DIFFERENCES IN REIMBURSEMENT PRICES AND INEQUALITIES TO ACCESS MOST COMMONLY PRESCRIBED MEDICINES IN BOSNIA AND HERZEGOVINA
Author(s)
Catic T
ISPOR Bosnia and Herzegovina Chapter, Sarajevo, Bosnia
Presentation Documents
OBJECTIVES: Bosnia and Herzegovina have highly decentralized healthcare system which is financed by 12 different health insurance funds (HIF) based on administrative organization of the country. Depending on budget ability different HIFs reimburse different essential medicine causing inequity to access essential medicines. Federal ministry of health tried to unify essential list in 10 different cantons by Order from 2011 but this has never been fully implemented by all 10 cantonal HIFs. In Republic of Srpska (RS) there is one HIF, and 3rd administrative part Brcko District (BD) has its own HIF. METHODS: We compered average reimbursed prices from main HIFs in B&H for most commonly proscribed primary care medicines based on 2014 Annual report on medicines utilization issued by Agency for medicines of B&H. Average prices have been taken into account since different presentation of the same INN (dosage and number of units in pack) are reimbursed. All prices are expressed in EUR and represents prices paid by HIF. RESULTS: Comparing Federal MoH proposed reimbursed prices and prices from RS HIF s it is noted that prices are higher in RS (+20% on average) except in case of bisoprolol. The highest difference is for atorvastatin (+39%). Prices in BD are on average lover for -14% vs Federal prices and -43% vs RSHIF prices. There are high differences among cantonal RB prices comparing to Federal proposal and among main 3 cantons. Atorvastatin is not reimbursed in Tuzla and Zenica Canton, while rosuvastatin is not reimbursed in Tuzla Canton and BD. Also different copayment levels are introduced at cantonal HIF level causing additional inequalities. CONCLUSIONS: Different prices cause inequity to access essential medicines for inhabitants living in different administrative regions. It also impact market indifferences. Implementation of unified and centralized pricing system would positively impact on access to medicines and HIFs spending.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PHP75
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity, Reimbursement & Access Policy
Disease
Multiple Diseases