A notable novelty has taken effect as of 1 January 2026. Under an amendment to the Czech Public Health Insurance Act, public health insurance companies can now centrally procure the purchase of selected medicines that are intended for hospitals with the status of highly specialised care centres[1]. The objective is plain and simple – to concentrate demand and achieve better prices. However, the question is whether savings can actually be achieved for the set of medicines specified by the law.
What medicines can now be centrally purchased?
The new regulation targets a specific group of medicinal products that typically represent a significant item in the costs of specialised centres. These are the medicinal products from one of the following categories:
- medicinal products that are billed separately along with the relevant medical treatment;
- medicinal products that can only be used for inpatient care.
As a key prerequisite, the drug must be the only authorised medicinal product with the given active substance – i.e. a product lacking generic competition.
There is also an important rule under which a hospital that chooses not to be involved in the central procurement will not be eligible for reimbursement of the product in question by the health insurance company. As a result, hospitals are de facto forced to become involved.
Are the central purchases going to bring real savings?
The intended purpose is clear. Like mandatory vaccines, where insurance companies already procure the purchase and distribution for the entire Czech market, the new piece of legislation seeks to leverage the power of collective purchasing to negotiate a better price.
The explanatory memorandum to the statutory provision in question states: “The proposed provision allows health insurance companies to award central public contracts for supplies of costly specialised medicinal products and thus to have the opportunity to negotiate favourable conditions for the volume consumed in the entire Czech Republic. In view of the expected highest efficacy, the bill initially includes the group of medicinal products intended for use in the specialised centre that must be the first authorised medicinal product containing the given active substance. For this type of medicinal products, the joint purchasing for the entire Czech market can be expected to result in the potentially highest savings.”
There is a paradox, though. According to the new regulation, the central public procurement is only possible for a medicinal product without generic competition, meaning that, for the given active substance, there is effectively only a single player on the market. The question therefore is how much room insurance companies really have, in the absence of any competition, to negotiate a better price. Regardless of the above, according to its Public Procurement Plan for 2026, VZP, the largest Czech public health insurance company, is not planning central procurement yet[2]. This may indicate that health insurance companies are still evaluating the legal, economic, and operational impacts of the new regulation.
- [1] – See the new Section 40d of Act No. 48/1997 Sb., on Public Health Insurance, as amended effective from 1 January 2026.
- [2] – See here: https://www.vzp.cz/o-nas/verejne-zakazky (in Czech only).
