The initial deductible on prescription drug reimbursements will change, affecting medication costs for many
Parliament has approved changes to the initial deductible on reimbursements of medicine costs. The initial deductible will go up from 50 euros to 70 euros in January 2025. In addition, the initial deductible will be tied to the National Pensions Index and will be reviewed annually.
Summary:
On 1 January 2025, the initial deductible on reimbursements of medicine costs will go up from 50 euros to 70 euros.
In addition, the initial deductible will be tied to the National Pensions Index, so that it will be index adjusted every year.
The initial deductible will still be applied from the beginning of the year in which a young person turns 19.
The changes will enter into force on 1 January 2025.
The changes in the initial deductible on reimbursements of medicine costs will enter into force automatically. The procedure for claiming reimbursement for medicine costs will not change.
Customers do not have to do anything and do not need to contact Kela.
Parliament has approved the changes the Government proposed to the initial deductible on reimbursements of prescription medicine costs. The Government seeks to lower reimbursement spending by 90 million euros.
On 1 January 2025, the initial deductible on reimbursements of medicine costs will go up from 50 euros to 70 euros. In addition, the initial deductible will be tied to the National Pensions Index, so that it will be index adjusted every year.
"The National Pensions Index reflects changes in the general cost of living”, says Vilja Juvonen, a legal counsel at Kela. “If the cost of living rises, so does the National Pensions Index, in turn increasing the initial deductible.”
Kela provides reimbursements for the costs of medicinal products, clinical nutritional products and emollient creams that have been prescribed for the treatment of an illness. Costs exceeding an annual initial deductible can be reimbursed. The initial deductible is applied from the beginning of the year in which a person turns 19.
The amount reimbursed depends on the specific medicine and the reimbursement entitlements granted. There are three categories of reimbursement: basic, lower special and higher special.
Fewer people will receive reimbursements as a result of the higher initial deductible
In 2023, about 55% of Finns, a little over 3 million persons, qualified for reimbursement of prescription medicine costs. Total expenditure on the reimbursements amounted to 1,779 million euros, most of which was accounted for by the reimbursements in the higher special category. Over-65s were the single largest group of reimbursement recipients.
“The higher initial deductible will have the greatest impact on those who need medicines in the higher special reimbursement category. The people who need such medicines often have multiple illnesses, little income and are on average older than others who purchase medicines”, Juvonen says.
The number of reimbursement recipients has increased over the past few years. In 2023, the number of recipients was up by 1.7% (a little over 51,000) year-on-year. In 2022, the number of reimbursement recipients grew by 84,000.
“We estimate that the higher initial deductible will reduce the number of reimbursement recipients by about 226,000. The under-45 age groups will have the largest number of people who do not clear the initial deductible threshold”, Juvonen says.
The changes in the initial deductible will go into effect automatically. The process of claiming reimbursement for medicine costs will remain unchanged.
Typically, the reimbursement is calculated off the price of the medicine at the pharmacy. If this is not the case or if a customer had to buy medicine before Kela had granted them a right to reimbursement, the reimbursement must be claimed afterwards from Kela.
Customers do not have to do anything in response to the change and do not need to contact Kela.