Tuesday, 16 August 2022

Savings Could be Made With More Generic Drugs on Croatian Market

August the 16th, 2022 - Replacements of certain medicines are set to arrive on the Croatian market as making savings becomes extremely necessary in the enfeebled Croatian healthcare system.

As Poslovni Dnevnik/Josipa Ban writes, counting the pennies within the wider Croatian healthcare system, especially in the consumption of medicines, is now more needed than ever. We've been witnessing accumulated debts for medicines for decades now, which, after numerous rehabilitation attempts by the Ministry of Finance, are still far from reduced. In fact, they only grew enough to reach slightly more than six billion kuna at the end of April this year.

HUP - the Association of Pharmaceutical Manufacturers have been warning about some of these debts for some time, noting that they definitely can be reduced. The Croatian healthcare system's annual savings could rise from the current 300 million to as much as one billion kuna if consumption were to increase and the procedure for including generic drugs on HZZO's list of drugs for the Croatian market was finally accelerated.

There are some substitute drugs that come to the Croatian market when the patent rights to the original drug eventually expire. As their placing on the Croatian market means more competition, the price of the medicine also drops at the same time. The situation here, at least according to data from back in 2019, is that 61 percent of the volume in the consumption of prescription drugs across the Republic of Croatia is made up of generic drugs, and they only account for 5% of the total healthcare sector's budget.

"Although this percentage has been increasing over the years, it's still somewhat lower than the EU average, which stands at 67 percent. This shows us that there is still a great potential for the use of generic drugs in this country,'' they emphasised from HUP- the Association of Medicines Manufacturers, whose members, in the period from 2010 to 2020, invested a total of 5.4 billion kuna. As far as biosimilar medicines are concerned, the situation is much worse, and back in 2019 they occupied a modest 13 percent of the Croatian market.

A complicated procedure...

One of the reasons for the lower consumption of generic and biosimilar drugs, which causes higher expenditures for such medicines, is the procedure that manufacturers must go through in order to get on HZZO's drugs list.

Jerko Jaksic, president of the PharmaS Management Board and president of the HUP Association of Drug Manufacturers, explained that the process of placing a generic drug on the Croatian market takes approximately one to two years.

"The first stage is the registration of the drug with HALMED or, for biosimilar drugs, with the European Medicines Agency (EMA). After approval from HALMED or EMA, it takes up to six months for the HZZO to place the drugs on their list. Although the situation is somewhat better than it was around ten years ago, that part of HZZO could and should be accelerated. What I mean by that is that following HALMED and EMA approval, these medicines should automatically be included in the lists of medicines, without any additional administrative steps because there's no need for them. Unfortunately, here too we have an example of resistance to changes and adaptation of the system, as well as the classic slowness of the administration,'' pointed out Jaksic, adding that automatic inclusion would speed up processes and the arrival of medicines on the Croatian market, as would cheaper drug therapies for patients in three to six months.

"It would also bring savings of several tens of millions of kuna on an annual level for the entire Croatian market," said the president of the PharmaS Management Board. HUP noted that the role of generic and biosimilar drugs is extremely important for both the healthcare system and the patients themselves.

"In fact, these drugs make many key therapies available to more patients, and for the same or at a lower cost than before their introduction. For example, two to three boxes of prescription drugs issued in Croatia come from the generic industry, and the share of generic drugs in the cost of all drugs is only 27 percent. If we look at the pharmacy system, the share of generic drugs is 65 percent, and this accounts for less than 40% of the drugs budget," they explained.

Great potential

In addition to all of the aforementioned, there is no fear for the patient because prescription drugs and generic drugs are the most organised part of the healthcare system. Jerko Jaksic noted that their importance has long been recognised by GPs. However, hospital doctors are not yet following suit.

"Hospital doctors have a lower level of knowledge of generic and especially biosimilar therapies, they also lack a developed awareness of the financial savings they can enable. There's a great untapped potential there, above all in the sense of using cheaper generic and biosimilar therapies in order to reduce costs for hospitals,'' said Jaksic.

There are, therefore, several mechanisms that we must change in order to accelerate the introduction of generic and biosimilar drugs on the Croatian market, and thereby contribute to significant savings.

"It's necessary to systematically implement the existing regulations for the determination of the price of drugs, to include generic drugs on HZZO's drugs list faster, and to enable the faster penetration of generic and biosimilar drugs into the wider hospital system,'' the HUP Association of Drug Manufacturers believes.

With these measures, along with measurements of treatment outcomes, they say, savings in the healthcare system can reach up to 1 billion kuna per year. So, the ruling party has a solution. But is the will there?

For more, make sure to check out our dedicated lifestyle section.

Saturday, 13 August 2022

Important Scan Can Now be Done Privately with HZZO Footing the Bill

August the 13th, 2022 - There have been some absolutely horrific stories about the state of the Croatian healthcare system of late, and so it might seem as if nothing within the four walls of a hospital can be trusted. While that is absolutely not true at all, it is more than understandable that people fear potential illness. Some good news is that HZZO will now foot the bill for a test that can be done in a private facility, without all of the long waiting times typically associated with busy, overworked state hospitals and other healthcare facilities.

Magnetic resonance imaging, commonly known as MRI, can reveal an extremely wide array of issues going on within the human body in a remarkably clear way. This type of scan is used for all sorts of health issues, and the waiting times associated with them are sometimes bafflingly long. A new plan for which HZZO (Croatian Health Insurance Fund) will gladly foot the bill may relieve some of that pressing problem, which is an issue for both hospitals and of course for the patients.

As Poslovni Dnevnik writes, in order to reduce the usually extremely long national waiting list for magnetic resonance imaging (MRI), HZZO came to what will be to most a very welcome decision on entering into a contract with Medikol Polyclinic.

As reported by the aforementioned polyclinic, according to that decision, HZZO will provide the Medikol Polyclinic with a list of patients who are on the waiting list for MRI scans in hospitals for a variety of different reasons, and the Medikol Polyclinic will provide them with magnetic resonance imaging through a referral by December the 31st, 2022. MRI scans carried out via this new agreement with HZZO will be available in Zagreb, Cakovec, Split and Osijek.

''We will be able to accept referals only from those patients who are already on waiting lists for MRI scans in hospitals and are on the list provided by HZZO,'' they wrote from Medikol when it announced the new plan on its Facebook page.

For more on healthcare in Croatia, make sure to check out our dedicated lifestyle section.

Monday, 27 June 2022

A Short Guide to Croatian Public Services and Institutions

June 27, 2022 - You see them on the street, you see them on your bills, and you hear them on the phone. Who is who among the Croatian public services and institutions? We'll tell you more in this short guide.

If moving to Croatia is one of your short-term projects, or even if you're already in the process of adaptation, you may have heard of or been in contact with one of these institutions. These Croatian public services and institutions will be part of your daily life here, and it is true that sometimes it can be a bit confusing trying to distinguish them from each other.

In this short guide, we've listed some of the Croatian public services and institutions that you will be in contact with most often, and we hope that this will help you when you don't know where to go for a certain task, or when it's time to do your accounts at home.

MUP

If you're working on getting your residency or citizenship in Croatia, you have most likely gone to a local MUP office. It's also likely that they've called you on the phone or have written you an email or two. MUP is the Ministry of the Interior, and it provides services to both locals and foreigners alike. At MUP, you will also carry out procedures to obtain your passport, your driver's license, your Croatian identification card, and more.

HZZO 

HZZO is the Croatian Health Insurance Fund, it's part of the Ministry of the Health and it includes everything that is related to public health insurance services in the country. As you well know, public health insurance is mandatory if you reside in Croatia. If you wish to enroll in the Croatian public health system, you must go to the HZZO offices in your city of residence. There you can also find out everything related to your health coverage, sign up with a family doctor, and more.

HZZ

HZZ is the Croatian Employment Office, and it serves to report your current employment status, whether you've found a job or if you don't currently have one. At the Employment Office, you can also find job openings that match your skills. 

HZMO

The Croatian Pension Insurance Institute (HZMO) is a public institution that is dedicated to the implementation of mandatory pension insurance based on generational solidarity (1st pillar of the pension insurance) and the child benefit entitlement procedure.

Porezna uprava

Porezna uprava is the Croatian Tax Administration, and it's a unique and independent administrative organisation within the Finance Ministry whose basic task is the application and supervision of tax regulations and laws on the collection of contributions. Most of your bills will be issued by Porezna uprava. They'll also issue you with tax rebates.

FINA

FINA, the Financial Agency, is a leading Croatian company in the field of financial and electronic service provision. Although state-owned, Fina operates exclusively on a market basis and cooperates with banks, the Croatian National Bank, numerous business systems, and other similar entities. A multitude of payments can be paid at their offices.

Hrvatska Pošta

Hrvatska Pošta is the Croatian Post Office, and it has locations in every city and town across the country. In addition to being the place where you can send letters and packages throughout the country and even abroad, it's also the place where you can pay for your phone, electricity, water, health insurance, and more.

HEP

A state-owned company, HEP is the Croatian Electricity Company and it is the only energy entity authorised to provide a public electricity supply in the Republic of Croatia. It also performs the activities of electricity production and heat production for central heating systems, in addition to the management, maintenance, construction, and development of the electricity distribution network.

HAC 

Hrvatske autoceste or Croatian Motorways Ltd is a Croatian state-owned limited liability company tasked with the management, construction, and maintenance of motorways in Croatia.

HRT

Croatian Radio and Television (HRT) performs the activity of providing public broadcasting services. On their radio and television channels, they dedicate themselves to the dissemination of news, information, culture and other related content. Even if you don't watch their channels or listen to their radio stations, a bill of 80 kuna from HRT will always arrive at your home.

For more, check out our lifestyle section.

Saturday, 4 June 2022

Croatian Company Atos to Work on eHZZO Project for 19 Months

June the 4th, 2022 - The Croatian company Atos has been chosen as the more favourable bidder for a new Croatian Health Insurance Institute (HZZO) project worth a lot of money. The company will spend nineteen months on the project.

As Poslovni Dnevnik/Marija Crnjak writes, the Croatian Health Insurance Institute (HZZO) has announced the start of the brand new eHZZO project, worth almost 115 million kuna, which aims to establish more efficient management and supervision within the healthcare system.

The construction of this brand new new system is being co-financed by the European Union (EU), and will enable easier communication with external users, as well as the high availability of data necessary for business process management and different forms of reporting.

"The Croatian Health Insurance Institute has one of the most important information systems in operation within the Republic of Croatia, so the eHZZO project will benefit all insurance policyholders through the better organisation and availability of the healthcare system," said Deputy Director of the Croatian Health Insurance Institute, Veronika Lausin.

The entire eHZZO project is worth a total of 114.7 million kuna, of which 85 percent is being financed with European Union money. The project will be worked on for the aforementioned period of nineteen months, and the strategic partner of the project, the Croatian company Atos, was selected as the most favourable bidder in the 2021 tender.

Three bidders, two consortia and one independent bidder appeared in the tender. The Croatian company Atos applied for the tender within a group consisting of a Czech company of the same name and a Macedonian enterprise called Nextsense, and their offer was the cheapest of all.

Ericsson Nikola Tesla and IN2 also competed together with CUSPIS. The third bidder was King ICT.

For more on Croatian companies, entrepreneurs and innovation, make sure to check out our dedicated business section.

Wednesday, 18 May 2022

HZZO to Cover Cost of Pregnancy Termination in Slovenia for Mirela Čavajda

ZAGREB, 18 May 2022 - The Croatian Health Insurance Agency (HZZO) will cover the cost of pregnancy termination for Mirela Čavajda in a hospital in Ljubljana.

The HZZO said this in a statement issued after earlier in the day the Jutarnji List daily reported that Čavajda would most probably not have the cost of her pregnancy termination abroad covered by the HZZO.

Čavajda is a woman six months into her pregnancy who who could not have her pregnancy terminated in Croatia despite the fetus's serious malformations.

Jutarnji List says is has learned from unofficial sources that Croatian doctors, even though they refuse to perform the procedure guaranteed by law, are also unwilling to put their refusal down in writing, and that hospitals have sent the HZZO notifications saying that Čavajda has been offered the necessary medical procedure - induced labour.

"Since she does not want that procedure but insists on pregnancy termination, the HZZO considers this to be a refusal of the medical service offered in Croatia, which makes it questionable if there are legal grounds for the HZZO to cover the cost of the medical service she will seek in Slovenia", the daily says.

For more, make sure to check out our dedicated lifestyle section.

Sunday, 17 April 2022

Faster HZZO Medicine Listing Would Save Another Billion for Healthcare System

April the 17th, 2022 - The much more rapid and efficient listing of HZZO medicine could end up saving the already enfeebled Croatian healthcare system another billion kuna.

As Poslovni Dnevnik/Marija Crnjak writes, the Croatian healthcare system could save an additional one billion kuna per year if the policy of putting generic and biologically similar drugs on the lists of the Croatian Health Insurance Institute (HZZO) was improved and accelerated, according to Croatian pharmaceutical generic companies within the Croatian Employers' Association (HUP).

Currently, the system saves about 300 million kuna a year with the use of this HZZO medicine, but the potential is significantly higher, said Jerko Jaksic, president of the Association of Drug Manufacturers at HUP, at a briefing for journalists which took place on Thursday.

According to data from back in 2019, 61 percent of the volume of prescription drugs in the Republic of Croatia is made up of generic drugs, which is slightly lower than the EU average of 67 percent. The situation with biosimilars is much worse, they accounted for a modest 13 percent of the market in total consumption of biological drugs.

Although further growth is expected in the coming years, in addition to education, it's necessary to accelerate their application when they are registered with the European Medicines Agency and the Croatian Medicines Agency.

As the manufacturers have explained, the HZZO procedure for listing a drug, which is purely administration and paperwork, takes an average of four to six months, during which time money is directly lost that could be saved by using generic instead of innovative therapy.

“So-called drug penetration into the system should be significantly quicker, which is even more significant when it comes to biological drugs, as biological drugs are very expensive. We have announcements from the Croatian Health Insurance Fund that this process could be accelerated, and we're very happy about that. There's no reason why a drug shouldn't automatically be on the list immediately after its registration, and it would be very good if the new procedure comes to life by the middle of this year because patents for some drugs expire soon,'' Jaksic said.

In particular, these are diabetes related drugs, and the potential for savings is 30 percent for the healthcare system, with the release of patient participation. With proper application, in 2023, 15 percent more patients could be treated for the same cost in this segment alone, HUP pointed out. The data also shows that biosimilars have increased the availability of biologic therapy.

For example, in the immunology segment, 67 percent more patients were treated for only 19 percent more. Back in 2021, 2.5 times more patients were treated with the chemotherapy mitigation drug than in 2019 for approximately the same total cost. In 2020 alone, biosimilars provided savings of 200 million kuna. However, the biggest shortcoming in the drug policy in Croatia is still poor cost control, due to insufficient therapeutic guidelines and measuring the effectiveness of therapies, they added from HUP.

Patient registries exist only for a small number of diagnoses and a large role in this is played by patient associations, which are as such fighting for the better availability of some drugs, but for most patients and diagnoses, not all treatment parameters are systematically monitored.

For more, check out our lifestyle section.

Wednesday, 13 April 2022

Croatian Health Insurance Fund Spends €666.6m on Fighting COVID-19 Epidemic, says Jutarnji List

ZAGREB, 13 April 2022 - The fight against the COVID-19 epidemic has cost the Croatian Health Insurance Fund (HZZO) HRK 5 billion (€666.6m) over the last two years and two months, Jutarnji List newspaper said on Wednesday.

The cost only includes testing, treatment, sick leave and vaccination, but not other economic costs, the cost of equipment or the cost of conversion of hospitals and other facilities used for the treatment of COVID patients.

As for the costs covered by the HZZO, treatment cost around HRK 1.9 billion (€253.3m),  testing HRK 1.7 billion (€226.6m), sick leave HRK 290 million (€38.6m) and vaccination HRK 1 billion (€133.3m).

The newspaper said that the amount spent by the HZZO would be enough to cover the debts of the health care system.

In addition to the cost of health care, by far the most expensive measure was the government's job retention scheme, which cost HRK 18 billion (€2.4bn).

In total, at least HRK 23 billion (€3.06bn) has been spent on combating the coronavirus epidemic since the first case was confirmed in Croatia on 25 February 2020, according to Jutarnji List.

(€1 = HRK 7.5)

For all you need to know about coronavirus specific to Croatia, make sure to bookmark our dedicated section and select your preferred language if it isn't English.

Saturday, 2 April 2022

Croatian Retirees Can Request Free Supplementary Health Insurance

April the 2nd, 2022 - Croatian retirees, we well as other groups of people legally resident in Croatia, can now request free supplementary health insurance coverage (dopunsko zdravstveno osiguranje) through the Croatian Health Insurance Fund, HZZO.

As Poslovni Dnevnik writes, HSU (Croatian Party of Pensioners) has called on all Croatian retirees, but also other residents to whom this new and very welcome rule applies, to make sure they take the opportunity to exercise their right to free supplementary health insurance.

Many Croatian retirees, as well as other groups of individuals who fall into the category of people to whom this applies, have still not exercised their right to supplementary health insurance at the expense of the state and may be needlessly paying for it, if they have it already. Amendments to the Law on Voluntary Health Insurance which came into force back in November last year, at the initiative of the HSU, raised the threshold.

This new free policy for an additional form of health insurance through HZZO can be realised by anyone who has an income of up to 2,065.60 kuna per family member, or 2,582 kuna for a single person.

If this is you, then what needs to be done?

If you are a Croatian retiree or fall into one of the aforementioned categories of people, you can make your way to your nearest local HZZO office and fill out the appropriate form to conclude your contract on supplementary health insurance at the expense of the state. A clerk working there will be able to point you in the right direction and guide you through the process and what you can expect from it if necessary.

For more, make sure to check out our dedicated lifestyle section.

 

Saturday, 26 March 2022

Health Insurance Institute Says Number of Sick Leave Cases Up 11% in 2021

ZAGREB, 26 March 2022 - The number of cases of sick leave in the pandemic year 2021 was up by 11% from 2020, and the number of cases of sick leave due to self-isolation grew by 14% compared to the previous year, the Croatian Health Insurance Institute (HZZO) said this past Friday.

The sick leave rate in 2021 was up by 11.1% and the related cost for employers grew by 15.6% and for the HZZO by 6.8%.

The number of cases of sick leave due to coronavirus-related self-isolation grew by 14% compared to 2020.

Sick leave controls covered the medical records of 49,265 persons, after which sick leave was terminated for 17,366 persons, or 35% of the cases checked, an increase of as much as 196% compared to 2020.

HZZO controllers conducted 18,951 checks of offices, hospitals and suppliers of medical equipment, focusing on family doctors, with 18,603 checks made. In 89% of the cases no irregularities were detected. As for breaches of contractual obligations in the remaining 11% of the cases, 2,066 decisions were made, including warnings, warnings with fines, and warnings prior to contract termination, and procedures were launched to terminate two health service providers' contracts with the HZZO.

Friday, 18 February 2022

Those Who Don't Seek Work Through Croatian Employment Service to Lose Health Insurance

February the 18th, 2022 - Those job seekers who aren't registered with the Croatian Employment Service and don't use the service to look for work could end up without any health insurance, it has emerged.

As Poslovni Dnevnik writes, all unemployed persons who have failed to register themselves with the Croatian Employment Service (CES) could be left without their right to health insurance. Namely, the Croatian Health Insurance Institute (HZZO), as part of their ongoing process of ''cleaning up'' their register, is preparing legal amendments which, twenty years after their initial abolition, will return the provision according to which an unemployed person acquires health insurance only if he is registered with the Croatian Employment Service.

This means that, according to some rough calculations, in the coming period, another 100,000 people could apply to the Croatian Employment Service. This would also regard all kinds of currently unemployed people who are not looking for a job through the service at all, because otherwise they could easily be left without healthcare coverage.

The number of unemployed Croatian residents registered at the Croatian Employment Service would double in such a case: according to the CES, there were a total of 129,459 people registered as unemployed with them on Wednesday, as was reported by Jutarnji list.

The Croatian Health Insurance Fund (HZZO) has already signed an agreement on the establishment of a proper IT connection with the service so that it can automatically control who is and who is not registered, and it has similar agreements with both the Ministry of the Interior (MUP) and the Tax Administration.

The purpose of the move is to ''clean up'' the register of insured persons of about 300,000 people, as many as are estimated not to be entitled to Croatian health care, yet are likely still accessing it.

For more, make sure to check out our dedicated lifestyle section.

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