Hungary justifies its decision:
The public reimbursement system for medicines of patients suffering from diabetes and prostate cancer has been recently amended. The provisions concern medicines of the above mentioned patient groups with increased (50%, 70%, 90%) and super increased (100%) reimbursement rates. The aim of the amendment was to further specify previous provisions, as well as to enhance the practical application of professional rules.
According to the new provisions, since 1 July 2012 the use of analogous insulin therapy, following a one-year period of application, may only continue if the patient’s appropriate carbohydrate metabolism target values, based on two measurements, were sustainable during the six months prior to the renewal of the specialist’s recommendation.
The Ministry of National Resources (NEFMI) expects the current amendment to significantly improve the effectiveness of insulin therapies for patients suffering from diabetes. The advantages of analogous insulin therapy – which is rather more expensive than human insulin – and the justification of its public financing can only prevail if patients fully comply with their doctors’ therapeutic recommendations.
It is important to note that we do not wish to penalize chronic patients, on the contrary: we wish to treat and support them in a way that motivates general practitioners (GP), via the GP indicator system, as well as specialists to constantly check their patients’ condition.
So, how do they determine whether someone is complying, but unable to get control within targets, and people who are not complying - can they really do it on the basis of two (presumably HbA1c) tests a year? Given a lot of the experiences I've read on the forum, that is simply not possible because there are so many factors to consider. It's not automatic that the dietary and lifestyle changes along with any medication will succeed as the goalposts can move signiflcantly even if someone tries their hardest. I do understand that people need to take responsibility, but it sounds like quite a few people who do will still fall through the net. How will this make them feel? Depressed, despondent, guilty, a failure...