Achitz: Parliament makes medication costs more effective

As soon as someone has issued 2 % of the net income for recipe fees, it is freed from it for the rest of the year. But not if you get many cheap medication. People’s attorney Bernhard Achitz made aware of this in February 2024. The retirementist Johann R. had complained to the public prosecutor because he had calculated: until November 28, he had spent 521 euros for medication, but only 360 euros were counted for the upper limit. This corresponded to the legal situation, but not the feeling of justice by Johann R. and many other affected people. “The National Council has now concluded this legislative gap at the proposal of the public prosecutor. In the future there will be a medication cost limit instead of a recipe fee.”

Recipe fees old limit

According to the previous legal situation, we do not count prescribed medication if your price is lower than the prescription fee. And to make it even more complicated: they do not count even if the so-called cash price, i.e. the discount price that the health insurance of the pharmacy pays, is lower than the prescription fee. In these cases, the patient has to pay the private sales price. If the private sales price is higher than the prescription fee, the pharmacy can only request an amount in the amount of the prescription fee due to the total pharmacy contract. Then the 7.55 euros are not counted towards the recipe fee limit. Thus, those affected are only freed from the prescription fees later in the year – or not at all.

Medicine cost lids new

“On the other hand, the medication cost cover that has now been decided by the National Council reaches its goal: to relieve people as soon as they have spent a certain proportion of their income for medication,” said Volksanwalter Bernhard Achitz. Because from 2026 a “remedial cost account” is planned, and not only the paid recipe fees, but also the cash prices of prescribed and reimbursable medication, which cost less than the prescription fee and have been paid by the patients themselves. This also gives an incentive to ask for a doctor or doctor to prescribe as more expensive medication. In addition, more people benefit from the medication cost lid from 2027, because it is gradually reduced from the net annual income from 2 % to 1.5 %.

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