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Selection from Decision-Making Practice – 11/2026

Pharmeca a.s. 11. 06. 2026

In administrative proceedings concerning a change in the amount and conditions of reimbursement, the marketing authorisation holder applied for an extension of the prescribing restriction to one additional medical specialty. Together with the application, the holder paid only the administrative fee applicable to cases that do not require a full clinical and pharmacoeconomic assessment.
However, during the proceedings, the State Institute for Drug Control (the Institute) subsequently requested payment of an additional amount, taking the view that the case required a comprehensive expert assessment.
The applicant appealed against this approach.

In the appeal proceedings, the Ministry of Health (MoH) upheld the Institute’s position, confirming that the administrative fee applicable to proceedings involving a full expert assessment was appropriate.
According to the MoH, any relaxation of prescribing restrictions facilitates patient access to treatment, which in itself creates the potential for increased expenditure from the public health insurance system. This applies even where the absolute number of patients in the indication does not increase, as treatment patterns may shift internally in favour of the medicinal product concerned. From the Ministry’s perspective, such shifts may also result in increased expenditure from the system.
The MoH therefore concluded that the Institute has a legitimate obligation to properly assess any potential impact on public health insurance funds and that the requested administrative fee corresponds to the scope of the assessment being carried out.


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Articles on decision-making practice are based on publicly available texts from the decisions of the Ministry of Health of the Czech Republic and the State Institute for Drug Control (SÚKL).

A continuously updated overview of decisions issued by SÚKL and the Ministry of Health in the field of pricing and reimbursement is available on the Pharmeca a.s. website.

The text was translated using ChatGPT 5.3.  

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