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Health Insurance Fund starts financing essential migraine drug

Tervisekassa.
Tervisekassa. Source: EHIF

Health Insurance Fund (Tervisekassa) plans to start funding chronic migraine from next month.

Getter Hark, the head of the medicines reimbursement service of the Health Insurance Fund, said that the application had already been submitted in 2020.

"After several years of negotiations with the marketing authorization holder, we have now reached an agreement that satisfies both parties and we can include the drug in the January list," said Hark. The newcomer drug will cost the health insurance budget €200,000 a year.

As of this year, just over 11,000 people have been diagnosed with chronic migraine. The drug is estimated to improve the quality of life of 200 patients.

"The number of users is likely to increase, if only because it was previously used only by Estonians who could afford it at full price. When the medicine becomes more affordable in January, it will undoubtedly become more popular as well, which will increase the number of users," Hark said.

According to Toomas Toomsoo, a neurologist, doctors are relieved to be able to provide an effective treatment that patients can also afford at a cheaper cost.

There are several eligibility criteria. Merlin Kalle, a board member of the Estonian migraine and headache patients association, said the funding of a new migraine drug is a positive start. She herself uses the drug Ajovy, but is unable to benefit from the discount price because she does not meet the criteria.

"We have a Facebook page, several thousand people follow it and there was a reaction: very good. Of course it's great that there are drugs like this, we hope that it will become even more available to people soon," Kalle said.

Starting in the new year, the health insurance fund will pay for several new hospital and prescription drugs. In addition, doctors will be able to use existing medicines for new indications and treat more patients. In 2024, the health fund budget for hospital and prescription drugs will be around €310 million.

The changes will expand treatment options for migraine, multiple sclerosis, thrombocytopenia, asthma, atopic dermatitis, non-Hodgkin's lymphoma, congestive heart failure, chronic kidney disease, growth hormone deficiency, nasopharyngitis with polyps and several cancers.

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Editor: Mari Peegel, Kristina Kersa

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