Changes to Determination of Insulin Cost Reimbursement Amount

On June 24, 2017, the amendments made to the terms of insulin preparations cost reimbursement approved by the Cabinet of Ministers of 05.03.2014 № 73 and 23.03.2016 No. 239 entered into force. In particular, we are talking about the official publication of Resolution of Cabinet of Ministers No. 439 of June 21, 2017.

First of all, the approach to determining the amount of insulin preparations reimbursement at the expense of the local budget has been changed. So, henceforth, the compensation amount for the cost of drugs may differ from the reference price set by the Ministry of Health. The only condition is the established upper limit: the amount of such compensation can not exceed the reference price.

Also, after making amendments, special conditions for reimbursement have been established for certain categories of patients, namely:

• adults who are diagnosed with diabetes at the age of 18 and who are prescribed a human insulin preparation in a vial and, if they wish, are ready to fund the cost of the human insulin drug in the cartridge with a syringe-pen;

• Adults who are prescribed a human insulin preparation who do not have contraindications to treatment with insulin analogues and who are willing to fund the cost of the preparation which is an insulin analog.

"Thus, if the retail price for a certain type and form of insulin products release form is lower than the reference price (full compensation price) for one pack for insulin preparations, the business entity shall use the retail price to calculate the cost recovery amount for these individuals. At the same time, the amount of the surcharge shall be 10% for them," - commented Zoia Zamikhovska, the expert of Legal Alliance Company.