The new markup model moves away from the percentage-based markup mechanism for wholesalers and pharmacies, which can incentivize pharmacies to sell more expensive medicines. Instead, one fixed markup will be applied to all reimbursable and prescription drugs per package regardless of price for wholesalers, and pharmacies will have fixed markups in three price groups. Key points of the new markup model include:
- The price of the manufacturer’s medicine may not exceed the price in Lithuania and Estonia. The price in the compensation system must also be provided in the pharmacy for prescription drugs outside of compensation. Manufacturer will be able to change prices only once every 12 months.
- To strengthen the pharmacist’s role and offset revenue losses, a prescription service fee of 75 cents per prescription will be introduced. The state will also cover an additional 75 cents per prescription for large pharmacies, and EUR 1.75 for small pharmacies. Small pharmacies in rural areas, which also fulfill a social function, have a higher service fee, similar to that of family doctors, in order to promote the availability of services. Children under 18 years of age and individuals in need will be exempted from the prescription service fee.
The patient’s co-payment for prescriptions will be required only for the first time, with subsequent refills exempt from additional charges. The purpose of the changes is to improve the availability of medicines and reimbursement, ensuring at least 75% reimbursement, and expanding the range of reimbursable pharmaceuticals and diagnoses.
The implementation of the new markup model will require additional funding starting from 2025, amounting to EUR 9.4 million annually.