Around 10,000 patients — most of them elderly — have been paying more than €20 a month in drug co-payments through the General Health System (GHS) for five consecutive months, and a deal reached between the Health Insurance Organisation (HIO) and pharmaceutical companies offers them no immediate relief.
Marios Kouloumas, honorary president of the Cyprus Federation of Patient Associations (OSAK), told Phileleftheros the situation was urgent. “This is a problem whose solution should have been found yesterday, because we are talking about around 10,000 patients, the majority of them elderly, whom we are putting at risk since they essentially have no alternative drug option,” he said.
Three cases have been logged with OSAK’s Patient Observatory. One patient living on public assistance said the benefit was not enough to cover the high co-payment and that the drug in question was his only safe treatment option. A second elderly patient filed a separate complaint. A third contacted the HIO a month ago asking whether the co-payment would be reduced and has yet to receive a reply.
How the problem started
The problem began after a drug price revision in February, Kouloumas said. When the patent on one drug in a particular category expired, it affected the pricing of the other products in the same group. The drugs belong to what is known as the “me too” category — medicines that treat the same condition but contain different active substances, meaning many patients cannot simply switch to another product.
“This situation is unacceptable,” Kouloumas said.
Failed negotiations
OSAK raised the alarm from the first month. A meeting was subsequently held at the HIO with pharmaceutical companies present, at which a cap on co-payments for the affected drug category was discussed. OSAK’s position was that patients should pay no co-payment at all when no alternative drug exists and their own medication has not changed in price.
The HIO largely accepted the cap proposal, but the pharmaceutical companies rejected it and submitted a counter-proposal of their own — one the HIO in turn rejected because it would have required a revision of the entire co-payment calculation system. A further meeting was held under the Health Minister but again produced no agreement.
HIO and the companies have now reached a deal, Kouloumas said, under which whenever a similar problem arises the HIO will negotiate with the affected company to agree a new co-payment. For the specific cardiac drug at the centre of the current crisis, however, those negotiations have not yet begun. “Nobody knows when they will conclude or where the co-payment will be set,” he said.
Call for action
“It is inconceivable that we reach agreements and decisions that do not put the patient first,” Kouloumas said, calling on the Health Minister to intervene directly and deliver a solution that helps citizens. He said options beyond a co-payment cap exist, including reconsidering the “me too” drug category itself. “Drugs that contain different active substances must be treated as different drugs,” he said. If no meaningful decisions are taken now, he warned, patients will continue to bear the cost every time a drug price list is revised or a patent expires.
