Generic substitution and the reference price system

Medicines can be divided into the following categories according to their substitutability (ability to be substituted with a pharmaceutically equivalent product):

  1. Medicines which are only included in the generic substitution system.
    • If a medicine you buy is covered by the reimbursement system, you get a reimbursement based on its full price.
  2. Medicines which are included in both the generic substitution system and the reference price system.
    • If a medicine you buy is higher in price than the reference price, you will not get a reimbursement for the part that exceeds the reference price.
  3. Medicines which are not included either in the generic substitution or the reference price system. These cannot be substituted at the pharmacy.
    • If a medicine you buy is covered by the reimbursement system, you get a reimbursement based on its full price.

Generic substitution

You can save on your medicine expenses by substituting your medicine with a less expensive equivalent product at the pharmacy.

Generic substitution is safe. All substitutable products contain the same amount of active ingredient and are biologically equivalent.

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The pharmacy is required to tell you about the least expensive substitutable product. You have the option of having the prescribed medicine substituted with a less expensive equivalent medicine, but you also have the option to decline substitution. The healthcare professional who prescribes a medicine can also rule out substitution on medical or therapeutic grounds.

Reference price system

Some of the substitutable and reimbursable medicines are included in the reference price system. Medicines included in the reference price system can be substituted with an equivalent product at the pharmacy. The reference price is the highest price for which a reimbursement is available.

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 on out-of-pocket costs.

If the healthcare professional who prescribed the medicine has ruled out substitution, you get a reimbursement based on the full 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.

Generic substitution rules and reference prices are updated quarterly

The list of medicines included in the generic substitution system, the substitution categories and the reference prices are updated quarterly.

  • The Finnish Medicines Agency (Fimea) decides which medicines are to be included in the generic substitution system.
  • The substitution categories are defined by Kela. Medicine packages in the same category contain the same amount of active ingredient. Kela also defines the so-called price bands which describe the minimum and maximum prices for substitutable medicines. The price bands are based on prices notified to Kela by the pharmaceutical companies.
  • The Pharmaceuticals Pricing Board (Hila) defines the reference price categories and sets the reference prices of the medicines included in the various categories. A uniform reference price applies to all of the medicines in a reference price group.

Updated price bands and reference prices become effective on 1 January, 1 April, 1 July and 1 October.

Pharmacy price lists are updated on the 1st and 15th of the month. Due to price competition between pharmaceutical companies, the prices of many medicines may change two weeks after the introduction of new price bands and reference prices. The price of your medicine and the amount of the reimbursement may therefore vary depending on when you purchased the medicine.

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