The reference price system applies to reimbursable medicinal products that are included in the sphere of generic substitution. In the reference price system, products are divided into groups, and a reference price is determined for each reference price group. The reference price is the highest price on the basis of which the reimbursement for a medicinal product in the same group can be calculated. If a medical physician has forbidden the substitution of a medicinal product, reimbursement is calculated on the basis of the price of the delivered medicinal product. Reference price groups are based on the Finnish Medicines Agency’s interchangeable drug list, on the Decree of the Ministry of Social Affairs and Health on the equivalence of package sizes and on the pharmaceutical companies’ price notifications.
The Pharmaceuticals Pricing Board determines the reference price groups, the products included in the groups and the reference prices for each quarter of a year. Reference prices are valid for the entire duration of a reference price period, which is three months.
The Pharmaceuticals Pricing Board releases four times a year a list of medicinal products subject to the price notification procedure based on the Finnish Medicines Agency’s interchangeable drug list. The reimbursement status of medicinal products subject to the price notification procedure is conditional upon submitting the notifications. Price notifications are submitted to the Social Insurance Institution, who conveys the information to the Pharmaceuticals Pricing Board and organisations responsible for maintaining price data.
Reference price group
Medicinal products included in the reference price system are classified into reference price groups. Products included in the same reference price group contain the same amount of the same active pharmaceutical ingredients or their versions in a similar dosage form and in a closely corresponding package size. It is a condition for the forming of a reference price group that a group of mutually interchangeable medicinal products contains at least two reimbursable medicinal products available on the market and at least one of them is generic, biosimilar, parallel-imported or parallel-distributed product.
The following package sizes will be included in the same reference price group:
- packages containing 28, 29 and 30 doses,
- packages containing 59 and 60 doses,
- packages containing 98, 99 and 100 doses,
- packages containing the same amount of doses in one or more containers and
-
starting and refill packages containing the same amount of doses.
Reference price groups are based on the Finnish Medicines Agency’s interchangeable drug list and on the Decree of the Ministry of Social Affairs and Health on the equivalence of package sizes.
Reference price
For each reference price group, a reference price is determined, and it is the highest price based on which the health insurance reimbursement for a medicinal product in the same group can be calculated. Reference prices are determined based on price notifications submitted by pharmaceutical companies. Reference prices are valid for the duration of the reference price period. The duration of a reference price period is three months.
A pharmaceutical company must submit a notification to the Pharmaceuticals Pricing Board regarding the wholesale price of a medicinal product, which will be valid at the start of the next reference price period. A medicinal product’s retail price is determined according to the Government Decree on pharmaceutical tariffs. The reference price is calculated based on the VAT-inclusive retail price of the cheapest medicinal product included in the reference price group.
The reference price is determined by adding EUR 0.50 to the VAT-inclusive retail price of the cheapest medicinal product of the group.
Reference price period
Each quarter of a year constitutes a separate reference price period. The duration of a reference price period is three months.
The reference price periods are
- 1.1. – 31.3.
- 1.4. – 30.6.
- 1.7. – 30.9.
- 1.10. – 31.12.
Organisations
Finnish Medicines Agency (Fimea)
Maintains and updates the interchangeable drug list.
Pharmaceuticals Pricing Board (Hila)
Releases the list of medicinal products subject to the price notification procedure based on the Finnish Medicines Agency’s interchangeable drug list.
Confirms reference price groups, reference prices set for the reference price groups, and medicinal products included in the reference price groups.
Social Insurance Institution (Kela)
Receives price notifications and maintains electronic services.
Holders of marketing authorisation
Prepare price notifications.