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Generic substitution and the reference price system

The pharmacy can substitute a medicine with an equivalent but less expensive product, if you wish.

A reference price has been set for some medicines that have alternatives. The price at which a medicine is sold may be higher than the reference price. However, the amount of the reimbursement cannot be higher than the reference price.

Generic substitution

Substituting a medicine with a generic one is safe. All substitute medicines contain the same amount of the active ingredient as the medicine you were originally prescribed.

The pharmacy is required to tell you about the least expensive available substitute medicine. If you wish, the pharmacy will switch your medicine for the less expensive option.

You always have the right to refuse the substitution. Your doctor can also rule out substitution for medical or therapeutic reasons.

Biological medications

You have the right to use a specific biologic medication with the same name consecutively for a period of 6 months. During this time, you will be reimbursed for the full cost of the medication, even if it is more expensive than the reference price. Once you have used a biologic medication with the same name consecutively for a period of 6 months, the pharmacy may substitute it with a less expensive equivalent medicine. The pharmacy may also substitute the medicine if you are starting biologic medication or your last purchase of the medicine was at least 6 months ago.

Substitution is not possible if a person on biologic medication is under 18 years of age.

All other principles governing generic substitution also apply to biologic medicines.

Medicinal Products Database

Look up generic alternatives and the reference price of your medicine.

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The reference price system

Some of the substitutable medicines that are reimbursable by Kela are included in the reference price system. The reference price is the highest price for which Kela can pay a reimbursement.

If a medicine you buy is higher in price than the reference price, you will have to pay not only a copayment but also the part of the price exceeding the reference price. The exceeding part does not count towards the initial deductible or the annual maximum limit on out-of-pocket costs.

If your doctor has ruled out substitution, you get the reimbursement based on the full sales price of the medicine. In that case the part exceeding the reference price will also count towards the initial deductible and the annual maximum on out-of-pocket costs.

The list of medicines included in the generic substitution system and the reference prices are updated four times a year. The new reference prices become effective in the beginning of January, April, July and October.

Due to price competition between pharmaceutical companies, the prices of many medicines change two weeks after the reference prices are updated.

Pharmacies update their price lists on the 1st and 15th day of every month.

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