Poland is preparing a broad overhaul of its prescription and reimbursement rules as part of wider efforts to reduce unnecessary public spending on medicines, improve the management of reimbursed prescriptions and curb misuse of pharmaceutical products.

The draft legislation would introduce changes affecting reimbursed and annual prescriptions, as well as the country’s free medicines programme for older people. While some proposals have raised concerns among healthcare stakeholders about restricting patient access to medicine, health officials insist the reforms are designed to make the system more efficient rather than limit access to treatment.

“The aim is to organise the rules governing reimbursed prescriptions and ensure a rational sequence of medicine dispensing, not to restrict patients’ access to therapy or deprive them of reimbursement because of technical issues related to pack sizes,” the health ministry told Euractiv.

Optimising reimbursement

One of the government’s main objectives is to reduce inefficiencies within Poland’s reimbursement system.

Officials say the current rules allow the public payer to fully reimburse medicines containing the same active substance and offering comparable therapeutic effects even when their prices differ substantially.

“The purpose of the proposed changes is not to influence individual clinical decisions, but to shape reimbursement rules so that they favour economically justified options while fully preserving physicians’ autonomy and keeping patient safety as the overriding priority,” the ministry said.

Officials argue that savings generated through better procurement could help finance access to new medicines without reducing the range of available therapies.

Free medicines programme

The planned reform also includes changes to Poland’s free medicines scheme for people aged 65 and over, one of the country’s largest publicly funded pharmaceutical programmes.

Authorities reject criticism that the reform would reduce access to treatment, arguing instead that it is intended to eliminate unnecessary spending on higher-priced medicines when lower-cost therapeutic equivalents are already available.

Since the programme was expanded in 2023, the number of reimbursed products available free of charge to older patients has more than tripled compared with its original launch in 2016. Today, around 94% of all reimbursed pharmacy medicines are included in the scheme for eligible seniors.

According to official data, more than 9.4 million patients have benefited from the programme since its introduction. In 2025 alone, Poland’s National Health Fund spent more than €2.1 billion on reimbursing medicines for people aged over 65, including more than €800 million on medicines provided entirely free of charge.

Health officials say maintaining that level of spending will require more efficient allocation of public resources as additional innovative therapies enter the reimbursement system.

“Our main objective is to optimise expenditure while ensuring that no patient loses access to free treatment, understood as the appropriate therapy for their clinical condition,” the ministry said.

Changes to prescription rules

Alongside reimbursement reforms, the legislation proposes technical changes to the operation of Poland’s electronic prescription system.

The government says the new rules are intended to improve the sequencing of reimbursed dispensing and reduce the accumulation of excessive medicine stocks by patients without introducing rigid limits on the amount of medicine that can ultimately be prescribed.

Separate provisions are also expected to strengthen safeguards against the misuse of medicinal products, particularly medicines that are increasingly purchased for non-medical purposes. However, officials denied media reports suggesting the ministry is considering a seven-day restriction on over-the-counter medicine purchases linked to patients’ national identification numbers (PESEL).

“We are not conducting analyses on introducing a seven-day sales block linked to PESEL numbers,” the ministry told Euractiv.

Instead, officials said the proposed legislation would introduce broader mechanisms to prevent abuse in the pharmaceutical market and to limit the non-medical use of medicinal products.

Part of a broader digital reform

The prescription reform forms part of Poland’s continuing digitalisation of healthcare, following the nationwide rollout of electronic prescriptions and the expansion of digital pharmaceutical services.

The proposals have already attracted considerable attention from medical organisations and pharmaceutical stakeholders, who are analysing their practical impact on prescribing, dispensing and reimbursement procedures.

Officials say the guiding principle behind the reform is to preserve clinical autonomy while ensuring that public reimbursement better reflects both therapeutic value and the efficient use of taxpayers’ money.

[VA, BM]