On 21 December 2011, the Danish Parliament adopted an amendment of the Danish Health Act with effect from 1 January 2012. It abolishes the increased co-payment for fertility medicine that was introduced on 1 January 2011. Please find a link to the Danish bill in the box to the right.
There are a number of implications for users of fertility medicine.
Reimbursement is once again calculated according to the general reimbursement rules
As of 1 January 2012, reimbursement for fertility medicine is calculated according to the general reimbursement rules, which also cover all other forms of reimbursable medicine. As from 2012, users of fertility medicine in Denmark will therefore only have one CTR balance in the Central Reimbursement Register (CTR), which means that the concepts CTR A and CTR B will no longer exist from 1 January 2012.
On the right-hand side, please find a link to the reimbursement thresholds and reimbursement rates effective in 2012.
Possibility of obtaining reimbursement for the chronically ill is restored
The amendment also implies that the possibility of obtaining reimbursement for the chronically ill is restored for people who have high expenses for fertility medicine.
The maximum co-payment for people who obtain reimbursement for the chronically ill is DKK 3,655 (in 2012). It is the patient's doctor who applies for reimbursement for the chronically ill to the Danish Medicines Agency.
Interim provisions
Interim provisions have been established along with the amended Act to ensure that no one is financially worse off than they would have been according to the rules in force in 2011.
The interim provisions imply that some people will have their reimbursement balance raised and will have their reimbursement period in the Central Reimbursement Register (CTR) extended. This is done to prevent anyone from ending up with a higher co-payment for fertility medicine in 2012 than they would have had according to the rules applicable in 2011.
For people who are affected by the interim provisions, the changes will take place automatically and centrally in the Danish Medicines Agency's Central Reimbursement Register. Because the pharmacies retrieve information from the CTR register when they service their customers, no action is required to make sure reimbursement is calculated correctly.
We expect the changes in the CTR register to be implemented during the first week of January. If you are covered by the interim provisions and buy reimbursable medicines before the changes have taken effect in the CTR register, you could receive too little reimbursement. Should this happen, the amount owed to you will be paid out to you by the pharmacy after the changes are in place.
Examples
In the box on the right, we give some examples in Danish, which explain how the interim provisions work. Please note that the examples presuppose that you always buy the least expensive medicine from a group of generic medicines.
The examples address two different reimbursement periods. The CTR A period is for all other reimbursable medicines than fertility medicine. The CTR B period is relevant only for fertility medicine. The length of the CTR A period and the CTR B period is 12 months for both. As mentioned earlier, the concepts CTR A and CTR B will no longer exist in 2012, but they are used in the examples to make it clearer how the interim provisions work.
