On the first day that the National Health Insurance Fund (NHIF) began to pay a higher percentage of over 52 groups of medicinal products for cardiovascular diseases, more than 33,000 electronic prescriptions were processed for products that switched from partial to full reimbursement by the NHIF. This was announced by the Health Insurance Fund on Tuesday, citing data from “Information Service”. Medicines paid by the NHIF must be prescribed and dispensed only with electronic prescriptions from June 2021, which makes it visible at any moment what their consumption is.
From 1 April, 56 cardiovascular drugs are now completely free and more than 300 at a reduced co-payment for patients, after the NHIF increased their reimbursement level.
In each of a total of 52 drug groups, there are one or more that are completely free for patients under the new reimbursement level. The change affects a total of about 600,000 people who take ACE-inhibitors, beta-blockers, drugs from the sartan group, diuretics, etc. For the more expensive drugs in a given group, there will be an additional payment by the patients, which, however, is significantly reduced compared to before – by an average of 58%, according to the Ministry of Finance. For 40 of the medicines, the co-payment is below BGN 1.
You can see whether your medicine is among them, whether you will pay extra in the future and how much, in the list below.
Some medicines require a change of prescription from the GP
The NHIF said that for most drugs, the increased level of reimbursement is automatically taken into account and there is no need for patients to renew prescriptions dated before April 1.
“In connection with the changes that have occurred in the Integrated Information System of the National Health Insurance Fund, the necessary actions have been taken to allow for all health insured persons with prescribed medicinal products from the INN, for which all indications fall within the scope of the diseases for which the change is being made, the active electronic prescriptions issued before 04/01/2024 to be issued with the increased level of reimbursement and not to require a visit to the general practitioner during the validity period of the electronic prescription”said the NHIF.
However, for drugs from 10 groups, patients need to visit their GP to benefit from the higher level of reimbursement of medicinal products: “For medicinal products from international non-proprietary names (INN) – Atenolol; Chlortalidone; Flecainide; Furosemide; Metoprolol; Propranolol; Sotalol; Spironolactone; Torasemide; Verapamil, for which not all indications are within the scope of the change in the level of payment, the existing NHIOC code is retained for diagnoses that are partially paid, and for the diseases with the increased level of payment, they are created new codes.
Only in these cases, if the health insured persons have an active electronic prescription issued before 01.04.2024 for some of the above-mentioned medicinal products and it has a diagnosis for which the corresponding medicinal product is reimbursed at a payment level of 100%, its prescription will be valid for implementation, but according to the order of payment by the NHIF until 01.04.2024 (i.e. partially).
In these cases, it is necessary for the health insured persons to be informed that if they wish to benefit from the new, higher level of reimbursement, they can visit their general practitioner. After canceling the already issued prescription, the personal physician should issue a new electronic prescription, respectively with a new NHOC code, for the specific medicinal product”.
“For the purpose of smooth implementation and reporting of electronic prescriptions issued before 01.04.2024, which, as a result of increasing the payment level to 100% of medicinal products intended for the treatment of cardiovascular diseases, contain both partially and fully paid medicinal products , a technical possibility has been created for them to be implemented in pharmacy software”also informed from the NHIF.
The increased level of reimbursement is worth BGN 45 million – BGN 34 million for the higher coverage of drugs by the NHIF and BGN 11 million for the fee for processing prescriptions in pharmacies for 100% paid products.
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