News - September 26, 2019

Revision of the Public Health Insurance Act in Czech Republic

The Czech Ministry of Health recently announced that the Public Health Insurance Act 48/1997, which regulates the scope and conditions under which health services are covered as well as their pricing and reimbursement, would be amended.

The foreseen amendments, expected to enter into force in Q1 2020, include:

  • New rules regarding the assessment of innovative and costly medicines to be introduced in the reimbursement system to facilitate access for patients.
  • Enhanced transparency in the approval process for applications for extraordinary reimbursement.
  • The maximum price of orphan drugs will be reviewed earliest after 3 years. Patients under treatment will continue to receive treatment should reimbursement be repealed after review.
  • Health insurance companies can initiate the review (e.g. in case of change in clinical practice, entry of new orphan for same indication, failure to meet expectations of efficacy or safety, failure to meet risk-sharing obligations, etc.)