After two hours of debating, the government on Tuesday approved a new mark-up system for medicines intended to reduce the prices of prescription medicines.
At the same time, the government agreed that the new system could come into force on January 1, 2025, giving time to prepare for the changes. Previously it was planned to introduce the new mark-up system from November 1 this year, but after months of objections from the pharmaceutical industry, a compromise solution was agreed, with the changes coming into force next year.
According to the Ministry of Health, the new mark-up system will abandon the non-transparent percentage approach to the mark-up mechanism for wholesalers and pharmacies, which can motivate pharmacies to sell more expensive medicines to patients rather than cheaper equivalents. Instead, there will be one fixed mark-up per pack for all reimbursable medicines and prescription medicines, regardless of the price, for wholesalers, and fixed mark-ups in three price bands for pharmacies.
The price of manufacturer medicines will not exceed the price of the same drugs in Lithuania and Estonia, and the price in the reimbursement system must also be guaranteed in the pharmacy for non-reimbursed prescription medicines. It will be stipulated that a manufacturer will only be able to make price changes once every 12 months.
To strengthen the role of pharmacists and to compensate pharmacies for the loss of revenue, a prescription service charge will be introduced – 75 euro cents per prescription for individual buyers. As the Health Ministry explained, the prescription charge of 75 cents is not set as an additional charge that would make the price of medicines more expensive. Moreover, it does not apply to the number of medicines prescribed. This means that the patient only pays the amount for the prescription, not for each medicine separately.
However, the state will cover another 75 cents for large pharmacies and EUR 1.75 for small pharmacies for each prescription. Pharmacies in rural areas, which also have a social function, will be charged a higher service fee, similar to that charged to GPs, to encourage access to services.
The Health Ministry stresses that regardless of the prescription charge, citizens will still see a significant reduction in prescription prices.
The ministry has also foreseen special incentives for certain groups of people. Children under 18 years of age will be exempted from the prescription service charge. Low-income people will also be exempted from the prescription charge.
Health Minister Hosam Abu Meri (New Unity) said that the main objective of the measures is to make medicines more affordable for patients – by increasing the reimbursement rate to at least 75 percent, expanding the range of reimbursable medicines and diagnoses, and changing the previously disproportionate system of mark-ups on medicines.
He points out that the new mark-up system will reduce the prices of medicines in pharmacies by an average of 15-20 percent. Prices in Latvia will be similar to those in the other Baltic countries and on par with the reimbursement system.
“The sector will benefit from a simple, transparent and sustainable medicines mark-up model, a strengthened role for pharmacists in healthcare and new services,” Abu Meri said.
The new mark-up model will be effective from January 1, 2025. Experts will monitor the situation and follow the actual implementation of the changes.
By February 1, 2026, they will report to the government on the analysis carried out and the effectiveness and results of the new mark-up system.
Additional funding needed to implement the new mark-up model is EUR 1,580, 377 in 2024, EUR 9,482,256 in 2025 and in following years.
Source: BNS
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