The Value for Money Unit (Útvar hodnoty za peniaze ÚHP) – an analytical wing of the Ministry of Finance (Ministerstvo financií Slovenskej republiky MF SR) – published its Revision of expenditure on medicines (Revízia výdavkov na lieky) on 13 February 2026. The report highlights that Slovak drug spending reached 1.65 billion euros in 2024 – a 51 per cent increase since 2019 – while failing to meet statutory budget limits by nearly 200 million euros annually.
The MF SR plans to claim a formal seat on the Categorisation Committee (Kategorizačná komisia) to oversee the fiscal impact of new listings. This reprioritisation includes 23 measures to regain control over medicinal spending. Central to the reform is a reduction of cost-effectiveness thresholds, which currently reach ten times the gross domestic product per capita for orphan medicines.
The ÚHP also targets the widespread use of 'exception' reimbursement. Under the proposal, regulators will limit coverage for products if manufacturers do not apply for formal categorisation within 24 months of registration. The report proposes retrospective reviews for 61 high-cost products that entered the market without formal evaluation by the National Institute for Value and Technologies in Healthcare (Národný inštitút pre hodnotu a technológie v zdravotníctve NIHO).
Previous listing decisions resulted in significant fiscal deviations, as the Ministry of Health (Ministerstvo zdravotníctva Slovenskej republiky MZ SR) ignored nearly half of NIHO's recommendations. The report estimates that adhering to these technical assessments would have reduced annual expenditure by 50 million euros. Future measures include implementing outcome-based reimbursement for cell and gene therapies and enforcing stricter indication restrictions. The government also intends to remove zero-co-payment status for certain groups to rationalise consumption.
These measures signal more stringent enforcement of health technology assessments and direct fiscal oversight of the MZ SR. The shift will increase the evidence burden and pricing pressure for innovative therapies in the Slovak market.
Source: Ministry of Finance of the Slovak Republic
Link: Revízia výdavkov na lieky (Revision of expenditure on medicines)
Date: 13 February 2026
