{"id":338114,"date":"2025-02-24T09:59:21","date_gmt":"2025-02-24T08:59:21","guid":{"rendered":"https:\/\/zakrasnejsivimperk.cz\/?p=338114"},"modified":"2025-02-24T09:59:21","modified_gmt":"2025-02-24T08:59:21","slug":"vseobecna-zdravotni-pojistovna-preskripcni-a-indikacni-omezeni-leku","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=338114","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Preskrip\u010dn\u00ed a indika\u010dn\u00ed omezen\u00ed l\u00e9ku"},"content":{"rendered":"

\"\"<\/p>\n

OT\u00c1ZKA:<\/h6>\n
Pro\u010d n\u011bkter\u00e9 l\u00e9ky m\u016f\u017ee p\u0159edepsat praktick\u00fd l\u00e9ka\u0159 a jin\u00e9 pouze l\u00e9ka\u0159 specialista? A m\u016f\u017ee to ovlivnit v\u00fd\u0161i doplatku?<\/b><\/h6>\n
ODPOV\u011a\u010e:<\/h6>\n

V\u00fd\u0161e a podm\u00ednky \u00fahrady l\u00e9k\u016f stanovuje St\u00e1tn\u00ed \u00fastav pro kontrolu l\u00e9\u010div (S\u00daKL), kter\u00fd je pov\u011b\u0159en rozhodov\u00e1n\u00edm o cen\u00e1ch a \u00fahrad\u00e1ch l\u00e9\u010div\u00fdch p\u0159\u00edpravk\u016f v\u00a0procesu spr\u00e1vn\u00edho \u0159\u00edzen\u00ed. Tyto podm\u00ednky \u00fahrady mohou zahrnovat preskrip\u010dn\u00ed a indika\u010dn\u00ed omezen\u00ed pro p\u0159edeps\u00e1n\u00ed l\u00e9k\u016f.\u00a0<\/b>To znamen\u00e1, \u017ee \u00fahrada l\u00e9\u010div\u00e9ho p\u0159\u00edpravku ze zdravotn\u00edho poji\u0161t\u011bn\u00ed m\u016f\u017ee b\u00fdt v\u00a0n\u011bkter\u00fdch p\u0159\u00edpadech omezena, a to z\u00a0d\u016fvodu zaji\u0161t\u011bn\u00ed spr\u00e1vn\u00e9, \u00fa\u010deln\u00e9 klinick\u00e9 praxe a hospod\u00e1rn\u00e9ho nakl\u00e1d\u00e1n\u00ed s prost\u0159edky ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. V\u00a0p\u0159\u00edpad\u011b, \u017ee nejsou dodr\u017eeny po\u017eadavky omezen\u00ed, nen\u00ed l\u00e9k z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazen.<\/p>\n

Co je to preskrip\u010dn\u00ed omezen\u00ed?<\/b><\/p>\n

Preskrip\u010dn\u00ed omezen\u00ed znamen\u00e1, \u017ee<\/b>\u00a0n\u011bkter\u00e9 l\u00e9ky jsou hrazeny z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed pouze tehdy, pokud je p\u0159edepsal l\u00e9ka\u0159 s odpov\u00eddaj\u00edc\u00ed specializac\u00ed<\/b>, nap\u0159\u00edklad kardiolog, neurolog nebo onkolog. V\u00a0ur\u010dit\u00fdch p\u0159\u00edpadech m\u016f\u017ee jin\u00fd l\u00e9ka\u0159 p\u0159edepsat takov\u00fd l\u00e9k rovn\u011b\u017e, ale pouze na z\u00e1klad\u011b zmocn\u011bn\u00ed specialistou.\u00a0Pokud nen\u00ed p\u0159edepisuj\u00edc\u00ed l\u00e9ka\u0159 specialistou zmocn\u011bn a dan\u00fd l\u00e9k pacientovi p\u0159esto p\u0159edep\u00ed\u0161e, mus\u00ed si l\u00e9k pacient uhradit s\u00e1m<\/b>.<\/p>\n

Z\u00a0hlediska odbornosti a specializovan\u00e9 p\u00e9\u010de z\u00e1vis\u00ed preskrip\u010dn\u00ed omezen\u00ed na odbornosti l\u00e9ka\u0159e a na typu diagn\u00f3zy pacienta. To znamen\u00e1,\u00a0<\/b>\u017ee l\u00e9ka\u0159 s\u00a0odpov\u00eddaj\u00edc\u00ed specializac\u00ed m\u00e1 vy\u0161\u0161\u00ed n\u00e1klady na p\u00e9\u010di<\/b>, proto\u017ee mus\u00ed zajistit komplexn\u00ed diagnostiku pacienta, odborn\u00e9 vy\u0161et\u0159en\u00ed a dal\u0161\u00ed pot\u0159ebn\u00e9 \u00fakony. Nap\u0159\u00edklad u slo\u017eit\u011bj\u0161\u00edch p\u0159\u00edpad\u016f m\u016f\u017ee b\u00fdt nutn\u00e9 prov\u00e9st specializovan\u00e9 laboratorn\u00ed testy, vyu\u017e\u00edt r\u016fzn\u00e9 zobrazovac\u00ed metody nebo konzultovat zdravotn\u00ed stav pacienta s dal\u0161\u00edmi specialisty, to v\u0161e v r\u00e1mci jednoho vyk\u00e1zan\u00e9ho v\u00fdkonu hrazen\u00e9ho z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed.<\/p>\n

Preskrip\u010dn\u00ed omezen\u00ed, kter\u00e1 z\u00e1vis\u00ed na specializaci l\u00e9ka\u0159e, jsou podle vyhl\u00e1\u0161ky \u010d. 376\/2011 Sb., ve zn\u011bn\u00ed pozd\u011bj\u0161\u00edch p\u0159edpis\u016f, definov\u00e1na takto:<\/b><\/p>\n

    \n
  • Preskrip\u010dn\u00ed omezen\u00ed \u201eE\u201c:<\/b>\u00a0l\u00e9k lze p\u0159edepsat s\u00a0\u00fahradou ze zdravotn\u00edho poji\u0161t\u011bn\u00ed pouze odborn\u00fdm l\u00e9ka\u0159em uveden\u00fdm v preskrip\u010dn\u00edm omezen\u00ed, kter\u00fd m\u00e1 uzav\u0159enou smlouvu se zdravotn\u00ed poji\u0161\u0165ovnou na poskytov\u00e1n\u00ed dan\u00e9 odborn\u00e9 p\u00e9\u010de. Tuto preskripci nelze delegovat na jin\u00e9ho l\u00e9ka\u0159e. Preskrip\u010dn\u00ed omezen\u00ed se uplat\u0148uje zejm\u00e9na u l\u00e9k\u016f, kter\u00e9 vy\u017eaduj\u00ed \u00fazkou odbornou kontrolu kv\u016fli mo\u017en\u00fdm specifick\u00fdm \u00fa\u010dink\u016fm nebo rizik\u016fm.<\/b><\/li>\n
  • Preskrip\u010dn\u00ed omezen\u00ed \u201eL\u201c:<\/b> l\u00e9k mohou s \u00fahradou ze zdravotn\u00edho poji\u0161t\u011bn\u00ed p\u0159edepisovat odborn\u00ed l\u00e9ka\u0159i uveden\u00ed v\u00a0preskrip\u010dn\u00edm omezen\u00ed, kte\u0159\u00ed maj\u00ed se zdravotn\u00ed poji\u0161\u0165ovnou smlouvu pro danou odbornost. V p\u0159\u00edpad\u011b pov\u011b\u0159en\u00ed m\u016f\u017ee p\u0159\u00edpravek p\u0159edepsat i jin\u00fd l\u00e9ka\u0159 na z\u00e1klad\u011b p\u00edsemn\u00e9ho zmocn\u011bn\u00ed. Od 1. 7. 2024 mohou tyto l\u00e9ky p\u0159edepisovat tak\u00e9 v\u0161eobecn\u00ed prakti\u010dt\u00ed l\u00e9ka\u0159i a prakti\u010dt\u00ed l\u00e9ka\u0159i pro d\u011bti a dorost, nen\u00ed-li to explicitn\u011b zak\u00e1z\u00e1no v souhrnu \u00fadaj\u016f o dan\u00e9m l\u00e9\u010div\u00e9m p\u0159\u00edpravku (SPC) \u010di v rozhodnut\u00ed o registraci.<\/li>\n<\/ul>\n

    Co je to indika\u010dn\u00ed omezen\u00ed \u00fahrady (symbol P)?<\/b><\/p>\n

    Indika\u010dn\u00ed omezen\u00ed \u00fahrady je jednou z mo\u017en\u00fdch podm\u00ednek \u00fahrady, kter\u00e9 stanovuje St\u00e1tn\u00ed \u00fastav pro kontrolu l\u00e9\u010div (S\u00daKL) u n\u011bkter\u00fdch l\u00e9\u010div\u00fdch p\u0159\u00edpravk\u016f.\u00a0<\/b>L\u00e9ky s t\u00edmto omezen\u00edm jsou ozna\u010deny symbolem \u201eP\u201c. Takov\u00fd l\u00e9k m\u016f\u017ee l\u00e9ka\u0159 p\u0159edepsat jen tehdy, pokud pacient spl\u0148uje n\u00ed\u017ee uveden\u00e9 podm\u00ednky.\u00a0<\/b>Toto omezen\u00ed znamen\u00e1, \u017ee n\u011bkter\u00e9 l\u00e9ky hrazen\u00e9 ze zdravotn\u00edho poji\u0161t\u011bn\u00ed m\u016f\u017ee dostat pacient za spln\u011bn\u00ed p\u0159esn\u011b stanoven\u00fdch podm\u00ednek.<\/p>\n

    Podm\u00ednky mohou zahrnovat:<\/b><\/p>\n

      \n
    • p\u0159esn\u011b uvedenou indikaci v\u010detn\u011b zah\u00e1jen\u00ed a ukon\u010den\u00ed l\u00e9\u010dby, pop\u0159\u00edpad\u011b bl\u00ed\u017ee ur\u010denou klinick\u00fdm stavem pacienta; pokud nelze zah\u00e1jen\u00ed a ukon\u010den\u00ed l\u00e9\u010dby p\u0159esn\u011b vymezit, stanov\u00ed se pravideln\u00fd interval p\u0159ehodnocen\u00ed \u00fa\u010dinnosti l\u00e9\u010dby,<\/li>\n
    • pou\u017eit\u00ed pro vyjmenovan\u00e9 skupiny pacient\u016f, charakterizovan\u00e9 konkr\u00e9tn\u00edm onemocn\u011bn\u00edm nebo klinick\u00fdm stavem, nebo,<\/li>\n
    • selh\u00e1n\u00edm, kontraindikac\u00ed nebo nedostate\u010dnou \u00fa\u010dinnost\u00ed p\u0159edchoz\u00ed linie terapie.<\/li>\n<\/ul>\n

      Jak zjist\u00edm, zda \u00fahrada ur\u010dit\u00e9ho l\u00e9\u010div\u00e9ho p\u0159\u00edpravku podl\u00e9h\u00e1 preskrip\u010dn\u00edmu nebo indika\u010dn\u00edmu omezen\u00ed?<\/strong>
      \nDatab\u00e1ze l\u00e9k\u016f,<\/b><\/span>\u00a0kterou zve\u0159ej\u0148uje S\u00daKL, obsahuje informace o v\u0161ech l\u00e9c\u00edch registrovan\u00fdch v\u00a0\u010cR.\u00a0<\/b>T\u00fdk\u00e1 se to l\u00e9k\u016f, kter\u00e9 maj\u00ed ze zdravotn\u00edho poji\u0161t\u011bn\u00ed \u00fahradu stanovenu i t\u011bch bez \u00fahrady. Seznam je pravideln\u011b aktualizov\u00e1n v m\u011bs\u00ed\u010dn\u00edch intervalech.<\/p>\n

      (vzp)<\/strong><\/p>\n

      \n

       <\/p>\n","protected":false},"excerpt":{"rendered":"

      OT\u00c1ZKA: Pro\u010d <\/p>\n","protected":false},"author":2,"featured_media":338116,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[88],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2025\/02\/24\/ram-vzp.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/338114"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=338114"}],"version-history":[{"count":1,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/338114\/revisions"}],"predecessor-version":[{"id":338115,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/338114\/revisions\/338115"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/338116"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=338114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=338114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=338114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}