In Hungary, certain decisions on named patient reimbursement of medicinal products and medical aids will be made by a public benefit foundation in addition to the National Health Insurance Fund (NEAK) as of 2025. In this article, we gathered the currently available information on this change, noting that the amendment raises several practical questions and some details have yet to be ironed out.
In more detail
The Hungarian legislator amended the laws governing named patient reimbursement of medicinal products and medical aids. On 14 January 2025, a new public benefit foundation was established (Batthyány-Strattmann László Alapítvány).
This foundation may, upon the request of the insured person and on a named patient basis, reimburse the cost of medicinal products and medical aids that are professionally accepted in Hungary but which are not included in regular reimbursement.
This also means that the foundation’s above competences do not extend to named patient supply of medicinal products and medical aids that are already included in regular reimbursement for any indication but are not reimbursed under the indication requested by the applicant. The foundation’s competences also do not extend to reimbursement of medical procedures, healthcare services and infant/ follow-on formula. In these cases, the NEAK will continue to decide on the named patient reimbursement applications.
The foundation, acting in its discretionary powers, will decide whether to reimburse on a named patient basis in a non-authoritative procedure, with a view to the protection of human life and health and social and economic responsibility.
The foundation must provide the named patient reimbursement to the extent covered by the assets made available to the foundation and the budget allocations under its management. The amendment’s statement of reasons explains that the legislator does not intend to set the criteria for the decisions, but rather leaves it to the foundation to decide in the context of social and economic responsibility. Since the foundation is yet to be established, the specifics of the decision-making procedure are not yet known.
The statement of reasons also points out that the decision-making in the form of a foundation opens up the possibility of donating 1% of personal income tax, tax relief on payments and contributions from business organizations, thus creating a new source of revenue for named patient supply.
According to Judit Bidló, deputy state secretary for the Professional Management of Healthcare, the budget allocations made available to the foundation will also be part of the health insurance fund’s budget allocations, but on a separate line. The creation of the foundation is, therefore, not primarily about saving money, but about using the money more efficiently.
The deputy state secretary also clarified that patients and physicians will not need to know whether the decision may be made by the foundation or NEAK. All applications must be sent to NEAK as a “one-stop shop,” and NEAK will distribute the applications based on competence. Finally, we highlight that this new system is not the first, just the latest attempt at reforming named patient reimbursement in Hungary. NEAK has been struggling for several years with the growing administrative and financial burden caused by the high number of applications. Accordingly, continuously monitoring legislative changes and practical implementation remains important.