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Reimbursements for medicine expenses exceeded EUR 1.5 billion in 2019

Last year, the reimbursements paid by Kela for medicine expenses increased by EUR 91 million (6.2%). The lowering of the client’s annual out-of-pocket maximum for medicine expenses meant an increase of almost one-fifth in the additional reimbursements paid for medicine expenses. Information about these and other statistics from Kela has now been published in Pocket Statistics 2020.

Refunds for medicine expenses 2005–2019

Last year, the reimbursements for medicine expenses amounted to EUR 1.5 billion. Most of them, EUR 1,029 million, consisted of special reimbursements. According to Pocket Statistics 2020, reimbursements for medicine expenses were paid at a basic rate to an amount of EUR 316 million and additional reimbursements to clients who had reached the annual out-of-pocket maximum to an amount of EUR 205 million.

The additional reimbursements paid to clients due to large medicine expenses increased by 17.7% from the previous year. The situation for persons with large medicine expenses was aided by decreasing the annual out-of-pocket maximum from EUR 605.13 to EUR 572 in 2019. Additional reimbursements were paid to 4.7% of the population.

70% of Finns, in other words 3.84 million people, bought medicines that are reimbursable. Of these persons, 3.01 million people received reimbursements for medicine expenses.

The so-called payback charges have not been deducted from the reimbursements for medicine expenses. In 2019, the pharmaceutical companies for the first time paid payback charges to Kela for medicines that were reimbursed under certain preconditions and the reimbursability involved a financial agreement. Payback charges were paid to a total amount of EUR 13 million.

An individual medicinal substance may mean an increase of millions of euros

A comparison of Pocket Statistics and other statistical data from Kela to the data for previous years shows that the medicine expenses continuously increase. This happens despite occasional saving measures. Most recently, the increase in medicine expenses was staved off by several different means in 2017. However, since then the medicine expenses have increased already for two years in a row.

– The increase in reimbursements for medicine expenses is mostly due to new and expensive medicinal substances that are not included in the reference pricing system, says Leena Saastamoinen, Head of Research at Kela.

One factor that increases medicine expenses is the broadening of the range of indications. Leena Saastamoinen mentions as examples two medicines used as anticoagulants whose range of indications have been broadened to include more common illnesses. A total of EUR 21 million was paid in reimbursements for these medicines in 2019. However, the largest increase in reimbursements occurred for a new medicine for migraine, erenumab: it became reimbursable in 2019 and, in the first year, the reimbursements paid for this medicine totalled EUR 13 million.

Benefit statistics in pocket format – check out Kela’s Pocket Statistics

Data on reimbursements for medicine expenses is one of the facts found in Kela’s latest Pocket Statistics, a concise collection in pocket format of information about Kela-provided social benefits and their recipients. The statistics are for 2019, but some data for 2018 are included for comparison purposes.

The Pocket Statistics are available online, and the printed version will be released in June. The Pocket Statistics are available free of charge. They are published in Finnish, Swedish and English.

Read more:

Pocket Statistics 2020

Kelan Taskutilasto 2020

Fickstatistik 2020

Additional information:

Leena Saastamoinen

Päivi Rastas

firstname.lastname@kela.fi

Publication: Kela’s Pocket Statistics 2020. Helsinki: Kela, 2020. ISSN 0359-5218 (printed publication), ISSN 1457-8727 (e-publication).

Publication orders: Tel. 020 634 1502, julkaisut@kela.fi