Medicine cost reduction: New account for patients from 2026!

Medicine cost reduction: New account for patients from 2026!

Österreich - From 2026, a new "remedial cost account" will be introduced, which should fundamentally change the calculation of the medication costs. This measure followed the criticism of the past few years, in particular by the public prosecutor Bernhard Achitz, who in February 2024 pointed out to the disadvantage of many patients through the existing regulation. So far, only recipe fees for the upper limit have been counted, while cheaper medications were left out. An alarming example is the case of pensioner Johann R., who spent 521 euros for medication by November 28, 2023, of which only 360 euros were counted. This regulation meant that many patients had to arise for medication that was below the prescription fee of 7.10 euros without being reimbursed by the health insurance companies.

The new regulation has the clear goal of relieving patients as soon as a defined share of their income has been issued for medication. This measure is particularly important for chronically ill people. From 2027, the upper limit will be reduced from 2 % to 1.5 % of the net annual income, which should further reduce the financial burden. People with low incomes can even be freed from recipe fees, as the new regulations show.

criticism of the existing regulation

Despite the new initiatives, the recipe fee limit is criticized. Many patients are still forced to pay for medication themselves, since medication that is below the prescription fee are not reimbursed by the health insurance companies. Achitz therefore calls for a more comprehensive upper limit for the total costs of medicinal products that include all medication prescribed. This claim is also supported by the Generic Association, which considers the idea of ​​a medication cost limit to be sensible in order to take financial pressure from patients and to enable health insurance companies to record the actual medication costs.

An important development comes into force from January 1, 2024: The data on medication that is below the prescription fee will also have to be transmitted to health insurance in the future. This could increase transparency and help to better understand the entire cost structure in the drug area.

price regulation in the drug area

reference to the price regulation in the drug area, the Federal Ministry of Health has introduced legally prescribed discounts for pharmaceutical entrepreneurs. For patent -protected preparations, the discount is 7 % of the tax, while patent -free, active ingredient -like medicines receive an additional 10 % discount. The recently decided law to amend health insurance regulations also introduces a price stop for those medication paid by health insurance companies, and in which no fixed amount or reimbursement amount applies. This price moratorium will apply by the end of 2026 and should help to contain the expenditure in the drug area.

Overall, it can be seen that the new regulations aim to relieve patients long -term. However, it remains to be seen how these measures will have an impact in practice and whether they can actually solve the problems, have pointed out to Achitz and other critics.