Health Systems in Transition - Hungary - World Health Organization ...

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Health systems in transition Hungary
One of the stated goals of successive governments has been to foster the
creation of jobs by deeply reducing the contribution rate of employers. This goal
has been pursued since the mid-1990s, but data from the employment database
of the HCSO show that the employment ratio for the population between the
ages of 15 and 64 years increased only slightly, from 53.6% in 1998 to 56.0% in
2000 and to 56.7% in 2008 (HCSO, 2010c). Although the economic situation in
Hungary has been complex in this regard, these data indicate, at the very least,
that lowering the employer contribution rate is likely not the panacea it has so
frequently been portrayed to be. As this is a particularly expensive policy tool,
it would be helpful to elucidate its impact on employment with more evidence.
Pharmaceuticals
In its programme presented in 2006, the government indicated that its chief
goal would be to contain expenditure on pharmaceuticals (Government of the
Republic of Hungary, 2006). Several new measures were introduced to this
effect in 2007, such as inciting competition in the generic market by fine-tuning
the reference pricing system (2006/20); using NHIFA-certified IT tools to
support and monitor the cost–effectiveness of physician prescribing; imposing
a 12% tax on pharmaceutical companies, a 2.5% tax on wholesalers and a
solidarity tax on pharmacies based on the reimbursed value of pharmaceuticals;
and introducing an annual tax of 5 million HUF (around €19 700) to be
paid by pharmaceutical companies for each marketing agent they employ
(2006/8). Moreover, as had been done by previous governments, the level of
reimbursement for pharmaceuticals paid by the HIF was reduced significantly,
that is, user charges were increased (2006/20). Altogether these led to a sharp
decrease in public expenditure on pharmaceuticals in real terms.
Also, before 2004 there was no systematic and elaborated process for
deciding which services should be included in or excluded from the statutory
benefits package and the final decisions were made in a non-transparent way.
With accession to the EU in May 2004, the adoption of the Council Directive
89/105/EEC, laying down harmonized provisions to ensure the transparency
of measures adopted by national authorities to regulate the pricing and
reimbursement of medicinal products, was used to establish the process (2006/8)
of HTA. The new appraisal process aimed to strengthen the active purchasing
of the NHIFA with proper evaluation of the application of the pharmaceutical
companies (see more detail in 2.7.2 and in 3.3.2). This was done successfully,
and since then, the usage of HTA was extended for other medical technologies
and equipment in 2010 (2010/3).