1. Monitoring of doctor´s prescribtion Michaela Gajdošová Gabriela Kliešková Ministry of Health Slovakia

2. Regulations before June 2006 20 Sk for Rp 50 Sk/day in a hospital

3. Monitoring of doctors Managment done by HCIC Cost effectivness analyses of doctors Each HCIC has revisory doctors Responsible for control of prescribtion limitation, indication limitation – all listed in our reimbursement list If IL is not kept HCIC do not pay patient´s book – future tool – control of doctors by PIN of patient

4. Monitoring of doctors In expensive treatment before priscribing a drug,doctor has to ask for a permision based on the patient´s condition patient´s HCIC Revisory doctors are responsible for giving such a permision Such drugs have a mark in indication limitation as - RL

5. Financially regulated prescribtion The most efficient gun ever discovered to fight for the controle of drug expenditure (Prof. E. Mossalios, London School of Economics and Political Science)

6. Financially regulated prescribtion Potential risks Expensive drugs could not be prescribed eventhough it is necessary Seriously ill patient could not be „atractive“ for a doctor

7. Pharmacy monitoring Every month pharmacy sends report of costs Rps are sent to HCIC All data in electronic version Every Q data are sent to national institute for statistics – for MoH

8. Pharmacy monitoring On each Rp dg is indicated Coupled in HCIC with doctor´s reports

9. Thank you