Press Release

Today, the General Directors of the Health Insurance Fund, Mr Sasho Klekovski and Mr Branko Adzhigogov, informed the public about three significant new developments in the work of the Fund, which directly improve the access to and quality of health services for insured persons.

1.Two oncology medicines transferred from the hospital list to the primary positive list

Two aromatase inhibitor medicines (letrozole, anastrazole) are being included on positive list A. These two medicines are used in the treatment of breast cancer and are used by around 2.500 persons. Until now, both medicines were dispensed at the Clinic for Oncology and Radiotherapy; from now on, this will be done in pharmacies, with a prescription. The change is at the request of both patients and the Clinic, in order to reduce the burden on both patients and the clinic.

Until now, patients had to come to the clinic in Skopje to collect the medicine, and the process at the clinic itself takes 2-3 hours.

On the other hand, at the clinic this generates, for example, in 2023, 11.437 examinations and bottlenecks at at least 5 points: 1. Counter for checking referral and insurance 2. Outpatient clinic for prescribing therapy 3. Counter for creating documentation for the HIF 4. Counter for dispensing therapy (day hospital for tablet therapy) 5. Clinical hospital pharmacy for collecting and recording the medicine.

This measure directly contributes to improving accessibility and facilitating treatment for oncology patients, especially women with breast cancer, while at the same time relieving the Clinic for Oncology and Radiotherapy of unnecessary administration.

2.Amendments to the Rulebook on medical rehabilitation - support for chronically ill insured persons

With the amendment to Article 12 of the Rulebook on specialised medical rehabilitation as extended hospital treatment, the period within which insured persons may use rehabilitation is extended. Namely, at the proposal of the National Association for Support of Persons with Multiple Sclerosis , as well as health institutions and patients, insured persons who are entitled to rehabilitation on the basis of a follow-up examination and specialist report will be able to use the rehabilitation within 6 months from the date of issue of the decision, instead of the previous 2 months.

This change has no financial implications for the Fund's Budget, but is of particular importance for persons with chronic diseases and a slow, progressive course of illness. It enables greater flexibility in the timing of use of the service, according to the individual medical needs and condition of the patients.

This concerns insured persons with the following diagnoses: multiple sclerosis, cerebral palsy, plegias and pareses, rheumatoid arthritis, oncological diseases in children, haemophilia and other blood diseases. This amendment demonstrates greater care and sensitivity towards vulnerable categories of patients.

3.Amendments to the Rulebook on orthopaedic and other aids - wider coverage and modern support

The third important new development concerns the adopted amendments and supplements to the Rulebook on indications for orthopaedic and other aids, which are the result of direct communication Mobility , patient associations and professional associations.

The amendments aim to provide wider access to necessary aids for insured persons, as well as the introduction of new, more modern devices that contribute to improving their quality of life.

Specifically, the amendments provide for:

• Inclusion of diagnosis B91 - Sequelae of poliomyelitis in the indications for obtaining a wheelchair;
• Expansion of the right for diagnoses G11, G12 and Q05 (ataxia, spinal muscular atrophy, spina bifida) to obtain a specialised wheelchair;
• Inclusion of persons with diagnosis G12 for the right to an anti-decubitus cushion;
• Introduction of a new orthopaedic aid - hydraulic hip joint (code 1317), for persons with hemipelvectomy, available for all age categories.

With these amendments, the Fund sends a clear message that it remains open to cooperation with patient associations and that it is continuously working to improve health insurance rights and conditions, in the interest of every individual.

The Health Insurance Fund remains committed to the continuous improvement of services for insured persons, guided by the principles of accessibility, fairness and quality in health care.