Observation (CEACR) - adoptée 2006, publiée 96ème session CIT (2007)

Article 9 of the Convention. Cost sharing. In reply to earlier comments by the Committee concerning the cost-sharing by victims of industrial accidents to the cost of pharmaceutical products prescribed outside hospitalization, the Government once again indicates that the provisions of the National Health Service Act regarding reimbursement of pharmaceutical expenses are fair to the extent that they target assistance towards those persons in the greatest financial difficulties. The Government remains convinced that the victims of occupational accidents in this category will be adequately protected by the above legislation. It further undertakes to ensure that over the course of the next three years increases in cost sharing will not exceed the inflation rate.

While it once again takes due note of this information, the Committee reminds the Government that any provision providing for cost-sharing by the victim of an occupational accident in the cost of prescribed pharmaceutical products is not in conformity with Article 9 of the Convention, as the aim of this provision is to prevent the financial consequences derived from the occupational injury being borne by the worker. In this connection, information previously communicated by the Government shows that, firstly, victims of occupational injuries are not required to share in the costs of prescribed pharmaceutical products when they are in a hospital or when their income is beneath a certain limit and, secondly, many categories of insured persons are exempt from cost sharing in respect of pharmaceutical products, irrespective of their level of income. Also, under the existing prescription prepayment arrangements (PPC), persons with paid annual or four-monthly certificates are exempted from the payment of prescription charges for the corresponding period. As a result of these arrangements, only 8.4 per cent of items are paid for at the point of dispensing. Taking these exemptions into account, the Committee still considers that the Government should be able to include all victims of occupational accidents, irrespective of their income level, within the category of insured persons exempt from cost sharing so that pharmaceutical assistance dispensed outside hospital is provided free of charge to all victims of industrial accidents. The Committee trusts that the Government will re-examine this question and take the measures necessary to ensure the full implementation of the Convention on this point.