Czechia
Czechia has been a member of the European union since 2004 but as of yet is not a member of the euro area. It is a parliamentary republic with a head of government, the prime minister and a head of state, the president. The country was formed in 1993, after Czechoslovakia was split into Czechia and Slovakia. The country is now divided into 14 regions, including the capital, Prague with the official language being Czech.
Healthcare budget
$13.7 billion
Inhabitants
10.7 million
GDP per capita
$25.804
Currency
CZK (1 CZK = 0,038 euro)
World Ranking
GDP 45th
Czech healthcare
Czechia operates a Social Health Insurance (SHI) system with a strong regulatory role for the Ministry of Health. The largest health insurance fund (VZP) owned by the state insured 56 % of Czechs in 2019. VZP plus six smaller private health insurance funds act as purchasers of care and negotiate annually with health providers to set prices and volumes. The population enjoys a broad benefit package and has access to numerous hospitals, most of which are owned either by the state (27%) or the regions and municipalities (45%).
Health spending as a share of GDP (7.2%) is below the EU average of 9.8%. The high share of public financing (82%), which is a traditional feature of the system, is the highest among the newer EU Member States and above the EU average (79%).
Public revenues for health are raised through earmarked, wage-related contributions, income-related contributions from the self-employed as well as state contributions (funded from general taxation) on behalf of various economically inactive groups.
Czechia’s Pharmaceutical environment
Czechia boasts a USD 3.38 billion pharma market, with one of Central and Eastern Europe’s highest performing healthcare systems. In addition to being one of the region’s leading economies, the Czechia’s healthcare and life sciences market is fast closing the gap on its Western European equivalents.
However, the country’s reference pricing system, whereby reimbursement is set based on the lowest price in the EU acts as a significant impediment in bringing both innovative and generic drugs to the Czech market.
By law, the cost for all medical procedures, including all pharmaceutical products, is covered by health reimbursement. Pharmaceutical products that are or should be used for inpatients, are fully reimbursed, without any HTA procedure/decision. HTA is mandatory only for (mainly) outpatient treatment.
‘Basic reimbursement’ is calculated using pricing references (ex-factory prices of products marketed in reference countries). For highly innovative drugs it is possible to grant reimbursement only if the pharmaceutical is reimbursed in at least 2 reference basket states.
Today’s challenges
Life expectancy increased by four years between 2000 and 2017 but remains about two years below the EU average. Czechia has successfully reduced mortality from ischaemic heart disease, stroke, colorectal and breast cancer, but mortality from Alzheimer’s disease is growing.
Behavioural risk factors, such as poor diet and low physical activity, contribute to a high prevalence of obesity, which reached 20% of the population in 2017, (EU average 15%). The smoking rate for adults fell to 18% in 2017 and has the potential for further reduction after the introduction of a strengthened smoking ban in 2017.
The expert in Czechia
Jiri Hermanek
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Achieving reimbursement and getting the right price are the 2 most important drivers for a successful launch of an innovative pharmaceuticals in our part of Europe. Health Authorities in any European country decide individually based on their local regulations, policies, framework, social values and available health care budget.
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Unlike other regions, in the EU a number of options is available to obtain a marketing authorisation. Centralised at the European Medicines Agency in Amsterdam or decentralised with the individual competent authorities of the member states, each marketing authorisation application procedure has its pros and cons. In the case of Switzerland, it has its own regulatory authority, Swissmedic, and processes.
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