PAYING BEYOND COVERAGE: NATIONWIDE REGISTER EVIDENCE ON OUTPATIENT CANCER MEDICINE COSTS AND REIMBURSEMENT IN FINLAND
Author(s)
Heini Kari, PhD, Ripsa Niemi, MSc, Kati Sarnola, PhD, Terhi Kurko, PhD, Hanna Koskinen, PhD.
The Social Insurance Institution of Finland, Helsinki, Finland.
The Social Insurance Institution of Finland, Helsinki, Finland.
OBJECTIVES: Outpatient cancer medicines are widely reimbursed in Finland, yet patients may still face financial burden from co-payments and non-reimbursed medicines. This study examined reimbursement patterns, out-of-pocket costs, and characteristics of outpatient cancer medicine users using nationwide Finnish register data.
METHODS: We conducted a nationwide register study including all individuals with at least one outpatient cancer medicine dispensing in Finland in 2025. Data were obtained from the national Kanta Prescription Centre and the Register of Reimbursable Dispensations under the National Health Insurance scheme. Cancer medicines were identified using ATC codes L01, L02, L04AX02, L04AX04, and L04AX06. Analyses included dispensing volumes, reimbursement status, demographics, income quintiles, and medicine-specific costs and out-of-pocket payments.
RESULTS: The study population comprised 79,258 individuals with 368,557 outpatient cancer medicine dispensings. Of all dispensings, 359,671 (97.6%) were reimbursed and 8,886 (2.4%) non-reimbursed. Overall, 4,939 patients (6.2%) had at least one non-reimbursed dispensing. Patients with at least one non-reimbursed dispensing were markedly younger than those with only reimbursed dispensings (median age 39 vs 72 years), were more frequently female (83.0% vs 56.9%), and were more often represented in the two highest income quintiles. Total outpatient cancer medicine costs were €380.6 million, of which reimbursements covered 98.3%. Patient out-of-pocket payments totaled €6.6 million, including €2.2 million from entirely non-reimbursed dispensings. Total costs were higher among males (€234.4 million) than females (€145.4 million), whereas the share of out-of-pocket costs was slightly higher among females (2.3% vs 1.4%). The highest patient out-of-pocket costs were associated with letrozole (€0.87 million), nintedanib (€0.53 million), and leuprorelin (€0.52 million).
CONCLUSIONS: Despite high reimbursement coverage for outpatient cancer medicines in Finland, patients incurred out-of-pocket costs through co-payments and non-reimbursed dispensings. Non-reimbursed use was more common among younger and female patients. Further research is needed on factors underlying patient cost burden in outpatient cancer care.
METHODS: We conducted a nationwide register study including all individuals with at least one outpatient cancer medicine dispensing in Finland in 2025. Data were obtained from the national Kanta Prescription Centre and the Register of Reimbursable Dispensations under the National Health Insurance scheme. Cancer medicines were identified using ATC codes L01, L02, L04AX02, L04AX04, and L04AX06. Analyses included dispensing volumes, reimbursement status, demographics, income quintiles, and medicine-specific costs and out-of-pocket payments.
RESULTS: The study population comprised 79,258 individuals with 368,557 outpatient cancer medicine dispensings. Of all dispensings, 359,671 (97.6%) were reimbursed and 8,886 (2.4%) non-reimbursed. Overall, 4,939 patients (6.2%) had at least one non-reimbursed dispensing. Patients with at least one non-reimbursed dispensing were markedly younger than those with only reimbursed dispensings (median age 39 vs 72 years), were more frequently female (83.0% vs 56.9%), and were more often represented in the two highest income quintiles. Total outpatient cancer medicine costs were €380.6 million, of which reimbursements covered 98.3%. Patient out-of-pocket payments totaled €6.6 million, including €2.2 million from entirely non-reimbursed dispensings. Total costs were higher among males (€234.4 million) than females (€145.4 million), whereas the share of out-of-pocket costs was slightly higher among females (2.3% vs 1.4%). The highest patient out-of-pocket costs were associated with letrozole (€0.87 million), nintedanib (€0.53 million), and leuprorelin (€0.52 million).
CONCLUSIONS: Despite high reimbursement coverage for outpatient cancer medicines in Finland, patients incurred out-of-pocket costs through co-payments and non-reimbursed dispensings. Non-reimbursed use was more common among younger and female patients. Further research is needed on factors underlying patient cost burden in outpatient cancer care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR68
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity, Public Spending & National Health Expenditures, Reimbursement & Access Policy
Disease
Oncology