How can you continue to be granted reimbursement?

23 January 2009

Even though some cardiovascular medicinal products (‘antihypertensives’) will have their reimbursement status changed as of 13 July 2009 – some lose their general reimbursement status and others have their reimbursement limited (conditional reimbursement) – all patients will still be eligible for reimbursement for their treatment. For some patients, this may mean that they have to switch to another, but less expensive medicinal product. If you are undergoing treatment with one or more of the medicinal products for which the reimbursement status is changed – see the overview of reimbursement status as of 13 July 2009 for medicinal products for the treatment of cardiovascular disease (link in the factbox) – you must talk to your general practitioner next time your prescription requires renewal. You have six months to talk to your general practitioner before the system enters into effect.

In practice, you must consider the following with your general practitioner:

  • if your treatment is not affected by the reimbursement change, no changes should be made to the treatment – unless, for instance, your blood pressure has not been lowered sufficiently.
  • if you are undergoing treatment with a dihydropyridine calcium channel blocker, for which reimbursement becomes conditional, the general practitioner must decide
  • if you can be switched to a less expensive dihydropyridine calcium channel blocker eligible for reimbursement or another medicinal product,

or

  • if you are comprised by the reimbursement condition. If so, the doctor writes “tilskud” (reimbursement) on the prescription, and you continue treatment with the same medicinal product.
  • if you are undergoing treatment with an ACE inhibitor which loses its reimbursement, the general practitioner should change your treatment to a less expensive ACE inhibitor eligible for reimbursement or another medicinal product eligible for reimbursement.
  • if you are undergoing treatment with an angiotensin II antagonist, the general practitioner must decide
  • if you can be switched to a less expensive ACE inhibitor eligible for reimbursement or another medicinal product eligible for reimbursement,

or

  • if you are comprised by the reimbursement condition. If so, the doctor writes “tilskud” (reimbursement) on the prescription, and you continue treatment with the same medicinal product.

To ensure a smooth transition for those patients affected by the changes in reimbursement, we have encouraged the pharmacists, in case of prescription dispensing for the affected medicinal products over the coming months, to ask their customers to talk to their general practitioner about their future blood pressure treatment when their prescription is next up for renewal.

A smaller proportion of the patients treated with an ACE inhibitor will experience an adverse reaction in the form of cough. If so, contact your general practitioner. In this case, the condition for being granted reimbursement for a medicinal product in the group of angiotensin II antagonists will have been met, and the general practitioner must write “tilskud” (reimbursement) on the prescription.