Health Systems in Transition

Health systems in transition

Portugal

125

Pharmaceuticals used by some highly vulnerable groups of patients are fully

paid for by the NHS. The following therapeutic categories or treatments are

fully covered:

•

immunomodulators

•

cystic fibrosis treatment

•

chronic kidney failure treatment

•

treatment for rejected transplants

•

amyotrophic lateral sclerosis

•

growth and anti-diuretic hormones

•

specific drugs for haemodialysis

•

haemophilia treatments

•

antivirals for hepatitis C

•

antiretrovirals for HIV.

In 1995, a new policy was introduced whereby the NHS imposed cost

sharing on private sector prescriptions at the same level as the public sector

prescriptions (Decree-Law No. 272/95, of 23 October 1995). The rationale of

this reform was to reduce the number of private prescriptions being taken to

primary care centres to be repeated on an NHS prescription.

5.6.2 Pharmaceutical expenditure and policy

The Portuguese pharmaceutical market has been subject to a large number

of policy measures over the last decade. These included the introduction of a

reference price system whenever competition from generics was possible (since

2003) and changes in the way the reference price is defined; administrative

price reductions (2005, 2007 and 2010); several changes in co-payment rules

and values; and the increased use of economic evaluation as a hurdle to the

introduction of new products, both in ambulatory care and hospitals. Since

2010 the package of measures seems to have had a noticeable impact on

public expenditure, with a reduction in public expenditures on pharmaceutical

products in ambulatory care and a slight slowdown in the increase of hospital

expenditure. The administrative price reductions, introduced in 2010, included

changes in the setting of maximum prices for pharmaceutical products, and

changes to co-payment rules for products included under NHS coverage.