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08-05-2025

Improved Access to Treatment: More Medications Reimbursed, Fewer Barriers

Iliustracija

In Lithuania, the number of users of reimbursable medicines and medical aids (MA) is steadily increasing, and the amount of money allocated by the state to reimburse them is growing. Every year, indications for prescribing medicines are expanding and more and more new medicines are entering the reimbursement system. All of this reflects improved access to medicines and state’s effort to reduce the financial burden on patients, as shown by the analysis of 2024 Compulsory Health Insurance Fund (CHIF) expenditures and patient co-payments for reimbursed medicines and MAs conducted by the National Health Insurance Fund.

45 pct. of population use reimbursed medicines

The number of patients taking reimbursable medicines and MAs is increasing every year. Last year, more than 45% of Lithuanian population – almost 1.3 million people - used them. This is an increase of 19% compared to five years ago, when the number of users of reimbursable medicines and MAs reached one million.

In total, more than EUR 628 million was needed to cover medicines and MAs in 2024.

The majority (88%) of the Compulsory Health Insurance Fund expenditures on medicine reimbursement consists of medicines and medical aid (MAs) intended for outpatient use. It is estimated that these expenses increased by 12% over the year, amounting to nearly 60 million euros, and have tripled over the past decade.

Priority – to decrease patient’s co-payments

Last year, half of all expenditures on medicines and medical aid (MAs) were allocated to reimbursing treatment for people of retirement age. However, for more than half a million patients – due to age, disability, low income, or having reached their co-payment limit – medicine co-payments were covered by the state budget. As a result, patients saved as much as 35 million euros in personal expenses last year.

“Reducing patients’ co-payments for reimbursed medicines is a priority for medicines policy. In five years, the amount allocated from the state budget to cover patients’ co-payments has increased five times,” says Evaldas Stropus, the head of Pharmaceuticals Reimbursement Division of the NHIF.

The analysis of the data also shows that the number of reimbursable prescriptions, which had been stable until then, has started to increase and has reached as much as 12 million in the last three years. It was estimated that in 2024, the average amount of the Fund’s expenditure per prescription for medicines or medical aid (MA) was EUR 51.50, while patients had to pay an average co-payment of approximately EUR 3.89.

The lion's share goes to cancer medicines

The largest share of reimbursed medicines budget – around EUR 244 million – was allocated to the treatment of oncological diseases last year. Over the past five years, these expenditures have doubled.

The analysis by the National Health Insurance Fund (NHIF) shows that nearly 39% of all Compulsory Health Insurance Fund expenditures for medicines and medical aid (MA) are allocated to antineoplastic medicines, even though they are used to treat only 4% of patients receiving reimbursed medicines. In contrast, 74% of patients – or one in three residents of the country – use reimbursed cardiovascular medicines, yet only 13% of the reimbursement budget is allocated to this group of medicines.

“The highest average annual amount reimbursed by the state per patient goes to those with oncological diseases. Last year, it reached EUR 4,700. This amount is 12 times higher than the average annual state expenditure per patient for cardiovascular medicines, which rank second,” notes E. Stropus. 

According to him, this is because cancer medicines are often new, original medicines, and treatment is expensive. As more new medicines are added to the list and pricing catalogue of reimbursed medicines, the costs of reimbursing original medicines continue to rise.

Currently, around 17% of the medicines listed in the reimbursement pricing catalogue are original medicines whose patent protection has not yet expired and for which no generic alternatives are available on the market.

“Paradoxically, only about one-third of patients use original medicines, yet they account for as much as 70% of the total medicines budget,” notes E. Stropus.

A record number of medicines added to the reimbursement system

To improve patients’ access to medicines, 42 new entries were added to the list of reimbursed medicines last year – either entirely new medicines or expanded indications for existing ones. Of these, a record number – 22 medicines – were included from the Reserve Medicines List, the highest figure in seven years.

Medicines for viral diseases such as HIV and hepatitis C, oncological conditions such as leukemia, prostate and lung cancer, melanoma, as well as for heart disease and cystic fibrosis, were included in the reimbursement system.

To accelerate the process of integrating new medicines into the reimbursement system and ensure financial sustainability, an increasing number of cost-management agreements are being concluded with manufacturers of expensive, original, and innovative medicines.

You can find the full 2024 analysis of Compulsory Health Insurance Fund expenditures and patient co-payments for reimbursed medicines and medical aid (MA) here.

The NHIF invites you:

Last updated: 17-06-2025

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