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Drugs for seniors “twice free”? How is it with these free drugs

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Some joke that after Jarosław Kaczyński’s last announcement, drugs for seniors “will be twice as free”. Others note that now only “a small amount of medicine” is free for seniors. Another PiS promise sparked a discussion about whether the first promise, made in 2015, was fulfilled as expected. We explain.

One of the announcements of what will happen after the possible victory of Law and Justice in the upcoming elections – which announcements were made during weekend convention “Programowy Street of Law and Justice” (May 14-15) – concerned the prices of drugs for seniors. PiS president Jarosław Kaczyński announced the introduction of free medicines for people under 18 and for those over 65.

Free drugs from the age of 65 in a very short time. Of course, this requires certain legal and budgetary solutions, but I think that it can also be said that the new year will be the beginning of this situation, but also free medicines for children and adolescents up to 18 years of age.

The Minister of Health, Adam Niedzielski, spoke more about this later. When asked on May 14 by the I.pl portal, how many people will be covered by this program, he replied: “We are talking about millions of people, because the population up to the age of 18 alone is seven million children and adolescents, and when it comes to seniors, we are practically talking about another approximately five million people. The minister added that “the program is well prepared not only in terms of calculation (of costs – ed.), but also in the sense that over the years of free drugs for seniors aged 75+, we have already developed mechanisms.”

Internet users: “A small amount of medicine is free for seniors”

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Niedzielski spoke of “more millions of people” and “increasing the list of drugs” because the program of free drugs for people from the 75+ group was one of PiS’s election promises before the 2015 elections. It was introduced in September 2016.

Therefore, after Sunday’s announcement by the PiS president about expanding the group covered by the program to include people between 65 and 75 and under 18 years of age, a discussion on this topic flared up online. Internet users reminded that the program of free drugs has been operating for several years. Some joked that “drugs for seniors will be twice as free”. Others commented that contrary to slogans about free drugs, in fact, not all drugs are free for people in the 75+ group. “A small amount of medication is free for seniors. Total margin. For the rest they pay normally”; “We are talking about free drugs that are already reimbursed. And the problem is the expensive unreimbursed drugs”; “There are no free drugs, there is only a list of reimbursed drugs, now for 75+ and this list is also determined and changed by the ministry” – they wrote.

Therefore, we explain what PiS has fulfilled from its promise from 2015: how many drugs are free for people from the 75+ group and what proportion of all reimbursed drugs they represent.

Health Minister: “Indeed, it will not be all drugs”

Free medicines for people over 75 were such an important program for the PiS government that Prime Minister Beata Szydło committed in November 2015 in her expose to introduce it within the first 100 days of rule. “I want to say today what we will do in the first hundred days of our rule. (…) Fourth: free medicines from the age of seventy-five” – ​​she announced.

But a few months later, in February 2016, the then Minister of Health Konstanty Radziwiłł he admitted thoughthat “indeed, it will not be all drugs”. “We will start with those that the elderly must take, not the younger ones,” he declared. The reason was the costs: the government declared that it intended to allocate from PLN 560 million in 2017 to PLN 830 million in 2020 for free drugs for seniors, while in 2015 people aged 75+ spent PLN 2.6 billion on prescription drugs . “500 million is the first step towards supporting the elderly who have problems with access to medicines” – said Minister Radziwiłł.

Free? “Almost half” of reimbursed drugs, and these are not all drugs

The program started on September 1, 2016. IN the act It was written that not all medicines will be free for people from the 75+ group, but only those entered on a special list of the Ministry of Health. The resort must publish it every two months, but it does not have to update it as often. Since the announcement of the first list of free drugs, the ministry has expanded it eight times. First of all, the act stipulates that only prescription products that have already been reimbursed can be included in the list.

In practice, it looks like this: on the latest leaves free medicines for people aged 75+ in force from May 1, 2023, there are 2046 items. This does not mean that the list includes 2046 drugs, because one drug may occupy several or even a dozen or so items, because different doses and package sizes are listed separately. As we calculated, there are about 600 individual drugs (trade names regardless of dosage) on this list, which is much less than all items.

The Ministry of Health, in response to the question Konkret24, what part of all reimbursed drugs available in Polish pharmacies are those free for people from the 75+ group, replied on May 15 that it is “nearly half”. This is confirmed by the data from the latest reimbursement announcement: all items on the list of reimbursed drugs are 4135, and on the list of free drugs 2046, which is 49.5 percent. This means that people over 75 can get about half of all reimbursed drugs for free – but after all, there are also non-reimbursed drugs and over-the-counter drugs that are not covered by the program.

Assessing the method of creating a list of free drugs, the Supreme Audit Office she wrote in 2019: “Despite the measurable benefits brought to the elderly by the introduction of the LEKI 75+ Programme, it cannot be clearly stated whether the needs of seniors have been optimally taken into account in the reimbursement announcements.” As explained by the Ministry of Health in March 2023 in responses to a parliamentary questionthe list is extended on the basis of a group of drugs indicated by the National Health Fund as the most frequently used by seniors aged 75+, additionally assessed by the Agency for Health Technology Assessment and Tariff System.

The trouble with prescribing “S” prescriptions

In its analysis, NIK also noted that initially primary care physicians, not specialist physicians, were authorized to issue prescriptions authorizing the purchase of free drugs. This changed at the beginning of 2021, when the Ministry of Health extended this possibility also to specialists – although only if they obtain the patient’s prior consent to access the patient’s history saved on the Patient’s Internet Account (IKP). In concept, the specialist must verify the number and type of drugs prescribed by other doctors.

How she noticed The My Patients Foundation, IKP, however, is not a tool commonly used by people over 75 years of age. As a result, sick seniors without IKP should still be referred by specialists to primary care physicians who can write out the so-called prescriptions “S” enabling the purchase of free drugs. For such people, this means the need for another visit to the primary care office or teleconsultation.

The Foundation addressed this problem to the Ombudsman for Patients’ Rights, who, on behalf of patients, applied to the Ministry of Health and the National Health Fund with a request to extend the possibility of prescribing “S” prescriptions by specialists to all patients over 75 years of age. However, the rules have not been changed so far.

The fact that the free medicine program does not fully solve the problems of people from the 75+ group with the purchase of necessary medicines was already written in 2021 by the Polish Economic Institute (PIE). It is known from article Wirtualna Polska, because the think-tank supervised by the Prime Minister has already removed this report from its website, explaining that it was unfinished. According to Wp.pl, in this document, the institute stated that the program does not eliminate the unequal burden of medication costs on the elderly, because statistics have shown that it is people aged 75+ who bear the greatest burdens related to the purchase of medicines.

They also show the scale of the problem results research of the Coalition “To help the dependent” from August 2022. As much as 82 percent of people aged 60-74 with multimorbidity and chronic diseases confirmed that in recent months they did not buy a prescription due to an increase in the price of medicines and other necessary products.

Main photo source: Shutterstock

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