Enrollment from the meeting with representatives of Slovak Psychiatric Society SLS, Association of Private Doctors of the Slovak Republic - Department of Psychiatry held on 21. 06. 2012 at 11.00 at MZ SR

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For MZ SR: - director of the Department of Classification, Pricing and Drug Policy of the Department of Pharmacy and Drug Policy of the Slovak Republic PharmDr. Rastislav PullmannZa Slovak Psychiatric Society SLS: - Member of the Committee of MUDr. Peter KorcsogZa Association of Private Doctors of the Slovak Republic - Department of Psychology: - MUDr. Vít Provazník - MUDr. Ján DúžekZa Slovak Medical Union of Specialists: - Coordinator for psychiatry MUDr. Ľubica FerenčákováThe meeting was convened on the basis of the requests made by the above-mentioned psychiatric representatives for the abolition of the transcription of depot antipsychotics in the regime of the "A' regime.Director of the Department of Classification, Pricing and Drug Policy of the Department of Pharmacy and Drug Policy of the Slovak Republic PharmDr. Rastislav Pullmann welcomed the guests and informed them about the written opinion of the main expert of MZ SR for psychiatry doc. Dr. Ivan Dóci, PhD, to abolish the A-mode of depot antipsychotics. He informed those present that the Ministry, in accordance with § 3 (2) (a). (d) and (e) Decree No 723/2004 of the Ministry of Health of the Slovak Republic Z.z. and with § 6 from 11 letter (e) Act No 363/2011 The Z.z. has changed the reimbursement taking into account the nature of the patient's disease and the risk of deterioration. Patient disease does not guarantee safe handling of the product. The main objective is to increase patient safety in order to avoid exposure to uncontrolled and dangerous handling of the product, the need to ensure their storage in refrigeration boxes exclusively by professionals at the office. He pointed out that the special method of reimbursement of the medicinal product did not in any way mean its unavailability to the patient, nor did it affect or induce any changes in the therapeutic process. Only the way the medicine was procured has changed. MUDr. Provazník, MUDr.Dúžek and MUDr. Ferenčáková:

1. They thanked them for their acceptance and stressed that the reason for their request was to resolve the problem as soon as possible and to reverse this unfavourable situation in the interests of their patients.
2. They pointed out, in particular, that the change in legislation, especially on ambulances, has led to situations where the doctor is forced to buy these medicines from his own financial resources, which brings many administrative, financial and medical problems.
3. They stated that if there was no further progress in addressing the problem, their concerns about the worsening quality and overall safety of the treatment of the most at risk group of psychiatric patients would be met.

• They reiterated in particular the fact that the time burden on the provider has increased disproportionately to the detriment of the quality of healthcare provision.
• Another problem was the administration of an injectable antipsychotic during the holiday or absence of a doctor, during hospitalization of a psychiatric patient due to other somatic illness, etc.
• The MZ SR submitted an inspirational letter in relation to the drug regimen
• They stated that an outpatient psychiatrist has to run a stock farm, which is relatively time-consuming and administratively-intensive in several neuroleptics, which is also not taken into account in the application of depot neuroleptics.

Dr. Korcsog:

1. He informed that this situation was established on the Categorisation Committee of the Slovak Republic, where it also needs to be addressed. He pointed out in particular the administrative burden on outpatient doctors, the lack of availability of depot antipsychotics in the representation of outpatient psychiatrists.
2. He referred to the issue of flat-rate income taxes in case the psychiatric ambulance acts as a SZČ and has flat-rate taxes.
3. He appealed for cancellation A regimen in obtaining and purchasing depot antipsychotics due to negative impact on lege artis treatment.
4. They asked the Director of the Department of Classification and Drug Policy of the Ministry of Health of the Slovak Republic to inform about the meeting and their request for the abolition of the regime of the Slovak Republic at the next meeting.

PharmDr. Pullmann:

1. He said that the main problem and shortcomings were seen by representatives in the increase in administration as well as in the indication of their own funds.
2. The method of reimbursement of medicinal products is consistent with the current legal situation.
3. He pointed to the Ministry's efforts to take account of the requirements, stating that the Ministry was preparing an amendment of laws 362/2011Z.z. and 363/2011 Coll., for which representatives, through professional companies, could submit proposals for changes.
4. The possibility of solving the problem of using own funds is in an agreement with the pharmacy care provider for the payment of the invoice for purchased medicines so that this period covers the period for payment of invoices by health insurance companies to the healthcare provider.
5. In conclusion, all present agreed that proper treatment of the patient was paramount in this case.

Conclusion:- Inform about the request of representatives of the psychiatry department to cancel the depot antipsychotic regime at the next meeting of the Categorisation Commission of the MZ She wrote: Želeňáková Schvál: PharmDr. Rastislav Pullmann, director of OKCLP,v.r.