Reimbursable pharmaceuticals and medical aids

Reimbursable pharmaceuticals and medical aids

To whom and how are reimbursable medicines and medical aids (MA) prescribed?

General practitioners or doctors of certain speciality, who are employed in the healthcare institutions that have contracts with the Territorial Health Insurance Funds can prescribe reimbursable medicine and medical aids in Lithuania. Medical doctors may prescribe only the medication enlisted in the Lithuanian National Register of Medication or other medication that may be used for health care in accordance with laws.

Similarly to majority of the European countries, only the expenses of medicines included into in the List of Diseases and Reimbursable Medicinal Preparations for Their Treatment (List A) or the List of Subsidized Medicines (List B) are reimbursed. Also only costs for MA, listed in the separate List of Reimbursable Medical Aids (List C), are reimbursed. Not the full purchase price applied to the medication or MA in a pharmacy is compensated, but so-called basic price that is calculated according to the procedure defined by the Government. The basic price of medicine of certain strength of the same therapeutic group or MA of the same group is the same. In majority of cases, the basic price of compensated medicine and MA is compensated by 100 percent, so the patient has to pay only the minor portion of the sale price – patient co-payment. The basic prices of small portion of the compensated medicines are compensated by 50 percent.

The compensated medicine and MA may be prescribed only for outpatients. These medications and aids are prescribed by electronic or paper prescriptions. If the compensated medicine or MA is prescribed to a citizen of another Member State of the European Union, or if the insured person does not have a book of prescriptions of the compensated medication, or if the electronic prescription cannot be issued because of disorders in the information system, or if the insured person is planning to buy the compensated medicine or MA in another Member State of the European Union, the prescription of form 3 (in exclusive cases) is issued.

Where can I get information about the prices of medicines and MA?

A pharmacist has to inform the patient about prices and co-payments of medicines and MA. However, information on the prices of reimbursable and non-reimbursable medicines can also be found even at home– by simply browsing the website of the National Health Insurance Fund under the Ministry of Health (www.vlk.lt) and open "Search for prices of medicines and medical aids” .

The highest possible prices of the medication in pharmacy are indicated in this information system in all the cases.

More information about compensated medication and MA are available on the NHIF website www.vlk.lt, section “Reimbursable Pharmaceuticals and Medical Aids”.