Greater accessibility and lower costs for patients
Enoxaparin, Nadroparin and Rivaroxaban – now available in pharmacies
The Health Insurance Fund of Macedonia continues to improve access to modern therapy and reduce costs for insured persons.
Starting from 1 July 2026, three frequently prescribed anticoagulant medicines are available in pharmacies across the country – Enoxaparin, Nadroparin and Rivaroxaban.
This measure significantly improves access to anticoagulant therapy. Enoxaparin and Nadroparin, which patients have until now obtained through a reimbursement procedure, are now available directly in pharmacies, while Rivaroxaban has been included on the Positive List of medicines for the first time.
With this decision, we show that the Positive List is not merely a list of medicines, but an instrument through which we directly reduce patients’ treatment costs. Today, thousands of citizens have easier access to modern anticoagulant therapy, and the savings created will enable us to continue expanding the Positive List with new, modern and more expensive medicines.- Sasho Klekovski, Director of the HIF, stated among other things
ENOXAPARIN AND NADROPARIN
Enoxaparin is available in several doses and packs, with a price ranging from 1.160 to 2.700 denars.
The medicine is available in two brands, of which one brand is issued without surcharge, meaning that patients pay only the statutory participation, which amounts to from 160 to 240 denars, depending on the dose and pack.
The reduction in the reference price ensures savings both for insured persons and for the Fund.
Key benefits
- 1.160–2.700 denars – medicine price
- 160–240 denars – participation
- 0 denars – surcharge for one brand of Enoxaparin
RIVAROXABAN
Rivaroxaban is a modern oral anticoagulant used by between 6.000 and 10.000 insured persons, and its previous price was from 2.000 to 2.200 denars per month, depending on the dose.
With its inclusion on the Positive List, the medicine will be available with participation of 160 denars, and the surcharge will amount to from 105 to 505 denars, depending on the dose and pack.
For the most commonly used pack – 30 tablets of 10 mg – the patient will pay 160 denars participation and 315 denars surcharge, which represents a saving of 1.752 denars per month compared with the previous price.
Key benefits
- 2.000–2.200 denars – previous price
- 160 denars – participation
- 105–505 denars – surcharge (depending on the dose and pack)
- 1.752 denars – saving for the most commonly used pack
From 1 January 2027, Rivaroxaban will be available without surcharge, meaning that patients will pay only the statutory participation, which will further reduce the financial burden.
THE FUND INVESTS AND SAVES
In addition to significant savings for insured persons, by reducing the reference prices the Fund will procure the medicine at a lower price, enabling more responsible and efficient use of public funds.
The reference price of Rivaroxaban will be halved, representing significant savings for the health system as well.
A STEP TOWARDS EXPANDING THE POSITIVE LIST
With this expansion, the Fund begins the systematic inclusion of more expensive medicines for chronic therapy in the price range of 2.000 to 3.000 denars per month, a policy that will continue in the coming period.
The inclusion of new medicines on the Positive List represents one of the most efficient mechanisms for reducing prices, improving the availability of therapy and reducing the financial burden on patients.
The Fund remains committed to ensuring higher-quality, more accessible and financially sustainable health care, through policies that simultaneously protect the interests of insured persons and ensure rational management of public funds.
