Lääkekorvausjärjestelmä

Lääkekorvausjärjestelmä, often translated as the pharmaceutical reimbursement system, is a mechanism in place in many countries to reduce the out-of-pocket costs for prescription medications for citizens. The primary goal of such a system is to ensure that essential medicines are affordable and accessible to those who need them, regardless of their financial situation.

Typically, the system operates through a combination of public funding and private insurance. When a doctor prescribes a medication, a portion of its cost is covered by the government or an authorized insurance provider. The patient then pays the remaining amount, which is usually a subsidized price. The level of reimbursement can vary depending on the medication's therapeutic importance, its price, and the patient's specific circumstances, such as income level or the presence of chronic conditions.

Different countries have unique models for their lääkekorvausjärjestelmä. Some may have a single national system, while others might involve a mix of public and private insurers. Eligibility criteria, reimbursement rates, and lists of covered drugs are often determined by national health authorities. The system can also encourage the use of generic drugs by offering higher reimbursement rates for them compared to their brand-name equivalents, thereby promoting cost-effectiveness. The aim is to balance the need for widespread access to medication with the sustainability of the healthcare system.