[et_pb_section fb_built=”1″ admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.16″ global_colors_info=”{}”][et_pb_row admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text admin_label=”TO BE EDITED – TEXT – Click on the WHEEL icon to open the text-area where you can type your text. Add a paragraph to introduce the Document” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n
User charges affect access to health care. In 2018, Estonia lowered thresholds and automated reduced co-payments for medicines via e-prescriptions, removing barriers. This increased eligibility and reduced out-of-pocket costs, improving financial protection.<\/strong><\/p>\n A new report highlights significant strides in Estonia\u2019s efforts to reduce financial hardship caused by out-of-pocket (OOP) expenses for health care. In 2016, OOP payments made up 24% of the country\u2019s health expenditure, and 8% of households<\/strong> experienced catastrophic health spending, with the poorest families most affected. The high financial burden was largely driven by co-payments for outpatient medicines, creating unmet needs, as 7% of people<\/strong> with prescriptions were unable to afford them. The complexity of the previous system\u2014high eligibility thresholds and cumbersome administrative processes\u2014limited the effectiveness of protection mechanisms.<\/p>\n In 2018, the Ministry of Social Affairs introduced reforms designed to simplify and improve financial protection. Key changes included lowering the annual threshold for reduced co-payments from \u20ac300 to \u20ac100, thereby increasing accessibility for vulnerable groups. To further enhance uptake, Estonia\u2019s centralized e-prescription system was upgraded to automatically track users\u2019 spending and apply reduced co-payments in real-time. This innovation eliminated administrative hurdles, such as the need to retain and submit pharmacy receipts. Additionally, the co-payment structure was standardized with a fixed rate of \u20ac2.50 per prescription.<\/p>\n These reforms led to immediate improvements. The number of people eligible for reduced co-payments rose from 8,000<\/strong> to 134,000<\/strong>, with 100%<\/strong> of eligible individuals benefiting from the reform\u2014up from 37.5%<\/strong> previously. As a result, the share of people who received reduced co-payments when filling prescriptions increased from 0.4%<\/strong> to 15.6%<\/strong>, while the number of households spending more than \u20ac250 annually on outpatient medicines dropped dramatically from 24,000<\/strong> to just 1,000<\/strong>. Overall, out-of-pocket costs for outpatient prescribed medicines decreased by 8%<\/strong> and remained below pre-reform levels in subsequent years.<\/p>\n Despite these positive outcomes, Estonia continues to face challenges. In 2020, 7.2% of households<\/strong> still experienced catastrophic health spending. The report recommends further policy measures, such as introducing caps on co-payments, exempting low-income groups and individuals with chronic illnesses from user charges, and replacing percentage-based co-payments with fixed rates to ensure equitable access to health care.<\/p>\n The success of Estonia\u2019s reform highlights the importance of robust monitoring and digital innovation in improving financial protection. Continuous data collection on unmet needs and household spending allowed policymakers to identify gaps in coverage and design more effective solutions. The centralized e-prescription system played a crucial role by automating processes, reducing administrative burdens, and increasing benefit uptake. Strong collaboration among the Ministry of Social Affairs, the Estonian Health Insurance Fund (EHIF), and pharmacies was also key to implementing these reforms successfully.<\/p>\n Estonia\u2019s experience provides a valuable model for other countries seeking to strengthen universal health coverage and reduce financial hardship. While the reforms have made health care more affordable for many, ongoing efforts are needed to close remaining coverage gaps and protect all citizens from the risk of poverty due to health expenses.<\/p>\n