Changes in reimbursement for diabetes control devices

On 10 April 2025, Ministerial Order 170/2025/1 was published in the Diário da Repúbica (the official gazette, establishing the exceptional reimbursement scheme for health technologies for self-monitoring of blood glucose and control of diabetes mellitus(“Ministerial Order”).

In view of the widely known difficulties in accessing state-subsidised technologies for self-monitoring diabetes mellitus, as well as recent reports of access to and misuse of these technologies that have compromised their availability to those who actually need them, the legislature felt it was imperative to guarantee fair, just and safe access to these essential resources.

Medicines belonging to the therapeutic class of GLP1 analogues and the medical sensor device for the measurement of interstitial glucose are covered by this exceptional reimbursement scheme.

These health technologies are limited to a maximum retail price (“MRP”), also approved by INFARMED, I.P. (the Portuguese national authority for medicines and health products). Together with SPMS - Serviços Partilhados do Ministério da Saúde, E.P.E., INFARMED is responsible for monitoring the use of the health technologies covered by the Ministerial Order, taking into account the prescription and dispensation data in the Portuguese National Health Service (“SNS”) under this scheme.

The health technologies covered by this Ministerial Order will be reimbursed by the state if they are intended for SNS beneficiaries diagnosed with diabetes mellitusand who present a medical prescription, according to the following rates:

a)        Medicines belonging to the therapeutic class of GLP1 analogues - 90% of the MRP (Tier A);

b)        Medical sensor device for interstitial glucose measurement - maximum 85% of MRP.

In addition to the fact that prescriptions for these technologies can only be issued by doctors specialising in endocrinology and nutrition, internal medicine, paediatrics and general and family medicine, they can only be issued under the exceptional reimbursement scheme provided for in the Ministerial Order, and the prescription must also expressly mention this scheme.

The law comes will enter into force within 120 days of its publication.