Outpatient doctors threaten protests

The Patronage of Independent Specialist Doctors (PMSPI) and the Professional Association of Outpatient Doctors (APMA) have expressed their "outrage" at the Government's intention not to comply with commitments regarding the increase in the value of the point per medical service in the specialized outpatient clinic. The doctors' representatives warn that they are considering protest measures, including the partial or total suspension of activity.

• Promises postponed again

The Government and CNAS had promised to increase the value of the point to 6.5 lei from August 2025 and to 8 lei from January 2026, but the implementation was initially postponed to October 1. According to the two organizations, there is now talk of a new postponement for 2026-2027, which is considered "a flagrant violation of the trust of doctors and patients".

• Ambulatory care, underfunded sector

PMSPI and APMA claim that maintaining the underfunding of outpatient clinics means "disregarding the work of specialist doctors, ignoring the needs of patients and destabilizing the most efficient component of the medical system”. "Our demands are clear: respecting the promise of increasing the point value, an appropriate budget for the outpatient clinic, a transparent and predictable strategy for financing independent practices”, the organizations say.

• Ultimatum for the authorities

In the absence of concrete measures, outpatient doctors announce that they do not rule out large-scale protests, which could even include the suspension of contractual activity with CNAS.

According to the two organizations, the outpatient clinic is "the only sustainable alternative for reducing pressure on hospitals”, offering highly professional medical services, but at a much more efficient cost than day or continuous hospitalizations.

• Decrease in reimbursement of medicines could affect millions of patients

The Association of Generic Medicines Manufacturers in Romania (APMGR) has warned that the new proposal of the Ministry of Health and the National Health Insurance House, regarding the reduction of the reimbursement level for a large number of medicines, risks affecting over 10 million patients.

• From 90% reimbursement to 50% or even 20%

According to the organization, some medicines that currently benefit from 90% reimbursement (List A) would be moved to List B, where the reimbursement drops to 50%. Other products from lists A and B could be transferred directly to List D, where patients receive only 20% reimbursement. In the case of medicines from List C, where reimbursement is full (100%), it is proposed to change the reference price, which would introduce additional co-payments for thousands of treatments.

• Significant increases in patient costs

According to APMGR, the impact on patients will be immediate and consistent. Additional monthly costs would range between 6 and 500 lei for each drug. The examples provided by the association are telling: Rosuvastatin - used to reduce cholesterol - will increase from 20 to 33 lei (+65%); Candesartan - a treatment for hypertension - will increase from 17 to 30 lei; Entecavir - used for chronic hepatitis - will increase from 0 to 32 lei; Lenalidomide - a treatment for multiple myeloma - will increase from 0 to 237 lei. "The number of patients affected by this decision is estimated to exceed 10 million. In an already difficult economic context, any increase in costs is painfully felt by the patient,” said Daniel Bran, president of APMGR.

• Contradictions between promises and reality

The association recalls that Prime Minister Ilie Bolojan has shown himself in the past to be a supporter of affordable treatments and the generic medicine industry. In this context, the decision to reduce compensation is seen as a contradiction between the promises made and the proposed measures. APMGR demands a direct dialogue with the Prime Minister and the amendment of the legislation so that generic and biosimilar medicines are immediately included in the Unconditional Compensation List, without the current delays of 1.5-2 years. The organization also warns that these measures will continue to put pressure on the generic medicines sector, despite the fact that they represent less than 20% of medicine spending, but have brought a budgetary optimization of over 1 billion euros in the period 2016-2023.

• A local industry ignored

Romania currently has 41 generic drug production facilities, which contribute to balancing the trade balance through intra- and extra-community exports. However, in the opinion of APMGR, current policies show that there is no real strategy to support generic drugs, although they could ensure more accessible treatments and efficient management of the health budget.