 25.13%; 23.80%; and 24.14%. For the same years, ATC group N included 233; 251; 254; and 258 pharmaceuticals, corresponding to 18.55%; 11.11%; 19.95%; and 19.77%. ATC group A included 130; 145; 126; and 115 pharmaceuticals, corresponding to 10.35%; 19.23%; 9.90%; and 8.81%. ATC group G included 104; 104; 104; and 103 pharmaceuticals, corresponding to 8.28%; 5.06%; 8.17%; and 7.89%.
CONCLUSIONS: Pharmaceuticals reimbursed at a 50% rate remained relatively stable between 2023 and 2026, with peak counts observed in 2024 and 2026. ATC Group C consistently represented the largest share, followed by Group N. Groups A and G also contributed notable proportions, although Group A declined over time.
METHODS: A descriptive reimbursement analysis was conducted using ‘EHIF Medicine Reimbursement List’ from 2023 to 2026, with data compiled in Excel and analyzed at the package level using *ravimikood* as the unique package identifier. Duplicate records were excluded for package-level counts; however, reimbursement categories were analyzed as non-mutually exclusive, since a single package may be reimbursed at different rates depending on indication or reimbursement criteria.The number and percentage share of pharmaceuticals reimbursed at 50% were calculated by ATC group and year, with emphasis on the ATC groups representing the largest shares.
RESULTS: Among pharmaceuticals reimbursed at a 50% rate, the total number of pharmaceuticals was 1,256 in 2023, 1,305 in 2024, 1,273 in 2025, and 1,305 in 2026. For the years 2023 through 2026, the number of pharmaceuticals in ATC group C was 311; 328; 303; and 315, respectively, corresponding to 24.76%; 25.13%; 23.80%; and 24.14%. For the same years, ATC group N included 233; 251; 254; and 258 pharmaceuticals, corresponding to 18.55%; 11.11%; 19.95%; and 19.77%. ATC group A included 130; 145; 126; and 115 pharmaceuticals, corresponding to 10.35%; 19.23%; 9.90%; and 8.81%. ATC group G included 104; 104; 104; and 103 pharmaceuticals, corresponding to 8.28%; 5.06%; 8.17%; and 7.89%.
CONCLUSIONS: Pharmaceuticals reimbursed at a 50% rate remained relatively stable between 2023 and 2026, with peak counts observed in 2024 and 2026. ATC Group C consistently represented the largest share, followed by Group N. Groups A and G also contributed notable proportions, although Group A declined over time.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR107
Topic
Health Policy & Regulatory
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas