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Pricing and reimbursement of medical device consumables

The Dental and Pharmaceutical Benefits Agency, TLV, regulates which medical device consumables will be reimbursed and included in the high cost threshold. Unlike prescription pharmaceuticals, the reimbursement of medical device consumables is not based on the least expensive alternative available at pharmacies.

Medical device consumables must be prescribed just as pharmaceuticals to be eligible for reimbursement. Patients can be prescribed medical device consumables by physician or other persons granted the ability to prescribe by The National Board of Health and Welfare.

Three types of medical device consumables are reimbursed. TLV regulates reimbursement for medical device consumables for administration of pharmaceuticals, self-monitoring of pharmaceutical levels, and stoma products.

Administration of pharmaceuticals

The medical devices needed by a patient to administer or control levels of prescription pharmaceuticals are fully reimbursed and therefor free of charge to patients. Examples are devices for diabetes and inhalation aids for asthma patients.

Stoma products

Medical devices for stoma patients are subject to the same reimbursement regulations as prescription pharmaceuticals. Applications for reimbursement of stoma products are processed and decided upon by the unit for medical devices at TLV. Pricing of reimbursed stoma products is also determined by the unit for medical devices at TLV.

Reimbursement of stoma products is managed through the use of a high cost threshold. Stoma products and prescription pharmaceuticals are paid for directly by the patient until the cumulative costs for both within a twelve month period reach the set high cost threshold. After the high cost threshold is reached, stoma products and prescription pharmaceuticals are fully reimbursed by the Swedish government and become free of charge to patients for the remainder of the twelve month period.

Senast uppdaterad 01 november 2019