Knesset approves drop in co-payments for many medications

Health fund members who are prescribed medication that is generic or has competition from generic drugs will have to pay 10% co-payment instead of 15%.

June 30, 2011 04:25
2 minute read.

Pills 311. (photo credit: Courtesy)

Starting on August 1, health fund members of all ages who are prescribed medication that is either generic or has competition from generic drugs will have to pay just a 10 percent co-payment instead of the 15% that is currently charged. The change was approved on Wednesday by the Knesset Finance Committee following a request last month by Deputy Health Minister Ya’acov Litzman.

In May, the deputy minister received a report by ministry deputy director-general for supervision of the health funds Dr. Yoel Lipschitz, who said the four health insurers had spent significantly less on prescription medications than the drug budget they had received for them in health taxes.

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Litzman then said that the “extra funding” would be plowed back into the health system, thus allowing “up to a 33% reduction” in co-payments for prescription drugs in the intermediate range of prices. The report – issued by Litzman at a May press conference – triggered a furious response from Maccabi Health Services, the second-largest health fund, which along with Clalit Health Services, Kupat Holim Meuhedet and Kupat Holim Leumit, had received an advance draft.

Litzman said he initiated the examination and report when he took office two years ago, when he suspected the insurers were spending less than they took in to cover drug costs.

”This is an important social step that will be expressed in reduced co-payments for medications,” the deputy minister said back then.

When presenting his report, Lipschitz said the drugs the insurers purchased and supplied to members cost them less because they received significant discounts from the manufacturers and importers. In addition, some older medications in the basket of medications – which remained on the list as deserving compensation – were not used because they had been replaced by newer drugs, he said.

A third of the NIS 150 million saved due to improved accounting, said the deputy director-general, will be devoted to reducing co-payments paid by the public who purchase generic drugs or brand name drugs that are original intellectual property but that compete with medications without patents. The medications whose co-payments will be reduced across-the-board are those costing above NIS 100 per unit, but will not include the very expensive drugs or the common ones that are much cheaper.

Maccabi spokesman Ido Hadari (a former ministry spokesman) then said that the ministry was “misleading the public,” adding that the health fund “absolutely rejects the report and the examination technique.” Maccabi did not issue any statement after the Knesset committee approved the plan on Wednesday.

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