The Finnish medicines reimbursement system has three steps:
- The basic reimbursement is 35 percent of the retail price of the medicine. This is the minimum reimbursement on prescription-only medicines prescribed by the doctor, except for certain special cases. The basic reimbursement will rise to 40 percent in the beginning of 2016.
- The medicines in the lower special reimbursement category entitle the patient to receive a 65 percent reimbursement on the retail price of the medicinal product.
- For the medicines in the upper special reimbursement category, the patient only pays a 3 euro patient co-payment.
The law prescribes the diseases that entitle the patients to receive the lower or upper special reimbursement upon an application made for the medicine by the company.
The ceiling of medicine costs prevents unreasonably high expenses
Every year, the State determines the so-called ceiling of medicines costs. If the medicine expenses paid by the patient in a year exceed a certain sum, they will pay only the 1.50 euro patient co-payment for the medicines purchased during the remaining part of the year. This ensures that the medicine expenses of those who use a lot of medicines or are on expensive medications will remain at a reasonable level.
The ceiling of medicines costs was lowered both in 2013 and in 2014. Today it is at 612,62 euro.
The health insurance is funded by the State and the insured. Each insured person pays a health insurance premium withdrawn from their pay. This payment is used to cover not only the medicines reimbursements but also travelling expenses related to medical care, the private doctor’s fees and examinations.
Health Insurance Financing
Health Insurance Benefits
Public Share of Medicine Costs in Some EU-Countries
Special Reimbursement Indications in Finland
Time from Marketing Authorisation to Basic Reimbursement in 2014
New Product Basic Reimbursement Process in 2014
Time from Marketing Authorisation to Special Reimbursement in 2014
New Product Special Reimbursement Process in 2014
Patients Access to New Medicines in Some EU-countries