Reimbursements of medicine expenses: Number of recipients and prescription data

NIT137A

Theme

Illness / Medicines

Data content

Reimbursements are paid from the National Health Insurance scheme for the costs for prescription drugs for which reimbursability and a reasonable wholesale price have been confirmed. In addition, the costs for products which correspond to medicines are reimbursed. Products which correspond to medicines include clinical nutrients used in the treatment of certain severe diseases and emollients which are used in the treatment of chronic skin conditions.

The report contains data on medicines and corresponding products which have been purchased during the statistical reference period and which have been reimbursed through pharmacies by ATC category and reimbursement category. The statistics include

• Number of persons who during the statistical reference period have purchased medicines which have been reimbursed through pharmacies. (Medicines and corresponding products = medicines in this report)
• Number of prescriptions for medicines reimbursed through pharmacies. A prescription means the batch of a certain medicinal product which is dispatched at the pharmacy at the one and the same time. A medicinal product which is prescribed for a year is usually registered in the statistics as several prescriptions, since the patient usually acquires the medicine every three months.
• Expenses for medicines purchased during the statistical reference period which have been reimbursed through pharmacies. Expenses mean the sum of the price of the medicine and the pharmacy's handling fee from which the reimbursement from the health insurance scheme has not yet been deducted.
• Reimbursements from the National Health Insurance scheme paid for medicines dispensed to the insured through a pharmacy during the statistical reference period
• Ratios amounts of costs and reimbursements in euro per reimbursed prescription

Variables and classifications

• ATC class of medicine. On the first level of classification the medicines are classified into main groups according to the organ or organ system which the medicine affects. Exceptions to this are class E, which contains data on reimbursements for emollients, class V (Others) and class 9 (Unknown). On the second level of classification, the main groups are divided into more specific pharmacological/therapeutic subgroups. Preparations without ATC classification are included under 'Unknown'. This includes such products as medicines prepared in the pharmacy as well as many emollients, clinical nutrition products and medicines dispensed under a special licence. Nutrition products classified as medications are included in category V06. However, until October 2010, category V06 also included occasional nutritional products not classified as medications.
• Level of reimbursement. The medicines are included in the statistics according to their reimbursement percentage. If the medicine is not included in the reference price system, the basic reimbursement is 40% of the costs for the medicine and the special reimbursement either 65% of the costs for the medicine or 100% of the costs for the medicine which exceed the medicine-specific copayment of 4,50 euros. Reimbursement for medicines which are included in the reference price system is paid at the most according to the reference price, no longer according to the price of the medicine.
  Starting 1 January 2016, reimbursements for prescription medicines under the Health Insurance Act will be available only after meeting an initial deductible of EUR 50 per calendar year. The initial deductible does not apply to persons under 18 years of age.
• Reference period. With the variable it is possible to choose the reference period: quarter or year
• Time period. The variable states the period during which the medicines which the statistics on reimbursement of medicine expenses refer to have been purchased.

Statistical reference period

Yearly data available since 2008 and quarterly data available for the current and two preceding years.

Updating frequency

Quarterly data updated during the second month following the relevant quarter, annual data updated in February.

Data source

Kela – The Social Insurance Institution of Finland. Statistical registers (total material) produced from the prescription data.

Additional information

Additional information on reimbursements for medicine expenses is available at www.kela.fi under Our Services » Sickness » Medicine expenses and at the same address under About Kela » Statistics » Statistics by topic » Reimbursements for medical expenses.

Contact information

Kela, Actuarial Department
Email: tilastot@kela.fi