The Health Insurance Fund: Pharmacies must continuously have more than 200 essential medicines in stock
Approximately one in ten reimbursable medicines must be constantly available in pharmacies. These are the medicines most frequently needed by patients, that are included in the List of Essential Reimbursable Medicines, the availability of which must be ensured by more than 1,350 pharmacies that have contracts with the Health Insurance Fund. These medicines are subject to the lowest co-payment, meaning that residents pay less for them or do not have to pay anything at all.
The List of Essential Medicines consists of medicines used to treat the most common health conditions. These include medicines that lower blood pressure, improve heart function, relieve pain, as well as certain antibiotics and medicines for diabetes, asthma, increased intraocular pressure, and other medicines most commonly prescribed to patients. Currently, the list contains 238 essential reimbursable medicines.
“The list of medicines that pharmacies are required to keep in stock is intended to ensure that patients can obtain the most important medicines even in unexpected situations,” says Evaldas Stropus, Head of the Pharmaceuticals Reimbursement Division at the National Health Insurance Fund.
The list is updated every six months, and if new generic medicines are added to the list of reimbursable medicines, it may be updated additionally. It does not include biological medicines, branded medicines, or single-manufacturer medicines with a reference price exceeding EUR 150, as well as certain groups of medicines, such as narcotic medicines or medicines used to treat HIV, which are sold only in a limited number of pharmacies.
A pharmacy may only be without an essential medicine in stock if it has not sold any of that medicine for six months. However, at a patient’s request, the pharmacy must order the required medicine so that it can be delivered: within 2 days if the pharmacy is located in a city, and within 4 days if it is located in a rural area. In cases where an essential medicine is unavailable in Lithuania due to supply disruptions, the pharmacy must offer another medicine containing the same active substance.
Almost half of Lithuania’s population uses reimbursable medicines and medical aids, and their use has increased by 14 percent over the past five years. Therefore, both the availability and the cost of medicines are becoming relevant to an increasing number of people.
Only medicines with the lowest co-payment are included in the List of Essential Medicines. When purchasing reimbursable medicines with the lowest co-payment, people accumulate their co-payments in a co-payment basket from the beginning to the end of each calendar year. Once the accumulated co-payment amount reaches the established threshold, which is EUR 70.02 this year, patients no longer have to pay for the lowest-priced medicines for the remainder of the year – the co-payment is covered by the state.
“Patients often assume that a more expensive medicine will be more effective, but a reimbursable medicine with the lowest co-payment contains the same active substance and has the same therapeutic effect. Therefore, by choosing the lowest-priced option, people can save money without compromising the quality of treatment,” notes E. Stropus.
The List of Essential Reimbursable Medicines helps improve access to medicines, ensuring that residents receive the treatment they need in a timely manner, while choosing medicines with the lowest co-payment can help reduce their expenses. The List of Essential Medicines is published on the Health Insurance Fund’s website here, while the list of pharmacies that have a contract with the Health Insurance Fund is available here.
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