The representative organizations of pharmacists and pharmacies in Romania are asking the authorities for legislative changes to ensure the predictability of payments for compensated and free medicines, after the National Health Insurance Agency (CNAS) succeeded in reducing historical settlement delays.
In a joint statement sent on Wednesday, the College of Pharmacists from Romania (CFR), together with the Association of Pharmacists and Pharmacists from Romania (AFFR), the Association of Pharmaceutical Distributors and Retailers from Romania (ADRFR), the Association of Independent Pharmacies Ethica (AFIE) and the Association of Traditional Pharmacies and Practitioners (AFTaP), appreciates the steps taken by CNAS, but warns that legislative measures are needed to prevent the recurrence of blockages financial.
“Community pharmacies are one of the pillars of patient access to treatment. Every day, they deliver compensated and free medicines, pay suppliers, employee salaries, taxes and contributions to the state and support all operational costs necessary to operate, long before the settlement of the amounts owed by the health insurance system. This is also emphasized in the decision of the European Commission, which states that ‘pharmacies pre-finance the supply of medicines, ensuring, at the same time, that patients have timely access to the treatments they need‘, the press release states.
CFR and the representative associations of community pharmacies believe that this is the time when the legislation must be improved, so that the funds collected through social health insurance contributions are used exclusively for the purpose for which they were collected and can be made available to the CNAS, without administrative delays, for the payment of legal obligations related to drugs already issued to patients.
“When the money exists in the system, but does not reach those who have already ensured the treatment of patients in time, the cost of delays is transferred to the pharmacies. They are obliged to bear additional financing costs, to support their operational flows from their own resources and to ensure, in the future, the payment of the salaries of professionals, suppliers and fiscal obligations.
Representatives of the pharmaceutical sector believe that the reduction in payment delays demonstrates that a predictable settlement system can work if the necessary framework is in place.
“The fact that Romania has made progress, in recent months, in reducing payment delays proves that it is possible to comply with a predictable system, according to legal deadlines”the release states.
The announcement comes after the European Commission decided to refer Romania to the Court of Justice of the European Union (CJEU) due to historical delays in the payment of medicines.
“The problem is no longer one of financing, but of the budgetary mechanism”
According to the signatory organizations, the recent message sent by CNAS after the decision of the European Commission indicates that the necessary funds exist, but the current legislative framework prevents their use quickly enough:
“Financial resources exist, but the current legislative framework does not allow their use with sufficient flexibility to comply with legal payment deadlines. Under these conditions, the problem is no longer one of financing, but of the budgetary mechanism.”
The last gasp for village pharmacies
Pharmacy representatives claim that administrative delays generate additional costs for operators in the field, who are forced to finance their current activity from their own resources until the amounts are settled by the health insurance system.
“Pharmacies pre-finance the supply of medicines”
The conclusions of the European Commission regarding the role of pharmacies in ensuring patients’ access to treatment are also mentioned.
“Pharmacies pre-finance the supply of medicines, while ensuring that patients have timely access to the treatments they neede”, the press release states.
Professional organizations point out that pharmacies issue compensated and free drugs on a daily basis, pay suppliers, employee salaries, taxes and contributions to the state, before receiving the related settlements.
What legislative changes are pharmacists asking for?
The College of Pharmacists from Romania and the representative associations propose several legislative changes, including:
• The use without administrative delays of the funds available in the Single National Social Health Insurance Fund (FNUASS) for the payment of due obligations;
• Exemption of the FNUASS budget from the mechanisms that limit the making of monthly payments when there are available financial resources;
• Ensuring priority use of the contributions collected for health for the purpose for which they were collected, so that the existing resources in the FNUASS are available in time to finance medical services and medicines;
• Establishing a predictable settlement calendar, which allows payments to pharmacies to be made by the 15th of each month at the latest, with the objective that, in the medium term, they will be made even before this deadline.
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“Such a mechanism would not only represent a support measure for pharmacies. It would allow ensuring the continuity of the supply of medicines, the stability of the entire pharmaceutical chain, maintaining the ability of pharmacies to honor their obligations to suppliers, employees and the state and, most importantly, the uninterrupted access of patients to the treatments they need”. states the same statement.
Call for a predictable and sustainable system
Pharmacist representatives believe that the European procedure on historical payment delays must be turned into an opportunity for reform.
“The European procedure on historical delays must be seen as an opportunity to definitively correct the mechanisms that made these situations possible”, it is further explained in the document.
At the same time, the organizations express their willingness to collaborate with CNAS, the Ministry of Health, the Ministry of Finance, patient organizations and the pharmaceutical industry to develop stable legislative solutions aligned with European practices:
“We reaffirm our commitment to remain responsible partners of the authorities in building a modern, predictable and sustainable financing mechanism that protects patients’ access to treatment and the stability of the Romanian health system“.
