[Effects of health-service reform in the field of medicinal drugs II. Analysis from the standpoint of financial participation of the patient in pharmacotherapy].

: Since 1 January 2008, the health service reform established the duty to pay a regulatory fee for the dispensation of one item on the prescription which is at least partially covered by the public health insurance and it also established a protective annual limit of the sum of a patient's financial participation in the provided health care. The study aimed to determine the effects of these measures. The complete medication of 100 patients for the year 2008 was examined. The patients' prescriptions included 2 062 items, out of which 841 items (41 %) were fully covered. The share of the items with non-zero supplementary charge was about 20 %. In the year 2008 the patients paid for medicinal drugs 180,703 CZK as supplementary charges (including the regulatory fees); the health insurance companies paid 2.7 times more than the sum paid by the patients for their treatment. Eight patients in the annual summary paid for their medicinal drugs more than the sum covered by health insurance companies. In the year 2008 no medicinal drug with a supplementary charge was prescribed for 12 patients. No patient exceeded the limit sum of 5,000 CZK as the sum total of paid regulatory fees and supplementary charges. Only one patient would exceed the limit of 5,000 CZK of the sum total of regulatory fee with the theoretically included supplementary charges (according to the valid code list).