News & Views

Legislative Proposal: Conditional Reimbursement System for Medicinal Products to Continue Until the End of 2025

2 September 2019

Authors: Amanda Blick and Juli Mansnérus

As of the beginning of 2017, the Finnish Pharmaceuticals Pricing Board (Hila) has had the authority to decide on the conditional reimbursement and the wholesale price for medicinal products. The risk-sharing model of conditional reimbursement enables a more rapid and frequent introduction of medicinal products containing either new active substances or new indications for medicinal products which are included in the reimbursement system and for which an extension of reimbursement is sought. By 30 August 2019, the Pharmaceuticals Pricing Board has issued 37 conditional reimbursement decisions for a total of 27 medicinal products, and it has now been proposed that this scheme, which was originally intended as temporary, would be extended by six years until the end of 2025.

In view of the experience gained from the ongoing scheme, the Finnish Health Insurance Act would be subject to further substantive amendments. These include clarifications to the legislation regarding the assessment criteria for reasonable wholesale prices of conditionally reimbursed medicinal products and the use of conditionally reimbursed medicinal products in reference pricing. In addition, it has also been proposed that the five-year maximum period for conditional reimbursement be removed, allowing an individual assessment on the appropriate length of conditional reimbursement for each medicinal product.

The draft amending the Health Insurance Act has been circulated to stakeholders, who can submit comments on the draft until 6 September 2019. The government proposal is due to be submitted to the Parliament in the autumn.