The Estonian Health Insurance Fund, known as Tervisekassa, has announced plans to fund the treatment of chronic migraine starting from January 2024.
The Estonian Health Insurance Fund, known as Tervisekassa, has announced plans to fund the treatment of chronic migraine starting from January 2024. Getter Hark, the head of the medicines reimbursement service of the Health Insurance Fund, revealed that negotiations spanning several years have culminated in an agreement with the marketing authorization holder. This agreement enables the inclusion of the migraine treatment drug in the list of covered medications starting in the new year, making it more affordable for patients.
The application for funding chronic migraine treatment was initially submitted in 2020, and after extensive negotiations, an agreement has been reached to satisfy both parties. The newcomer drug, expected to significantly improve the quality of life for individuals suffering from chronic migraine, will incur an annual cost of €200,000 to the health insurance budget.
As of the current year, over 11,000 people in Estonia have been diagnosed with chronic migraine. The drug’s coverage is anticipated to benefit approximately 200 patients initially. However, with the increased affordability in January, it is expected that a growing number of individuals will avail themselves of the treatment, thereby expanding the user base.
“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,” commented Getter Hark.
Medical professionals and patient advocacy groups have welcomed the initiative, acknowledging the positive impact it will have on providing effective treatment options at a more affordable cost. Neurologist Toomas Toomsoo expressed relief at being able to offer an effective treatment that patients can afford.
While the funding of the new migraine drug is considered a positive start, there are eligibility criteria that patients must meet.
Merlin Kalle, a board member of the Estonian Migraine and Headache Patients Association, highlighted the positive response on social media platforms, emphasizing the hope that the drug will become even more accessible to a broader population in the future.
“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,” said Kalle.
Starting in 2024, the Estonian Health Insurance Fund will extend coverage to several new hospital and prescription drugs. Additionally, doctors will have the flexibility to use existing medicines for new indications, broadening the scope of treatment options for various medical conditions.
The health fund’s budget for hospital and prescription drugs in 2024 is estimated to be around €310 million. The expanded coverage will not only benefit individuals with chronic migraine but will also encompass conditions such as multiple sclerosis, thrombocytopenia, asthma, atopic dermatitis, non-Hodgkin’s lymphoma, congestive heart failure, chronic kidney disease, growth hormone deficiency, nasopharyngitis with polyps, and several types of cancers.
As Estonia takes steps to enhance healthcare accessibility and treatment options, the funding of chronic migraine treatment marks a significant stride in addressing the needs of individuals suffering from this debilitating condition.