Poland has introduced a new review process for medicines supplied without patient co-payment to people aged 65 and over. The ‘S’ list provides an additional entitlement on top of ordinary reimbursement: selected reimbursed medicines are dispensed free to eligible older patients, with the public payer meeting the cost.
The country operates zero-co-payment arrangements for several patient groups, including people aged 65 and over, children under 18 and women during pregnancy. The August measure focuses on the 65+ ‘S’ list, by far the largest of these schemes, under which selected ordinarily reimbursed medicines are supplied to eligible older patients without any patient contribution.
The Ministry of Health (Ministerstwo Zdrowia, MZ) says the fee medicines list removes the barrier to eligible patients being dispensed higher priced products as they do not have to incur an expensive copay. This can result in higher public expenditure for equivalent treatments.
Under rules introduced on 28 August, MZ will periodically review individual products receiving zero-co-payment status. Price relative to reimbursed equivalents, supply continuity and budget impact will form part of the assessment. Higher-cost products may be removed from the S list where lower-priced alternatives remain available free to patients.
Manufacturers facing removal will have an opportunity to offer lower prices or alternative financing terms. The mechanism nevertheless gives MZ direct administrative control over which brands qualify for the additional public subsidy.
Removal from the S list does not necessarily end ordinary reimbursement of the product. It removes the additional entitlement under which eligible patients pay nothing. Free access to the underlying treatment can therefore continue through lower-cost equivalent medicines.
MZ says around 60% of Poland’s PLN16 billion community-pharmacy reimbursement expenditure in 2025 related to medicines supplied free under the senior scheme. It estimates that tighter selection of products receiving zero-co-payment status could release hundreds of millions of złoty for additional reimbursed treatments.
Source: Ministry of Health
Link: Listy bezpłatnych leków mają służyć pacjentom, a nie firmom farmaceutycznym. Ministerstwo Zdrowia porządkuje zasady refundacji na liście „S”. Celem jest konsekwentne zwiększanie dostępności do leków (Free-medicine lists should serve patients, not pharmaceutical companies. The Ministry of Health is organising reimbursement rules for the ‘S’ list. The aim is to consistently increase access to medicines)
Date: 27 August 2026
Source: Ministry of Health
Link: Komunikat Ministra Zdrowia w sprawie wyłączenia leku Pradaxa z listy bezpłatnych leków dla osób powyżej 65 r.ż. oraz postępowania w ramach aptecznego zamiennictwa (Minister of Health communication on removing Pradaxa from the free-medicines list for people aged over 65 and pharmacy substitution)
Date: 31 March 2026
