DISTRIBUTION OF PHARMACEUTICALS REIMBURSED AT A 100% RATE BY ANATOMICAL THERAPEUTIC CHEMICAL (ATC) GROUP IN ESTONIA, 2023-2026: AN ANALYSIS USING ESTONIAN HEALTH INSURANCE FUND (EHIF) DATA
Author(s)
Yagmur Faiz, BSc1, Selin Okcun, MSc2, Filiz Darici, MSc1, OZNUR SEYHUN, BSc, MFE, MSc3, Guvenc Kockaya, MSc, PhD, MD3.
1Econix Research, İstanbul, Turkey, 2Health Economist, Econix Research, İstanbul, Turkey, 3Econix Research, Tallin, Estonia.
1Econix Research, İstanbul, Turkey, 2Health Economist, Econix Research, İstanbul, Turkey, 3Econix Research, Tallin, Estonia.
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 100% 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 100% were calculated by ATC group and year, with emphasis on the ATC groups representing the largest shares.
RESULTS: Among pharmaceuticals reimbursed at a 100% rate, the total number of pharmaceuticals was 865 in 2023, 912 in 2024, 987 in 2025, and 1,023 in 2026. For the years 2023 through 2026, the number of pharmaceuticals in ATC group L was 252; 271; 296; and 311, respectively, corresponding to 29.13%; 29.71%; 29.99%; and 30.40%. For the same years, ATC group N included 231; 201; 208; and 209 pharmaceuticals, corresponding to 26.71%; 22.04%; 21.07%; and 20.43%. ATC group B included 78; 113; 134; and 134 pharmaceuticals, corresponding to 9.02%; 12.39%; 13.58%; and 13.10%. ATC group C included 86; 90; 100; and 95 pharmaceuticals, corresponding to 9.94%; 9.87%; 10.13%; and 9.29%.
CONCLUSIONS: The 2023-2026 trajectory indicates steady growth in pharmaceuticals reimbursed at a 100% rate. ATC Group L consistently dominated, while Groups N, B, and C contributed notable shares. In conclusion, full reimbursement remained concentrated within selected therapeutic domains, reflecting targeted formulary expansion rather than uniform therapeutic growth.
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 100% were calculated by ATC group and year, with emphasis on the ATC groups representing the largest shares.
RESULTS: Among pharmaceuticals reimbursed at a 100% rate, the total number of pharmaceuticals was 865 in 2023, 912 in 2024, 987 in 2025, and 1,023 in 2026. For the years 2023 through 2026, the number of pharmaceuticals in ATC group L was 252; 271; 296; and 311, respectively, corresponding to 29.13%; 29.71%; 29.99%; and 30.40%. For the same years, ATC group N included 231; 201; 208; and 209 pharmaceuticals, corresponding to 26.71%; 22.04%; 21.07%; and 20.43%. ATC group B included 78; 113; 134; and 134 pharmaceuticals, corresponding to 9.02%; 12.39%; 13.58%; and 13.10%. ATC group C included 86; 90; 100; and 95 pharmaceuticals, corresponding to 9.94%; 9.87%; 10.13%; and 9.29%.
CONCLUSIONS: The 2023-2026 trajectory indicates steady growth in pharmaceuticals reimbursed at a 100% rate. ATC Group L consistently dominated, while Groups N, B, and C contributed notable shares. In conclusion, full reimbursement remained concentrated within selected therapeutic domains, reflecting targeted formulary expansion rather than uniform therapeutic growth.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR167
Topic
Health Policy & Regulatory
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas