Wstępny model oceny kosztów rzeczywistych ponoszonych przez podmiot leczniczy w związku z realizacją onkologicznego programu lekowego

Abstract

Introduction and objective Modern drug therapies are made available on the basis of specific legal and economic solutions. In Poland, a model for financing modern therapies by the public payer in the form of a drug programme has been developed. The basic principles of such a strictly defined therapeutic procedure, apart from ensuring maximum safety and clinical effectiveness, is the need to define a budget that can be used for these usually expensive drugs. The aim of the study was to identify and analyse the actual costs related to the treatment process of a patient within the framework of an oncological drug programme, incurred by a healthcare entity. Material and methods The oncological drug programme B.50 ‘Treatment of patients with ovarian cancer, fallopian tube cancer or peritoneal cancer’, implemented in an oncology centre in 2018–2021, was selected for the analysis. On average, 19 patients were treated annually. Results The lump-sum method of financing healthcare benefits under the drug programme, adopted by the public payer, does not cover the actual costs of treatment. Providing patients with all necessary medical services at every stage of the treatment process, which are not financed by the payer under the drug programme, creates a real risk of indebtedness to the healthcare entity. Conclusions The chronic nature and therapeutic process of many diseases generate additional costs for the treatment of complications. Without the valuation of benefits adequate to the actual costs of treatment, a significant increase in the availability of innovative therapies to patients may become impossible.

Keywords

• programy lekowe
• finansowanie
• rak jajnika