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Kazimieras de Panevėžys has been using the compensatory cardiovascular drugs Tarka for some time. Casimir always bought packages of 56 tablets. The doctor prescribed two of those packs, that is, 112 tablets. For this reason, the residents of Panev solžys used to leave about nine euros in the pharmacy, this year about 12 euros.
“I was prescribed the same medicine again last week. I go to the pharmacy and there it turns out that there are no more bottles of 56 tablets, only 28 tablets,” says Kazimieras.
Such changes mean that the buyer has to scratch more euros.
After visiting various pharmacies in Panevėžys, Kazimieras discovered that these reimbursable drugs in larger packages are probably no longer available and are not even anticipated to be available. The husband was deprived of his mother when he found out at the pharmacy the premium he would have to pay.
“For 112 tablets – 4 boxes of 28 tablets – a surcharge of up to 24 euros. Previously, 12 packs of 56 tablets were enough for two packs. What do we pay, either for the drugs or for the packaging?”, The resident of Panevėžys, astonished, that he still hasn’t bought the prescription drugs.
Now Casimir finds it strange that the government is boasting that countervailing drugs are pinging. After all, buying medicine in smaller packages results in a larger quantity than larger ones.
We will have to reconcile
Juras Kirkus, owner of the Juro pharmacy operating in Panevėžys, admitted that there is currently a shortage of medicines from some manufacturers in Lithuania.
“For example, there is the French manufacturer Sanofi, whose really popular drugs are Prestarium, Preductal, and they are starting to be lacking,” says Kirkus.
And that, he says, is not the only drug that patients sometimes seek, even in multiple cities. According to J. Kirkus, Tarka drugs in larger containers are no longer available in pharmacies.
“We also faced problems with the packaging of Tarka drugs. The man who came in refused to buy a smaller package. He was hoping to find a package of 56 tablets, although I doubt where else there are. And the smaller the box, the higher the premium and you have to accept that ”, said the pharmacist.
According to J. Kirkus, it is not possible to change these drugs, because the preparation is a compound.
“It would be much worse if they didn’t exist,” says the Panevėžys resident.
J. Kirkus considers that these changes may also be related to the small Lithuanian market; perhaps it is simply not worth it for pharmacists to allow the line and produce medicines in Lithuanian containers of a certain size due to several thousand boxes. Another reason could be a change in base prices. According to him, the lower the base price, the higher the premium.
Juras Kirkus
© Sekundė.lt
Criticize the compensation procedure
Vida Augustinienė, president of the Council of Representatives of Lithuanian Patient Organizations, stated that she did not know what specific reasons led to the lack of larger packages of Tarka drugs. However, when it comes to reimbursable medicines, according to V. Augustinienė, during these four years there has been a terrible situation due to the reimbursement of medicines.
The rebate price lists change every three months. So, as of October 1, the changes await again.
“Those price lists change every three months and will be unknown again; it is possible that there will be no drugs left,” fears V. Augustinienė.
According to her, the focus is on the cheapest drugs and if they are more expensive, the patient must pay for them.
“If the base price calculated for a group of drugs is, say, five euros, a company offers an even cheaper drug, then the base price is recalculated and drugs that exceed this price by a few cents are eliminated,” explains the Lithuanian Council of Patient Organizations. President.
According to her, there are many newer drugs that are not reimbursed.
“There are drugs that lower blood glucose and protect against heart and kidney disease, but they just don’t compensate. They are compensated only when absolutely nothing helps, but they won’t help either. If a doctor could prescribe such a drug right away, a person would avoid complications. It is important that it is cheap today and who will not be it tomorrow ”, says V. Augustinienė angrily.
Evaldas Stropus
Chief of the Drug Compensation Division of the State Health Insurance Fund
Tarka’s patient premium in the third quarter of this year did not change and was the same as in the second quarter: for a pack of 28 tablets – 4.12 euros, for a pack of 56 tablets – 6.36 euros. In the first quarter, the premium was € 4.12 for a smaller pack and € 4.71 for a pack of 56 tablets.
Premium premium package in 2019 Q2-Q4 and Q1 2020 was € 4.71 and from 2020 Q2 – 6.36 EUR
This medicine is a compound medicine from a supplier and according to the Resolution of the Government of the Republic of Lithuania no. 994 may be subject to the maximum allowable premium for the patient, regardless of the base price. The patient’s premium is the difference between the retail price and the base price of the drug, that is, it depends on the manufacturer’s price and the base price.
The maximum allowed patient premium for a compound medicine from a supplier can be up to 6.36 euros, so the supplier, taking this into account, provides the price to Lithuania. According to the supplier of the medicine, a large package will no longer be sent to Lithuania and the waste will be sold in pharmacies. According to the provider, there are more than 50 large package pharmacies. Small packages will continue to be supplied to Lithuania.
It should be noted that it is up to the manufacturer, on the basis of prices, to decide which packaging to market and, at the same time, to compensate.
This drug is a compound and could be replaced by 2 separate drugs that are currently reimbursed.
Suppliers ask VLK to have one or another drug (or individual package) removed from the price list due to a production or supply disruption. If a drug that is no longer supplied to Lithuania has no analogues, VLK tries to find a supplier who provides an analog drug, even if it is not registered in Lithuania, so that patients do not experience a shortage. In this case, there is no shortage of medicine, there is only the issue of a premium of 1.88 euros for the purchase of 2 small packs instead of 1 large.
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