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Selection from Decision-Making Practice – 13/2026

Pharmeca a.s. 08. 07. 2026

The State Institute for Drug Control (the Institute) received a joint request from medical societies to establish increased reimbursement for medicinal products containing a selected active substance for the treatment of paraphilic disorders, an indication that falls outside the approved marketing authorisation (i.e. an off-label indication). In their statement, the medical societies explained that the request was supported by clinical experience, scientific evidence, and safety considerations.

The Institute concluded that the therapy represents the only available treatment option. Consequently, it did not require the submission of a cost-effectiveness analysis; a budget impact analysis based on the number of patients reported by the medical societies was considered sufficient.

Based on the submitted documentation, the Institute concluded that reimbursement in this off-label indication is adequately supported by current scientific evidence and that the therapy constitutes the only available treatment option. It therefore proposed granting increased reimbursement for this indication as well.

According to Section 39b(3) of the Public Health Insurance Act:
“…The Institute may establish reimbursement for an unregistered medicinal product where its use is sufficiently justified by current scientific knowledge and it represents the only available treatment option, or where its use is cost-effective compared with available treatment, for the duration of an approved specific treatment programme. The Institute may also establish reimbursement for a registered medicinal product for indications not included in the Summary of Product Characteristics, provided that the use of the medicinal product is sufficiently justified by current scientific knowledge and represents the only available treatment option, or where it is cost-effective compared with existing treatment.”



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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 English translation was prepared using the latest available ChatGPT model.

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