Finnish welfare regions deny redirecting costly cancer drugs to Kela for savings

Finnish welfare regions have rejected claims by the Ministry of Social Affairs and Health that they directed patients to obtain expensive medications, including certain cancer drugs, through the national social insurance institution Kela to cut costs.

Kela announced at the start of July that it would no longer reimburse certain high-cost drugs, such as some cancer treatments, if administered in public healthcare. The change shifted the costs to welfare regions, with South Karelia alone facing annual expenses of €1–2 million.

Tuula Karhula, chief medical officer at the South Karelia welfare region, said the practice of patients collecting nurse-administered drugs from pharmacies had been standard for decades across Finland. She denied any wrongdoing or cost-shifting, calling the new interpretation a surprise mid-year when budgets had already been set.

The ministry maintains some regions used the method as a cost-saving measure, redirecting expenses for drugs that should have been provided free by the welfare regions themselves. Karhula and Marianne Riekki, acting chief medical officer at the North Ostrobothnia welfare region Pohde, both denied this, emphasizing they had followed existing guidelines and legislation.

Kela clarified its reimbursement rules in early July, requiring more precise details on where, by whom, and under whose arrangement treatment is administered. The agency said it sought ministry guidance in spring 2025 after discovering inconsistencies in regional practices.

Jouni Kurola, service area director at Kuopio University Hospital, confirmed the long-standing practice but noted the new guidelines have already impacted hospital operations.