Drug programs in the PTKM report. President Michał Chrobot: "We have the data, it's time to make decisions."
For years, the implementation of drug programs has been burdened by excessive bureaucracy and opaque financing, but the direction of change is becoming increasingly clear. Hospitals, doctors, and patients are united in saying that a simpler, better-organized billing structure is needed. A report by the Polish Society of Medical Coders shows that technological improvements and dialogue with the National Health Fund (NFZ) can significantly improve the functioning of drug programs in Poland. Here's a concept for achieving this.
The Polish Society of Medical Coder (PTKM) report, "Drug Programs in Poland – Survey Findings," is one of the most comprehensive analyses to date of the challenges and needs of healthcare providers in contracting, implementing, and financing drug programs. Data collected in February and March 2025, comprising 195 surveys from healthcare providers, helped describe the issues that hospital directors, clinicians, and patients have been reporting for years.
We've finally managed to take a comprehensive approach to the topic of drug programs. We conducted a survey because we felt it was worth verifying what's often discussed and commented on – to give it a realistic, research-based approach and verify whether what seems obvious to us is actually so," said Dr. Michał Chrobot , President of PTKM.
He emphasized that the most frequently cited barriers included financing issues, excessive bureaucracy, inadequate valuation of services and the inability to settle the costs of drug disposal.
The vast majority of surveyed healthcare providers found the SMPT system used to report on the implementation of drug programmes to be too time-consuming and incompatible with hospital HIS systems.
We hope that the planned transition to the SMPL system based on the P1 platform will enable automatic data feeding from HISs and significantly reduce workload, explained Dr. Michał Chrobot.
Integration with the central e-health platform is to be one of the key steps towards simplifying settlements and shortening reporting times, which is also hoped for by representatives of the National Health Fund and hospital directors.
SMPT (Therapeutic Program Monitoring System) is an IT system of the National Health Fund used for recording, billing, and reporting drug programs. Providers enter data about patients, therapy progress, and drug utilization into the system. In practice, however, this system often frustrates doctors and hospital directors – it is too bureaucratic and does not fully cooperate with hospital information systems (HIS).
HIS ( Hospital Information System ) is software that supports the management of all clinical and administrative processes in medical facilities. It includes patient registration, medical record keeping, hospitalization, examination, and treatment records, as well as National Health Fund (NFZ) billing and data reporting. The lack of integration between HIS and SMPT means that staff must manually enter the same information into two different systems. This significantly increases the administrative burden and takes away time that could be spent with patients.
One of the most telling statements during the debate accompanying the PTKM report came from Professor Mariusz Bidziński , national consultant in gynecologic oncology. The expert emphasized the real financial consequences of systemic limitations.
Another problem is the lack of reimbursement for the discarded portion of the drug. Vials often contain more than is needed for a single patient, and hospitals are not reimbursed for the unused portion. This generates real losses—as much as 10–15% of the drug's value ," said Professor Bidziński.
As the authors of the report point out, the National Health Fund only reimburses drugs actually administered to patients, which in the case of rare diseases or centers with a small number of patients means huge losses.
This is particularly painful for smaller hospitals, which, despite limited budgets, cannot refuse treatment.
I can't imagine stopping patients from being enrolled in drug programs. I won't put my staff in a position to choose who to give the drug to and who to refuse," said Sylwia Modrzyk , director of the Voivodeship Hospital Center of the Jelenia Góra Valley.
She emphasized that despite the long waiting time for reimbursement and the lack of financing for unused portions of drugs, facilities continue to run drug programs out of a sense of mission.
Drug programs are not unlimited benefits, but I cannot imagine refusing a patient participation in the program, added Director Modrzyk.
From the patients' perspective, it is crucial that drug programs are not only enshrined in regulations, but actually available in every region of the country.
Patients greatly appreciate drug programs. They see them as a tremendous opportunity, and the opportunity to participate in the program is a great blessing and a privilege. Those who take advantage of them are truly grateful," said Magdalena Kołodziej , president of the MY PATIENTS Foundation.
She added that many patients would like to start treatment earlier – before the disease develops – and are counting on the stability of program financing , which is a key condition for safety today.
Professor Brygida Kwiatkowska , national consultant in the field of rheumatology, also spoke about clinical and administrative problems.
The biggest challenge remains bureaucracy and the time-consuming nature of the service. Instead of dedicating time to the patient, doctors spend hours filling out paperwork in the SMPT system. In practice, a dedicated team is needed to support clinicians with administrative support," she pointed out.
She also added that too rigid criteria for inclusion and exclusion from programs do not allow for flexible adaptation of therapy to individual patient needs.
Iwona Kasprzak , director of the Department of Drug Management at the National Health Fund, spoke about the activities of the National Health Fund in response to the demands of healthcare providers.
In 2024, we shortened the time needed to verify reports and initiate payments. We are also working on integrating the SMPT system with HIS systems so that data on drug programs is automatically transferred to the P1 platform ," she assured.
She added that the National Health Fund also wants to introduce monitoring of the clinical effectiveness of drug programs so that public funds are spent where they actually improve treatment outcomes.
At the end of the conference, Dr. Michał Chrobot presented the postulates resulting from the PTKM report: abolishing the limits on financing drug programs, simplifying the settlement rules and making the valuation of services more realistic, as well as providing additional funds for the inclusion of new molecules in reimbursement.
Data is incredibly valuable – as long as it's properly analyzed and used to make management decisions. We hope that the new P1 IT system will be open, integrated with HIS systems, and will significantly reduce the burden on healthcare providers, " he concluded.
Updated: 03/11/2025 17:30
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