In a new global report, the World Health Organization used the Finland diabetes co-payment reform as a cautionary example of how policy changes can affect treatment access. The 2017 decision raised patient costs for diabetes medication and, according to the WHO, pushed many low-income individuals into financial hardship.
The reform was introduced under then-Prime Minister Juha Sipilä’s administration. It altered the patient payment model for non-insulin diabetes drugs. Instead of a flat fee of €4.50 per prescription, users were made to pay 35 percent of the full retail price.
What looked like a minor policy adjustment on paper had a sharp effect in practice. Patients began to face higher out-of-pocket expenses, and those on lower incomes felt the change most.
Studies tracking the aftermath of the reform revealed some serious side effects. More people reported that they could no longer afford their medications. Applications for social assistance increased as patients tried to manage the extra cost. Meanwhile, use of essential non-insulin diabetes drugs went down.
The World Health Organization noted that this drop in medicine use was not due to improved health outcomes. Instead, it reflected the new financial barriers people were facing.
This kind of cost-shifting, the report warned, often saves money in the short term but risks bigger problems down the line. When patients skip treatments or abandon medications, health systems may later face higher costs from hospitalizations or complications.
The WHO used Finland’s case to underline a broader issue. When governments pass treatment costs onto individuals, especially those with chronic illnesses, the result can be reduced access to care and rising inequality.
The 2017 reform was part of a wider effort to cut state spending. But critics at the time pointed out that the burden fell most heavily on vulnerable groups. Pensioners, people with long-term health issues, and low-income earners were among the hardest hit.
While policymakers aimed to balance the budget, the human cost was significant. Patients who had managed their conditions for years suddenly faced choices between buying medicine and covering other basic needs.
Finland’s experience shows how even a small change in policy can trigger major effects in public health. The WHO’s report suggests that while financial reform is sometimes necessary, shifting costs to patients can backfire.
The case also highlights a need for balance. Cost-saving strategies should not undermine access to care, especially for those most in need.
Healthcare policy decisions have long-term consequences, and the Finnish example is now part of the global conversation on how to design fair and effective systems.
