Contributions
Abstract: PB1757
Type: Publication Only
Session title: Quality of life, palliative care, ethics and health economics
Background
Estonia, located in the shores of Baltic Sea has a population of 1,3 million with population density of 29,8 inhabitants per km2 (2011) . There are 2 major islands which are accessible from mainland by ferry or airplane. After the restruction of the hospital network 19 hospitals remained, incl. 3 regional, 4 central and 11 county hospitals.
Aims
Patients with haemophilia live everywhere. Replacement factors are distributed from regional hospitals, two are located in Tallinn (population 500 000) and one in Tartu (population 100 000). The network of retail pharmacies is very well established. The social support in rural parts of the country is suboptimal; from the other hand the pharmacy services are developing rapidly, including the door-to-door deliveries.
Methods
It was one of Kreuth III recommendations to establish a national roundtables to develop the treatment of coagulation disorders. Estonian Hemophilia Society (EHS) initiated a meeting in September 2013 where high-level stakeholders – from Ministry of Social Affairs, Health Insurance Fund, Estonian Hematology Society’s working group on coagulation disorders – supported the improvement in treatment access. It was proposed that 20% of the coagulation factors will remain for hospital use in case of emergencies and surgeries and 80% will be included to the reimbursement list and can be obtained from retail pharmacies as prescription drugs.
Results
Some of the coagulation factors were included to the reimbursement list and became available in retail pharmacies in early 2015. However, as the regional hospitals had economically favorable tender contracts which tied the sale of the donated plasma to the purchase of plasma-derived factors, the system change was not fully implemented. EHS continued the work for better access. National tender and better access to replacement factors was supported by WHF-EHC-EAHAD joint visit to Estonia in October 2015. The major breakthrough took place in July 2019 when new medicines were included to the reimbmursement list by Health Insurance Fund. Also all plasma derived products, long acting coagulation factors, recombinant factors, aPCC are included to the list, which are prescribed electronically by physicians.
Conclusion
The delivery to pharmacies takes place within 24 hours. The door-to-door delivery to patients is developing as well. The new coagulation factor delivery system has reduced patients' financial burden, travel time and has brought high satisfaction among Haemophilia community in Estonia.
Keyword(s): Coagulation factors, Hemophilia, Patient, Quality of life
Abstract: PB1757
Type: Publication Only
Session title: Quality of life, palliative care, ethics and health economics
Background
Estonia, located in the shores of Baltic Sea has a population of 1,3 million with population density of 29,8 inhabitants per km2 (2011) . There are 2 major islands which are accessible from mainland by ferry or airplane. After the restruction of the hospital network 19 hospitals remained, incl. 3 regional, 4 central and 11 county hospitals.
Aims
Patients with haemophilia live everywhere. Replacement factors are distributed from regional hospitals, two are located in Tallinn (population 500 000) and one in Tartu (population 100 000). The network of retail pharmacies is very well established. The social support in rural parts of the country is suboptimal; from the other hand the pharmacy services are developing rapidly, including the door-to-door deliveries.
Methods
It was one of Kreuth III recommendations to establish a national roundtables to develop the treatment of coagulation disorders. Estonian Hemophilia Society (EHS) initiated a meeting in September 2013 where high-level stakeholders – from Ministry of Social Affairs, Health Insurance Fund, Estonian Hematology Society’s working group on coagulation disorders – supported the improvement in treatment access. It was proposed that 20% of the coagulation factors will remain for hospital use in case of emergencies and surgeries and 80% will be included to the reimbursement list and can be obtained from retail pharmacies as prescription drugs.
Results
Some of the coagulation factors were included to the reimbursement list and became available in retail pharmacies in early 2015. However, as the regional hospitals had economically favorable tender contracts which tied the sale of the donated plasma to the purchase of plasma-derived factors, the system change was not fully implemented. EHS continued the work for better access. National tender and better access to replacement factors was supported by WHF-EHC-EAHAD joint visit to Estonia in October 2015. The major breakthrough took place in July 2019 when new medicines were included to the reimbmursement list by Health Insurance Fund. Also all plasma derived products, long acting coagulation factors, recombinant factors, aPCC are included to the list, which are prescribed electronically by physicians.
Conclusion
The delivery to pharmacies takes place within 24 hours. The door-to-door delivery to patients is developing as well. The new coagulation factor delivery system has reduced patients' financial burden, travel time and has brought high satisfaction among Haemophilia community in Estonia.
Keyword(s): Coagulation factors, Hemophilia, Patient, Quality of life