As of 1 July, Amendments to the List of Medicinal Products of the Estonian Health Insurance Fund as well as to the Regulations on the Reference Prices of Pharmaceuticals Enter into Force

 

On 19 June this year the Minister of Social Affairs signed the regulations to change the list of medicinal products and the reference prices of pharmaceuticals which will enter into force on 1 July 2012.   For the first time,   The following medicinal products with a 100% discount rate will be added to the list:
  • TAFLOTAN ophthalmic solution – a medicinal product which contains 0.015 mg/ml 0.3 ml (N30) of tafluprost as its active ingredient. A100% discount rate is to be applied if the product is prescribed under the following conditions: the first prescription can be given by an ophthalmologist for the treatment of glaucoma (H40−H42) if continuing therapy with other pharmaceuticals is contraindicated due to a proven sensitivity to benzalkonium chloride or their significant toxic effect on the front part of the eye.
  • TOBI PODHALER, an inhalation powder in hard capsules containing tobramycin, 28 mg (N224), if it is prescribed under the following conditions: a pulmonologist or a paediatrician can prescribe this medical product for the suppressive treatment of chronic pulmonary infection due to Pseudomonas aeruginosa in patients with cystic fibrosis (E84).
The following medicinal products with a 75% discount rate will be added to the list:
  • TRAJENTA, a pharmaceutical that contains the active ingredient linagliptin; film-coated tablets, 5 mg (N30). This can be prescribed with a 75% discount rate under the following conditions: for triple oral therapy of type 2 diabetes (E11, E14) in combination with metformin and sulphonylureas or for dual oral therapy in combination with either metformin or sulphonylureas if starting or continuing the treatment with metformin or sulphonylureas is contraindicated.
The conditions for prescribing the following medicinal products on the list will be changed:
  • Conditions for prescribing medicinal products containing the active ingredient perindopril will change – in addition to the 50% discount rate enforced thus far, a 75% discount rate will be applied for the treatment of hypertension (I10−I13; I15) and heart failure (I50).
  • In addition to the 50% discount rate of the medicinal products containing the active ingredient riluzole (RILUTEK) already listed in the list of medicinal products of the Estonian Health Insurance Fund, this pharmaceutical received a 100% discount rate; neurologists have the right of giving the first prescription for patients with amyotrophic lateral sclerosis without the need for mechanical ventilation.
  • Conditions for prescribing DUPLECOR, a medicinal product which contains the active ingredients amlodipine and atorvastatin, were specified in the case of a 75% discount rate as follows: it can be prescribed for the treatment of hypertension and myocardial ischemia (I15, I10−I13, I20) if the conditions for prescribing atorvastatin with a higher discount rate (75% or 100%) are met.
  • Conditions for prescribing medicinal products containing the active ingredients fluconazole, itraconazole and voriconazole with a 100% discount rate are going to change as follows: these pharmaceuticals can be prescribed for the treatment and prevention of mycosis (B37 candidiasis, B44 aspergillosis, B45 cryptococcosis, B48.2 allescheriasis, B48.8 other specified mycoses) related to congenital or acquired immunodeficiency (the treatment of malign tumours, following an organ transplant, HIV, aplastic anemia or systemic connective tissue disorders).
  • The conditions that apply in case of the active ingredient ezetimibe will be harmonized with the conditions applied in case of statins. In the case of a 75% discount rate, the following conditions will be enforced: for the treatment of dyslipidemia in the case of patients with myocardial ischemia or atherosclerosis of other arteries (I25, I63, I65, I66, I70.2), diabetes (E10−11, E13−14), hypertensive heart disease or chronic kidney disease (I11, I12) or after a myocardial infarction or a myocardial revascularization (I21−I22, Z45, Z95) in combination with atorvastatin or rosuvastatin if, despite using an optimal dosage of the aforementioned pharmaceutical, the target level of cholesterol is not achieved. In case of a 100% discount rate, the following conditions will be enforced: for the treatment of patients with dyslipidemia who have a chronic kidney disease starting from stage 3 (N18) in combination with atorvastatin or rosuvastatin if, despite the use of the optimum dosage of the aforementioned medicinal product, the target level of cholesterol is not achieved.
  • An additional discount rate of 100% will be added to the active ingredient gabapentin under the following conditions (similarly to alternative new generation anti-epileptics): the first prescription can be given by a neurologist for the treatment of epilepsy (G40) if there is a contraindication to the pharmaceuticals of the previous generations, they are ineffective or have significant side effects.
 
New generic medicinal products with active ingredients also included in the composition of other medicinal products that have already been listed in the list of pharmaceuticals with a discount:
  • Pharmaceutical preparations containing the following active ingredients will be added to the list of pharmaceuticals with a 50% discount rate:
1)     donepezil (for the treatment of Alzheimer's disease);   2)     levocetirizine (an anti-allergic);   3)     lornoxicam (an analgesic);   4)     sertraline (an antidepressant);   5)     torasemide (for the treatment of hypertension);   6)     trimetazidine (a supplementary anti-ischemic agent).
  •  Pharmaceutical preparations containing the following active ingredients will be added to the list of pharmaceuticals with a 75% discount rate:
1)     alendronic acid (for the treatment of osteoporosis);   2)     amlodipine (for the treatment of hypertension);   3)     atorvastatin (for lowering blood cholesterol levels);   4)     glimepiride (for the treatment of diabetes);   5)     calcipotriol + betamethasone (anti-psoriatic);   6)     losartan (for the treatment of hypertension);   7)     montelukast (for the treatment of asthma);   8)     sitagliptin (for the treatment of diabetes);   9)     infant formula (formula for infants with a low birth weight);   10)    valsartan.    Pharmaceutical preparations containing the following active ingredients will be added to the list of pharmaceuticals with a 100% discount:   1)     fluconazole (for anti-fungal treatment);   2)     quetiapine (anti-psychotic);   3)     ibuprofen (an analgesic);   4)     letrozole (for the treatment of tumours);   5)     levetiracetam (for the treatment of epilepsy);   6)     mycophenolic acid (for post-transplant treatment);   7)     olanzapine (anti-psychotic);   8)     sevelamer (for the treatment of chronic kidney disease);   9)     phenylalanine-free nutrients (formula used in the case of phenylketonuria).     Due to price changes or the development of new pharmaceuticals, new reference prices have been calculated for medicinal products containing the following active ingredients:   - lornoxicam; preparations with a price agreement are XEFO film-coated 4 mg tablets (N20) (Nycomed SEFA AS) and XEFO RAPID film-coated 8 mg tablets (N20) (First Pharma OÜ);   - alendronic acid; preparations with a valid price agreement are ALENOTOP 70 mg tablets (N4) and ALENDRONIC ACID ACCORD 70 MG 70 mg tablets (N4);   - amlodipine; preparations with a valid price agreement are HIPRES 5 mg tablets (N30); HIPRES 10 mg tablets (N30); HIPRES 5 mg tablets (N60) and HIPRES 10 mg tablets (N60);   - atorvastatin; preparations with a valid price agreement are ATORVASTATIN BILLEV film-coated tablets, 10 mg (N60), ATORVASTATIN BILLEV film-coated tablets, 20 mg (N60) and ATORVASTATIN BILLEV film-coated tablets, 40 mg (N60);   - donepezil; preparations with a valid price agreement are YASNAL Q-TAB orodispersible tablets, 5 mg, N28; YASNAL Q-TAB orodispersible tablets, 10 mg, N28; and YASNAL Q-TAB orodispersible tablets, 10 mg, N84;   - fluconazole; preparations with a valid price agreement are DIFLAZON hard capsules 150 mg, N1; FLUCONAZOLE MEDOCHEMIE hard capsules 50 mg, N7; FLUCONAZOLE MEDOCHEMIE hard capsules, 150 mg N1; and FLUCONAZOLE MEDOCHEMIE hard capsules 150 mg, N2;   - glimepiride; preparations with a valid price agreement are GLIMEPIRIDE ACCORD, 1 mg, N30; GLIMEPIRIDE ACCORD 2 mg, N30; GLIMEPIRIDE ACCORD 3 mg, N30; and GLIMEPIRIDE ACCORD 4 mg, N30;   - ibuprofen; preparations with a valid price agreement are IBOPROFEN LANNACHER film-coated tablets, 600 mg, N100; and IBUPROFEN LANNACHER film-coated tablets, 400 mg, N100;   - infant formula; preparations with a valid price agreement are APTAMIL PREMATIL powder, 400 g; and FRISO PREMATURE powder, 400 g;   - quetiapine; preparations with a valid price agreement are KVENTIAX film-coated tablets, 200 mg, N60; KVENTIAX film-coated tablets, 100 mg, N60; KVENTIAX film-coated tablets, 25 mg, N30; QUETIAPINE ACCORD prolonged-release tablets, 200 mg, N60; QUETIAPINE ACCORD prolonged-release tablets, 300 mg, N60; QUETIAPINE ACCORD prolonged-release tablets, 400 mg, N60;   - letrozole; preparations with a valid price agreement are LETROZOLE TEVA film-coated tablets, 2.5 mg, N30; and LETROZOLE ACCORD film-coated tablets, 2.5 mg, N28;   - levetiracetam; preparations with a valid price agreement are LEVETIRACETAM GSK film-coated tablets, 250 mg, N30; LEVETIRACETAM GSK film-coated tablets, 500 mg (N30) and LEVETIRACETAM GSK 1000 MG film-coated tablets,1000 mg (N30);   - levocetirizine; preparations with a valid price agreement are LEVOCETIRIZINE ACTAVIS tablets, 5 mg, N28, and CEZERA tablets, 5 mg, N30; - losartan; preparations with a valid price agreement are LOSARTAN ACCORD 50 MG film-coated tablets, 50 mg, N28; and LOSARTAN ACCORD 100 MG film-coated tablets, 100 mg, N28;   - montelukast; preparations with a valid price agreement are MONTELUKAST ORION chewable tablets, 4 mg, N28, MONTELUKAST ORION chewable tablets, 5 mg, N28 and MONTELUKAST ORION tablets, 10 mg, N28;   - mycophenolic acid; preparations with a valid price agreement are CELLSEPT capsules, 250 mg, N100, CELLCEPT film-coated tablets, 500 mg, N50, MYCOPHENOLATE MOFETIL ACCORD film-coated tablets, 500 mg, N50;   - olanzapine; preparations with a valid price agreement are OLANZAPINE ORION 5 MG orodispersible tablets, 5 mg, N28; OLANZAPINE ORION 10 MG orodispersible tablets, 10 mg, N28; OLANZAPINE ORION 15 MG orodispersible tablets, 15 mg, N28; KOZYLEX orodispersible tablets, 5 mg, N28; KOZYLEX orodispersible tablets, 10 mg, N28; KOZYLEX orodispersible tablets, 15 mg, N28; LAZAPIX film-coated tablets, 5 mg, N28; LAZAPIX film-coated tablets, 10 mg, N28; and, LAZAPIX film-coated tablets, 15 mg, N28;   - sertralin; preparations with a valid price agreement are SERTRALIN ACTAVIS 50 MG film-coated tablets, 50 mg, N28 and SERTRALIN ACTAVIS100 MG film-coated tablets, 100mg, N28;   - phenylalanine-free nutrients; preparations with a valid price agreement are XP MAXAMAID (ORANGE FLAVOURED) powder, 500 g, N4, MAXAMAID (UNFLAVOURED) powder 500 g, N4 and PKU SQUEEZIE 85 g ready-to-feed protein substitute, N30;   - torasemide (15 mg); preparations with a valid price agreement are TORASEMIDE TEVA tablets, 5 mg, N30, TORASEMIDE TEVA tablets, 10 mg, N30 and TORASEMIDE HEXAL tablets, 10 mg, N30;   - trimetazidine; preparations with a valid price agreement are TRIMETAZIDINE ACTAVIS modified-release tablets, 35 mg, N60 and TRIMETAZIDINE TEVA modified-release tablets, 35 mg, N60;   - valsartan; preparations with a valid price agreement are SUVARTAR 80 MG film-coated tablets, 80 mg, N28; SUVARTAR 160 MG film-coated tablets, 160 mg, N28; VALSACOR film-coated tablets, 320 mg, N28; and SUVARTAR 320 MG film-coated tablets, 320 mg, N28;   - doxazosin; preparations with a valid price agreement are DOXALFA prolonged-release tablets, 4 mg, N28 and DOXAZOSIN TEVA prolonged-release tablets, 4 mg, N30;   - hydroxychloroquine; preparations with a valid price agreement are PLAQUENIL film-coated tablets, 200 mg, N60 (First Pharma);   - clarithromycin; preparations with a valid price agreement are KLERIMED 250MG tablets, 250mg, N14 and KLERIMED 500MG tablets, 500 mg, N14;   - latanoprost; preparations with a valid price agreement are LATANOPROST-RATIOPHARM ophthalmic solution, 50 mcg/ml, 2.5 ml, N1 and UNILAT ophthalmic solution, 50 mcg/ml, 2.5 ml, N1;   - iron; preparations with a valid price agreement are FERRUM LEK syrup, 10 mg Fe/ml, 100 ml, N1;   - temozolomide; preparations with a valid price agreement are TEMOZOLOMIDE TEVA hard capsules, 20 mg, N5; TEMOZOLOMIDE TEVA hard capsules, 100 mg, N5; and TEMOZOLOMIDE TEVA hard capsules, 250 mg, N5.   From now on, the following preparations will not appear in the list of medicinal products with benefit rates due to the expiration of marketing authorization or the termination of marketing:   ABILIFY tablets 10 mg N28   DHC CONTINUS 90 mg N10   BONEFOS capsules 400 mg N30   CEFZIL granules 50 mg/ml 60ml N1   DAIVONEX solution 50 mcg/ml 60ml   DURACEF capsules 250 mg N12   DURACEF granules 50 mg/ml 60ml N1   ELMETACIN SPRAY solution 8 mg/ml 50ml N1   LENDRATE tablets 70 mg N4   ORONAZOL tablets 200 mg N20   RALENOST 70 MG tablets 70 mg N4
  For further information, visit the website of the Ministry of Social Affairs.