The current principle of issuing the cheapest reimbursable medications may create risks for patients with cardiovascular diseases. Cardiologist Iveta Mintale believes that frequent changes in medications undermine treatment stability and patient trust in therapy.
Cardiologist Iveta Mintale expressed concern about the current system of reimbursable medications in Latvia, where patients are given the cheapest available drug with the same active ingredient at the pharmacy, writes LETA. According to the doctor, this approach may negatively affect the treatment of patients with hypertension and high cholesterol.
Mintale notes that many patients have been taking specific medications for years and achieve stable therapeutic results. However, after price changes at the pharmacy, they may be given a different equivalent — and this can lead to fluctuations in blood pressure, worsening cholesterol levels, and anxiety due to the change in treatment.
According to the doctor, the problem concerns not only psychological comfort. “Such changes are not just a matter of well-being, but also a factor of increased risk of stroke or heart attack,” warns the cardiologist.
Mintale emphasizes that adherence to treatment is built not only on the discipline of the patient but also on trust in the specific therapy. Frequent changes in medications, in her opinion, undermine this trust, as people begin to doubt the effectiveness of new drugs and fear side effects.
The doctor also sees a separate problem in that patients may become confused about medications after the replacement of drugs. This is especially dangerous for elderly people and patients taking several medications at once. Errors can lead either to the discontinuation of treatment or to the accidental intake of several similar drugs simultaneously.
The cardiologist also disagrees with the assertion that all drugs with the same active ingredient are completely identical in practice. According to her, differences may concern excipients, absorption rates, and production quality.
Another problem Mintale identifies is the limited availability of combination drugs based on the “one pill” principle, where several diseases are treated with one medication. Such drugs are usually more expensive and less likely to be the cheapest in the reimbursement system.
“Right now, my patients are treated by officials from the Ministry of Health. But the responsibility is demanded from me,” said the doctor, commenting on the current system.
According to the specialist, patients should be allowed to pay the difference for their usual medication if the state reimburses the cost of the cheapest equivalent. Mintale believes this would enhance treatment safety without additional costs to the budget.
The topic has become relevant again after 24 medical and patient organizations sent a joint letter to the Ministry of Health and the National Health Service last year, urging changes to the medication reimbursement system.
The Ministry of Health, meanwhile, reminds that a doctor can already prescribe a specific brand name of a drug if there is a medical justification. The department also emphasizes that the system of the cheapest medications helps reduce patient expenses and encourages manufacturers to lower prices.
