Reimbursed medicine list changes in eight national programmes: 20 positions out, 59 get new prices

For a patient enrolled in a national health programme, the practical question is not what the medicine costs at the pharmacy counter, but how much the state pays for it. This order rewrites precisely that list: 20 positions disappear, 59 get new values. The Order of the interim Minister of Health No 1.034/2026 and of the President of the National Health Insurance House No 1.388/2026 was published in Official Gazette of Romania No 664 of 11 August 2026 and amends Annex 2 to Order No 1.605/875/2014. It is the third intervention this summer on medicine prices, after the introduction of prices for ten new medicines in the National Catalogue. The list was updated again a month later, through MS Order no. 1.212/2026 and CNAS Order no. 1.566/2026, which change 39 positions.

Annex 2 is the document that states, for every medicine in a national programme, the accepted commercial name, the manufacturer, the pack size that is reimbursed and the price at which it is reimbursed. The amendment does not change the prescribing rules, only the basis on which the reimbursement is calculated. In practice, a medicine removed from the list can no longer be reimbursed under the programme, while one that is added becomes available to patients in that programme.

The eight programmes affected are P1, the national programme for communicable diseases, with its subprogrammes for HIV/AIDS and tuberculosis, P3 for oncology, P4 for multiple sclerosis, P5 for diabetes mellitus, P6 for rare diseases and severe sepsis, with its subprogrammes for haemophilia and thalassaemia, cystic fibrosis, idiopathic pulmonary fibrosis and conditionally included medicines, P7 for endocrine diseases, P9 for transplantation, with its subprogrammes for bone marrow, heart, kidney and lung transplants and for outpatient post-transplant care, and P11 for mental health, with its subprogrammes for drug dependence and major depressive disorder.

A few concrete examples show what kind of moves the list contains. Two new positions are added to the HIV/AIDS subprogramme, a levofloxacin 500 mg film-coated tablet and a fluconazole solution for infusion. In the tuberculosis subprogramme, the positions for two injectable forms of vitamin B6 are amended and a new levofloxacin is added. In oncology, the position for decitabine is updated, among others, while in mental health the positions for esketamine nasal spray and for methadone tablets, the medicine used in the treatment of opioid dependence, are amended.

The eligibility forms in the same programme are being updated as well: nivolumab and pembrolizumab now have specific forms, alongside another 13 revised eligibility forms.

What it changes in practice

It applies from August 2026, not from some future date. Article II of the order states expressly that it enters into force starting with August 2026, so the new reimbursement prices are already the ones in effect for the month in which the order was published.

Twenty positions drop out of reimbursement. The repeals are spread across nine points: three positions in HIV/AIDS, three in tuberculosis, two in diabetes mellitus, two in haemophilia and thalassaemia, one in cystic fibrosis, one in endocrine diseases, four in bone marrow transplantation, two in outpatient post-transplant care and two in major depressive disorder.

Fifty-nine positions receive new data. Each comes with a CIM code, an ATC code, a commercial name, pharmaceutical form, strength, manufacturer, country, pack size, prescription type, number of units and three price values. Amending an existing position means, in most cases, a different reimbursement value for the same product.

Patients need do nothing, but they may feel the change at the pharmacy. If the medicine they had been receiving has been removed from the list, the treating doctor will have to prescribe an alternative from within the programme. If the reimbursement price has changed, a co-payment may appear wherever the retail price exceeds the reimbursed value.

The underlying structure is untouched. The order does not change the methodology for calculating prices, nor the list of international non-proprietary names approved by Government Decision No 720/2008. Only the content of Annex 2 changes, that is, the commercial names and the values. The catalogue of maximum prices moved again in September 2026, on the vaccine given to almost every newborn: the BCG price was multiplied tenfold ten days after entering the list.

What has changed compared with the previous situation

Compared with the previous version of Annex 2, the difference is one of content, not of architecture. The 2014 order remains the basic act, with its whole mechanism intact, and these amendments join a long series of periodic updates. What changes now is the actual composition of the list across eight programmes at once, which makes this edition one of the most extensive updates of the summer.

The second novelty is the direction of the moves. The areas with the most intervention are transplantation, with four subprogrammes affected and the largest number of positions repealed within a single subprogramme, and mental health, where both subprogrammes are amended. For drug dependence, an entirely new position is also added, after position 9.

In oncology, the intervention is one of updating rather than of narrowing: seven positions are amended and three new ones are added, after position 821. The same logic can be seen in multiple sclerosis and diabetes mellitus, where groups of consecutive positions receive new values.

It is worth noting that no changes appear for subprogrammes that the order does not mention at all. For patients in those programmes, the list remains as set out in the previous version of the annex.

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