1. Drug Reimbursement in Slovakia Role of the Slovak Myeloma Society Dr. Katarína Fedorová

2. Health Insurance Not included in the scope of social insurance Obligatory for every resident 3 Heath insurance companies - Všeobecná zdravotná poisťovňa, Dôvera, Union Insured person - right on health care leading to prolonging life and improving its quality -art. 40 Constitution with Act No 580/2004 Coll. on Health insurance Act No 576/2004 Coll. on Health care

3. Scope of drug reimbursement Reimbursed - all drugs provided in inpatient care In outpatient care - drugs enlisted in the List of categorized medicines

4. Categorization Process of setting whether a drug will be reimbursed from the health insurance and in what scope Categorization Committee: –Slovak chamber of doctors –Health insurance companies –Ministry of Health 12 times a year Key factors of categorization: –Average monthly income in Slovakia two years ago = € 824 –Quality- Adjusted Life Year (QALY)

5. Categorization Drug can be: –categorized if QALY < 24 x average monthly income –conditionally categorized if QALY = 24-35 x average monthly income Drug can not be categorized if QALY >35 x average monthly income (€ 28 840) Exception - disease with prevalence in Slovakia lower than 1:100.000 =>NOT MYELOMA

6. Categorized = Let’s have them all?

7. Categorized drugs Limitation of prescription  Prescribed by specialist/on his recommendation Limitation of indication  Prescribed only in case of specified condition  Prescribed only in specified departments Need of prior approval of HIC  Provider has to submit a request Supplementary charge paid by patient

8. Treatment of Myeloma Velcade (bortezomib) – categorized, limitation of prescription, limitation of indication, prior approval of HIC needed, –no supplementary charge Revlimid (lenalidomide) - categorized, limitation of prescription, limitation of indication, prior approval of HIC needed –no supplementary charge Imnovid (Pomalidomide) – not categorized  Slovak Myeloma Society sends application to health insurance companies in behalf of a patient - currently not successful –Patients on Imnovid – gift from Celgene to a hospital pharmacy Thalidomide Celgene – not categorized

9. Slovak Myeloma Society Early diagnostics of myeloma => Raising Awareness Campaign Seminars for GPs, neurologists, orthopedists Distribution of “Diagnostic Tool” Questionnaires for myeloma patients and hematologists Access to treatment => Statements on reimbursement Adherence to treatment => Project DIALOG = Education and Counseling - www.mydialog.sk Interactive web page with online medical and legal counselling Magazine “Spravodaj” Brochures on myeloma, nursing care, legal issues Webinars

10. Not just work!

11. Fun in Slovakia

15. Thank you for your attention katarina1.fedorova@gmail.com www.myelom.sk facebook/mnohopocetnymyelom