Inclusion of medicines in the reimbursement scheme

The Pharmaceuticals Pricing Board operating in connection with the Ministry of Social Affairs and Health decides whether reimbursements are available for specific medicines, i.e., whether they are reimbursable.

The Pharmaceuticals Pricing Board

Prices and reimbursements

Look up the price and reimbursement status of medicines

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  • confirms whether a specific medicine is reimbursable at the basic or special rate and sets a reasonable wholesale price
    • The special rate of reimbursements is only available for medicines used in the treatment of illnesses listed in Council of State Decree 25/2013.
  • confirms whether a specific clinical nutrient is reimbursable and sets a reasonable wholesale price
    • Reimbursements are only available for products used in the treatment of illnesses listed in Council of State Decree 27/2013.
  • confirms whether a specific emollient cream is reimbursable and sets a reasonable wholesale price.

A particular medicine can only be confirmed as reimbursable with respect to specific medical indications noted in the summary of product characteristics. The Pharmaceuticals Pricing Board can also limit reimbursability to apply to a specific diagnosis or for certain indications noted in the summary of product characteristics.

Kela is responsible for implementing the reimbursement decisions made by the Board.

Situations where you cannot get a reimbursement for your medicine

Applications for reimbursability are typically submitted by pharmaceutical companies. If a particular product has not been confirmed to be reimbursable, customers must pay full price.

You cannot get a reimbursement in the following situations:

  • the pharmaceutical company has not applied for reimbursability
  • the pharmaceutical company has not applied for an extension of reimbursability (decisions of the Pharmaceuticals Pricing Board are valid for a specified period of time)
  • the Pharmaceuticals Pricing Board has turned down an application submitted by the pharmaceutical company
  • the pharmaceutical company has withdrawn the product from the reimbursement system.

With medicines available on a special license, the application for reimbursability may also be submitted by the manufacturer, importer, wholesaler or a customer, or the pharmacy acting on behalf of a customer.

Pharmaceuticals Pricing Board publishes information about reimbursability decisions

The Pharmaceuticals Pricing Board publishes the following monthly lists:

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