On 1 December 2015, the Universal Healthcare Programme was discussed on the talk show, Archevani,

on air on Rustavi 2. Emphasis was made upon the fact that pensioners cannot afford to buy medicine. The Deputy Minister of Labour, Health and Social Affairs of Georgia, Zaza Sopromadze, named the abuse of medication as the principal cause of the problem. Mr Sopromadze also stated: "For everyone who uses the Universal Healthcare Programme’s service, medicine is covered. There will be a lot more progress in this direction in the future."

The Leader of the New Political Centre – Girchi, Zurab Japaridze, commented upon the Deputy Minister of Labour, Health and Social Affairs’ statement. Mr Japaridze stated: "Part of the medicine is indeed funded from the Universal Healthcare Programme when it is about hospital treatment. However, medicine prescribed by a doctor is not covered and prices for medication are on the rise. According to the latest data, the prices of medicine have increased on average by almost a third, by 27.7% as compared to the previous year."

FactCheck

verified the cases in which the Universal Healthcare Programme envisages the funding of medicine. We also verified the changes in the prices of medicines.

The Universal Healthcare Programme covers the costs of medicine for emergency hospital treatment and emergency ambulatory treatment. However, medications are not covered for non-emergency medical treatment because the programme’s basic package does not envisage the reimbursement of medicines prescribed by a doctor.

Of note is that the reimbursement of the means of treatment is envisaged for target groups although upon a minimal basis. Children up to the age of five years and socially vulnerable individuals have their expenses for medicine reimbursed within the annual GEL 50 limit (with 50% paid by the beneficiary himself). Disabled children, children with visible disabilities and pensioners have their expenses for medication reimbursed within an annual GEL 100 limit (with 50% paid by the beneficiary himself). Socially vulnerable pensioners, however, have their expenses for medication reimbursed within an annual GEL 200 limit (with 50% paid by the beneficiary himself). The expenses for medicine are reimbursed for veterans as well within an annual GEL 50 limit (with 50% paid by the beneficiary himself). Of further note is that the aforementioned target groups (with the exception of veterans) used to have the state health insurance package even before the Universal Healthcare Programme was launched with their expenses for medicines being reimbursed in a similar way (Government of Georgia Ordinances N218 and N165). In 2014, those individuals who used to have the state health insurance package were transferred to the Universal Healthcare Programme but retained their previously held health insurance packages as well.

A report entitled Research on the Use of Health Services and Expenses in Georgia was published in 2015 (based on 2014 data). The research was carried out with the assistance of the World Health Organization, USAID and the World Bank. According to the report, the amount of money directly paid by the population for healthcare, especially during hospital care, did indeed decrease after the launch of the Universal Healthcare Programme. However, the amount of money paid for medicines by individuals under the most impoverished category as well as those living in villages increased.

According to the National Statistics Office of Georgia, the prices for medication increased by 17.7% in January-November 2015 as compared to the same period of the previous year. We have to clarify that the National Statistics Office of Georgia monitors price changes for medicines which are widely used such as antibiotics, vitamins, painkillers, vasodilator drugs, anti-inflammation drugs and medications for the digestive system. The increase in the prices of medicine was mostly caused by the depreciation of GEL. However, the rise in the prices of medication started before the depreciation of GEL, from February 2014 (see FactCheck’s article).

In 2011-2013, the prices of medicine were on the decrease although increased by 14.2% in 2014 with the latest data from November 2015 showing an increase by 24.2% (see Graph 1). We have to further clarify that calculating the annual changes in the prices of medicine implies comparing the numbers registered in the month of December with the numbers registered in the previous December. However, in the case of 2015 (as December’s data are not yet known) we compared the prices registered in November 2015 to the prices registered in December 2014.

Graph 1:

 Changes in the Prices of Medicine in 2011-2015 (%)

image001

The Deputy Minister of Labour, Health and Social Affairs named the abuse of medication as the principal cause behind the affordability of medicine. Naturally, the abuse of medicine makes the affordability problem more severe but this is not the principal cause. Additionally, the Minister of Labour, Health and Social Affairs, Davit Sergeenko, stated that medicine can only be purchased by a doctor’s prescription beginning from 1 January 2015 which decreased the abuse of medicine and all things being equal could have resulted in a drop in prices and not vice versa. The principal problem with regard to the affordability of medicine is that prices for medications are being increased.

Of particular note, too, is that the Ministry of Labour, Health and Social Affairs plans to increase the affordability of medicine by widening the segment of generic medications.

Conclusion

The Universal Healthcare Programme covers expenses for medication in the cases of hospital care and emergency ambulatory care. The Programme’s basic package does not cover medications prescribed by a doctor. The expenses for medicine within minimal annual limits (GEL 50, GEL 100 or GEL 200) are reimbursed only for target groups (disabled children, children with visible disabilities, pensioners and veterans) with 50% paid by the beneficiary himself.  The aforementioned target groups (veterans being the only exception) used to have state health insurance before the Universal Healthcare Programme was launched with their expenses for medicine being reimbursed in a similar way.

In 2014-2015, the prices for medicines have increased which creates problems in terms of their affordability. Prices for medicines increased by 24.2% in November 2015 as compared to December 2014.

FactCheck concludes that Zurab Japaridze’s statement is TRUE.

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