OBJECTIVES

: Bosnia and Herzegovina (B&H) has decentralized healthcare system with two major public health insurance funds (HIFs) on entity level. Since 2017 maximal price are regulated expecting to ensure savings for HIFs.

Objective of this study is to evaluate effect of price control on top twenty reimbursed drugs by HIFs.

METHODS

: Prices for top twenty medicines reimbursed by HIF in Federation of B&H (FB&H) and Republic of Srpska (RS) are compared before and after implementation of price regulation. We have analyzed percentage of savings and impact of the price ordinance on reimbursement prices and reimbursement prices differences among two entities - FB&H and RS.

RESULTS

: Twenty INNs identified with 48 different dosages that are mostly prescribed and reimbursed by HIFs. Before implementation of price control, in FB&H 54% reimbursed medicines had higher price, 40% lower and 6% on the same level vs regulated with average price per unit-pack of 9,48€. After implementation of price regulation for 54% of medicines price was decreased 46% had already lower price kept or did not have impact, none of reimbursed medicines exceed maximum allowed price with average price per unit-pack 8,30€.

In RS price ordinance still not implemented; 60% have higher and 40% lower price than regulated. Average price per unit-pack in RS is 10,76€. Comparing to FB&H, 65% of drugs have higher and 23% lower price in RS.

CONCLUSIONS

: Price control mechanism ensured savings for HIF in Federation of B&H, while in Republic of Srpska price control mechanism is still not implemented. There are significant differences in reimbursed prices between entities. It is expected that implementation of price control in future will additionally result in price decreases and potential savings for HIFs.