New practise: Kela to collect a one-off payback fee from pharmaceutical companies in 2016

News • 21.01.2016

Under the amended Finnish Health Insurance Act, pharmaceutical companies must return a portion of their 2015 net sales to the National Health Insurance Fund of the Social Insurance Institution Kela. This non-recurring payback fee only applies to Kela-reimbursed actual sales and it must be paid by 1 September 2016. The aggregate amount payable by pharmaceutical companies totals EUR 6.9 million.

Kela will determine the payback fee payable by each marketing authorisation holder or its representative. A draft decision will be issued before the final decision.

The payback fee will be determined on the basis of actual sales (at wholesale prices) reimbursed under the health insurance scheme in 2015. The following products will be excluded: medicinal products available on special permit for compassionate use, clinical nutritional products and basic creams, dose-dispensed medicinal products, divided sales packages and therapeutic oxygen and blood.

Amendments to the Health Insurance Act designed to reduce medicinal product compensation expenditure to be implemented in 2016 became effective on 1 January 2016.

Want to know more? Our price and reimbursement team will be happy to provide you with further information about the amendments and help you with any issues related to reimbursement, prices and health economic evaluations.