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ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of December 31, 2019 No. KR DSM-154

About approval of Rules of implementation of copayment on medicines and medical products

According to subitem 83-2) of Item 1 of article 7 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" PRIKAZYVAYU:

1. Approve the enclosed Rules of implementation of copayment on medicines and medical products.

2. To provide to department of provision of medicines and standardization of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication.

3) within ten working days after state registration of this order submission to Legal department of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1) and 2) of this Item.

3. To impose control of execution of this order on the vice-Minister of Health of the Republic of Kazakhstan Nadyrov K. T.

4. This order becomes effective since January 1, 2020.

Minister of Health of the Republic of Kazakhstan

E.Birtanov

Approved by the Order of the Minister of Health of the Republic of Kazakhstan ot31 December, 2019 No. KR DSM-154

Rules of implementation of copayment on medicines and medical products

Chapter 1. General provisions

1. These rules establish copayment procedure on medicines and medical products.

2. In the sphere of drug circulation and medical products, in case of payment of difference in the cost of medicines, medical products and the established marginal price of their compensation within the guaranteed amount of free medical care (further - GOBMP) and in system of compulsory social medical insurance (further - OSMS), it is performed by authorized body in the field of health care by copayment of difference in the cost of medicines, medical products and the established marginal price of their compensation.

3. In these rules the following basic concepts are used:

1) information system of accounting of out-patient provision of medicines (further - ISLO) - the information system determined by authorized body in the field of health care for automation of accounting of the statement of recipes, goods issue to suppliers of pharmaceutical service or service in accounting and realization within GOBMP and in the OSMS system;

2) fund of social medical insurance (further - Fund) - the non-profit organization making accumulation of assignments and fees, and also performing purchase and fee of the subjects of health care providing medical care in amounts and on the conditions provided by the agreement of purchase of medical services and other functions determined by the laws of the Republic of Kazakhstan;

3) copayment - payment of difference in the cost of medicines, medical products and the established marginal price of their compensation within GOBMP and in the OSMS system;

4) the list of medicines and medical products for free and (or) preferential out-patient ensuring separate categories of citizens with certain diseases (conditions) (further - the List) - the list of medicines and medical products within GOBMP including separate categories of citizens with certain diseases (conditions) of free and (or) preferential medicines and medical products at the out-patient level approved by the order of the Minister of Health of the Republic of Kazakhstan of August 29, 2017 No. 666 (it is registered in the Register of state registration regulatory legal acts of the Republic of Kazakhstan at No. 15724);

5) the international non-proprietary name of medicine (further - MNN) - the name of medicine recommended by the World Health Organization;

6) compensation within GOBMP and in the OSMS system - payment of cost of use of medicines and medical products within GOBMP and the OSMS system at the expense of budgetary funds and assets of fund of social medical insurance, with forming of the corresponding economically reasonable rate or marginal price;

Marginal 7) the price for the trade name of medicine or medical product within GOBMP and in the OSMS system - the price of the trade name of medicine or medical product above which the purchase within GOBMP and in the OSMS system cannot be made;

8) the ceiling price for MNN of medicine or technical characteristic of medical product within GOBMP and in the OSMS system - the price of MNN of medicine or technical characteristic of medical product above which the purchase within GOBMP and in the OSMS system cannot be made;

Marginal 9) price of compensation of medicines on MNN, medical products on technical characteristic and/or structure within GOBMP and in the OSMS system - the cost of one packaging of medicine, with certain dosage, release form on MNN of medicine and/or on technical characteristic and/or certain structure of medical product which is fully or partially compensated by Fund to Objects in the sphere of the appeal of LS, expected by multiplication of purchase price according to the price list of the Single distributor MNN of medicine within GOBMP and in the OSMS system for unit of measure in case of purchase on quantity of units of measure in consumer packaging.

10) the electronic recipe - the document created by the health worker in electronic format by means of the electronic passport of health in ISLO containing information on appointment to the patient of medicine and the medical product for further leave by objects in the sphere of drug circulation having permission (license) for the implementation of pharmaceutical activities for retail sale of medicines and medical products received according to the legislation of the Republic of Kazakhstan on permissions and notifications (further - Objects in the sphere of the appeal of LS) and signed by the digital signature of the doctor;

Chapter 2. Copayment procedure

4. Copayment of difference in the cost of medicine and medical product and the established marginal price of their compensation, is performed in case of out-patient providing the population according to the List in Objects in the sphere of the appeal of LS performing services of accounting and realization and/or pharmaceutical services within GOBMP and OSMS with possibility of the choice of more expensive medicine with copayment in case of disagreement of the patient to receive compensations provided on free leave within marginal price trade names of medicines and medical products, having replaced them with more expensive trade names at its sole option.

5. All trade names of medicines and medical products registered in the Republic of Kazakhstan and entering the List of medicines on MNN and also medical products on technical characteristic and/or structure which cost exceeds marginal price of compensation, except purchased from the international organizations and domestic manufacturer for long-term agreements of delivery are subject to copayment.

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