Web-economic-crisis-health-systems-and-health-web

468 Economic crisis, health systems and health in Europe: country experience
Changes to health coverage
Population (entitlement)
• No response reported.
The benefits package
• The number of covered visits to a GP for the same condition capped at
five (2010) and then reduced to three (2011).
• Any additional visits must be paid for OOP by the patient.
• Removal of drugs of limited therapeutic benefit from statutory coverage
(2011).
• Some branded drugs replaced with generic drugs in the list of drugs used
in national health programmes (2011).
User charges
• Introduction of exemptions from user charges for children, veterans and retired
persons with monthly incomes of less than RON 700 (2011).
• New user charges were planned for 2011 but implementation of new primary
care user charges (RON 5 for a GP visit, RON 15 for a GP home visit) has
been postponed several times.
• Introduction of new user charges for hospital care (RON 10 per day in
hospital and RON 50 for hospitalization of more than one day, capped at
RON 600 per individual per year).
• From 2013, a new co-payment of RON 5–10 (hospitals can set their own
rate of not more than RON 10) is to be paid on discharge from hospital.
Changes to health service planning, purchasing and delivery
Prices of medical goods
• Introduction of a new e-prescription system (2012).
• Introduction of tighter prescribing controls (2011).
• Under pressure from drug companies and wholesalers, the Ministry
of Health updated prices to reflect the new exchange rate (which had
worsened because of inflation), leading to an increase in prices (2009).
• Introduction of a clawback mechanism using a sliding scale based on total
sales (2010).
• SHI modified reference pricing introduced to encourage prescribing of
cheaper drugs (2011).