President Andrzej Duda, alongside Prime Minister Mateusz Morawiecki, enacted legislation expanding free medicines to include children under 18 and seniors over 65. The reform is projected to reach around 16 million people. The evolution of reimbursed medicines over the years and Polish public opinion about the new programme are key topics as the changes take effect.
Action against free drugs signed by the president
The expansion to cover minors and older adults is framed as direct support for families and a health protection measure at the community level. The president underscored that the amendment to the Public Health Care Act and the Act on the Reimbursement of Medicines, Foods for Special Nutrition, and Medical Devices broadens access and strengthens everyday health security.
The reform updates the framework for medicine reimbursement, aligning it with broader goals of affordable care and safer, more reliable access to essential treatments for those who need them most.
In historical context, the policy has evolved through a series of amendments intended to improve access, transparency, and sustainability of the public health system. The system now emphasizes predictable support for patients while encouraging cost-effective prescribing and negotiation outcomes between producers and health authorities.
The expansion aligns with long-standing efforts to balance patient access with the financial realities of national health funding and to ensure that vulnerable groups receive timely pharmacological support.
Drug Reimbursement Act
Historically, the Drug Reimbursement Act introduced in 2000 ended self-payment for medicines and created three reimbursement categories: basic medicines with full reimbursement, additional medicines at 50% reimbursement, and certain off-label medicines reimbursed at 30%. Costs are covered by the national health system to improve both access to effective therapies and overall treatment affordability.
The first major amendment came in 2004, establishing a funding limit that guides the level of co-financing by the public fund for each prescription. It also broadened reimbursement to include certain over-the-counter medicines and raised reimbursement levels for various medicine groups.
A 2008 update required the publication of a list of reimbursed medicines every two months, rather than quarterly, and expanded reimbursement to some foods for special nutrition and medical devices used in care.
The most significant reform occurred in 2012 with the introduction of the guaranteed benefit package, defining a core set of medicines and related health services to which patients are entitled within the public system.
Medicines are categorized into four payment levels: free, PLN 1, 30 percent, and 50 percent of the wholesale price. The reforms also mandated price and reimbursement negotiations between manufacturers and the Minister of Health to determine terms that ensure patient access and system sustainability.
The 2016 amendment introduced reimbursement for certain innovative, original products through therapeutic programs and also opened reimbursement for some generic products under a cost-limit framework, ensuring identical active substances and dosing could be accessed at comparable prices.
From 2020, new pilots and commercial programs began testing the effectiveness and safety of emerging medical technologies under clinical conditions. Some products were reimbursed through commercial programs funded by manufacturers or distributors, broadening the landscape of drug coverage.
In 2020, reimbursement costs were around PLN 18.5 billion, representing roughly a quarter of total health care expenditure. Compared with 2019, reimbursement costs rose by about PLN 1.5 billion, signaling a growing commitment to pharmacological access within fiscal limits.
What do the Poles think?
Public opinion on the free medicines law has generally been positive in conversations with Polskie Radio 24 reporters. Respondents praised the government’s efforts and the president’s leadership in expanding access to essential therapies.
One parent noted that the policy reduces household expenses and provides much-needed relief for families managing medical costs. Seniors emphasized that the inclusion of medicines for children and teens helps families allocate resources toward education and activities beyond basic care.
A retiree described feeling valued by the policy, remarking that the program makes a previously overlooked demographic feel recognized. Others welcomed the lower age threshold and the broader availability that follows, expressing relief about the overall impact on daily life and family planning.
In general, many respondents pointed to the tangible savings and improved access that accompany the expanded coverage, while acknowledging the ongoing need to balance costs with the public health system’s sustainability goals.
The Ministry of Health will publish the updated lists on its website. The new seniors list includes nearly 3,800 free medicines, while the list for children and youths up to 18 contains more than 2,800 medicines. These numbers reflect a robust reform designed to support health outcomes for families and aging populations alike.