“In 2019, Hungary used 30.5 % of health care spending for inpatient care, 29.5 % for outpatient care, and 30.2 % for pharmaceuticals and medical devices. The proportions of spending on inpatient and outpatient care broadly align with the EU averages, but spending on pharmaceuticals and medical devices is over 10 percentage points higher. This relatively high level of spending reflects low overall spending on health (see Figure 8). Conversely, spending on long-term care (LTC) in Hungary, as well as other Visegrád Four countries, is significantly below the EU average (Figure 9).”

“Hungary’s benefits package includes a positive list for pharmaceutical products (see Section 4). Relative to other EU countries, this list is slim.

“Policies to boost consumption of generic over branded products aim to reduce costs and improve access to medicines. The two major policies in this area are generic substitution and generic prescribing, both of which are voluntary in Hungary, although policies are in place to incentivise generic use. For example, the NEAK [National Institute of Health Insurance Fund Management] provides pharmacies with financial incentives to substitute originators with their generic equivalent.

“National policies to improve access to medicines align with pillar one of the European Commission’s pharmaceutical strategy for Europe, implemented in November 2020 (European Commission, 2020b). The remaining three pillars aim to support competitiveness, innovation and sustainability; enhance crisis preparedness and response mechanisms; and promote safe, high-quality and efficacious medicines.”

“The National Institute of Pharmacy and Nutrition issues marketing authorizations through the same process that has been standardized across the EU. Only health technologies that have received marketing authorization can apply for public reimbursement.

“The Hungarian HTA Department was established in 2004. The department is currently part of the National Institute of Pharmacy and Nutrition. Like other EU member states, the aim of establishing an independent health technology assessment (HTA) body in Hungary was to support decision makers in the rational and efficient use of scarce resources, by providing critical appraisals of different health technologies [11]. The HTA Department critically evaluates reimbursement submissions of pharmaceuticals (since 2004), simple medical devices such as therapeutic appliances (e.g., walking stick and hearing aids) (since 2007), and complex medical devices such as hospital technologies (since 2010). The department participates in international projects such as the European Network for Health Technology Assessment, consults with decision makers regarding financial protocols/guidelines, and provides an expert opinion on various issues related to health economics.

“Until December 2016, the National Health Insurance Fund (NHIF) was responsible for the administration of the health insurance system and public reimbursement of health technologies. The NHIF collected, processed, and analyzed statistical data on the health insurance system for internal purposes. As a result of recent legal and organizational changes, the NHIF was reorganized to National Institute of Health Insurance Fund Management (NIHIFM) with highly similar responsibilities. In the NIHIFM, the Department of Reimbursement is responsible for coordinating the pricing and reimbursement decision-making process. Health technologies are reimbursed from different dedicated budgets (e.g., primary care, outpatient care, and acute and chronic inpatient care) [12], which are allocated by the NIHIFM from the annual health care budget set by the Ministry for National Economy.

“The State Secretary of Health (SSH) together with the Ministry for National Economy have a major influence on the system for financing health technologies through developing, improving, and revising the laws and decrees, in cooperation with the NIHIFM.”

“The Hungarian reimbursement system for pharmaceuticals is very complex and applies several reimbursement techniques. The reimbursement levels are established according to the specifications of the therapies; the more chronic and severe the disease, the higher is the reimbursement level. There are two major types of reimbursement techniques in the outpatient care: the normative reimbursement and the indication-linked reimbursement (Table 2) [12].

“Normative reimbursement applies to all physicians with general prescription rights and may be used for all indications listed in the Summary of Product Characteristics. This technique is associated with reimbursement levels of 25%, 55%, and 80%, resulting in levels of patient’s co-payment of 75%, 45%, and 20%, respectively.

“Indication-linked reimbursement restricts reimbursement to only certain professionals who can prescribe the drug. The reimbursement is granted only in a subset of authorized indications and is granted if the conditions defined by the payer are met. The levels of reimbursement are 50%, 70%, 90%, and 100%, resulting in levels of patient’s co-payment of 50%, 30%, 10%, and 0%, respectively.

“For each unit, there is a fixed prescription fee of ft300 (ft ¼ Hungarian forint; €1 ¼ ft315 [2016]) for drugs with 0% copayment. Pharmaceuticals used in the inpatient care have 100% reimbursement and are financed through the implemented hospital financing system (i.e., diagnosis-related groups) [10]. Patient’s co-payment may also vary according to the applied internal reference pricing system for off-patent products (for generics and biosimilars, see detailed descriptions later).

“There is no separate reimbursement technique for orphan drugs in Hungary. Patients can, however, receive these pharmaceuticals individually or through the itemized reimbursement system purchased via central tendering. Individual reimbursement is also available under the principles of equity in case of pharmaceuticals that are not on the regular reimbursement list (named patient program) [19].”

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated August 8, 2022 by Doug McVay, Editor.