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◘ In June 2003, legal amendments dramatically changed the drug categorization system. The number of ATC groups in which at least one drug has to be fully reimbursed by law decreased to 122.

◘ The composition of the categorization committee was changed, with greater participation of health insurance companies΄ representatives and a higher emphasis on cost-effectiveness analysis.

◘ Generic substitution, maximum prices, price monitoring in the reference countries are implemented within the Slovak’s drug policy and introduction of a degressive margin is prepared.

Problems: The cost – effectiveness threshold is not agreed. ATC group NamedosisPrice per day € A02BC01Omeprazol 10 mg 0.52 A02BC01Omeprazol 20 mg 0.12 A02BC02Pantoprazol 1.45 A02BC02Pantoprazol 40 mg 1.27 A02BC05Ezomeprazol 20 mg 0.86 A02BC05Ezomeprazol 40 mg % 1208 % an example:

The majority of HTA are transfrered. however Not all participated parties within reimbursement process determine 14 transferability factors: ◘ To which content it is relevant for the investigated technology ◘ How much it corresponds between the study and country’s decision ◘ The likely effect of the transferability factor on the cost-effectiveness ratio

◘ Inconsistent reimbursement decisions can be consider as one of the main reasons for the accumulation of expenditures on drugs within the Slovak Republic. ◘ The principe “VALUE FOR MONEY” as a reasonable criterion for making resource allocation decision within the health care system should be implemented more deeply.