1. 29.-30. October 2007. Warsaw1 Price Volume Agreements in Hungary National Health Insurance Fund Administration (OEP) Pharmaceutical Department Tamás Kovacs Deputy Head of Pharmaceutical Department

2. 29.-30. October 2007. Warsaw2 Reimbursement modes and percentages in Hungary Categories –Normative (25%, 55%, 85%) 50% for Magistral formulas –Indication dependent (50%, 70%, 90% 100% - minimal co-payment 1,2€) –Hospital (DRG financed) Techniques –Percentage –FIX (ATC 5 level active substance) –FIX (ATC 4 level, therapy) –Reimbursement-volume Agreements –Special Allocated Budget (Public procurement)

3. 29.-30. October 2007. Warsaw3 Principles of Reimbursement-Volume Agreements in Hungary NHIFA has to make a contract for every medicines in the Indication dependent reimbursement category Usually High-Price Drugs (EPO, Biology Therapy, Long Acting Analog Insulin, Olanzapin) Professional College of Specialist Doctors (e.g.: Cardiologist Collage) estimates and suggests the prevalence and the cost of the therapy of the given disease (e.g.: Chronic Heart Failure 600.000 patients) NHIFA

4. 29.-30. October 2007. Warsaw4 Different methods for pay-back A fixed amount (or fixed %) after every boxes sold with reimbursement Payment obligation after the overstepping the limit (for 1 brand) Payment obligation after the overstepping the limit (for a group of product with the same active ingredient or therapy, partition of the pay-back by the share of the turnover) Around 20-30 Mio.€ pay-back/year 50-60 contracts 

5. 29.-30. October 2007. Warsaw5 Example: Counting the limit value for the Reimbursement-Volume Agreements Suggestion of the Professional College of Specialist Doctors prevalence (e.g.: 200 patients) Calculation of the cost of the therapy for 1 patient (e.g.: 3.000€) (calculated from the product characteristics, and from the suggestion of the Professional Collage) Total expenditure 600.000€ (200patients * 3.000€) limit value for the Reimbursement-Volume Agreement  

6. 29.-30. October 2007. Warsaw6 Thank you for your attention! kovacs.tam@oep.hu