Costa, Filipa Alves daMartins, Ana Paula2019-07-242019-07-2420189780128119457http://hdl.handle.net/10400.26/29333This chapter provides an overview of the functioning of the Portuguese National Health Service (PNHS), focusing on access to high-cost medicines. The pharmacotherapeutic groups representing higher costs to the PNHS are described, highlighting aspects of costs, financing and access.Access to innovation has been described as suboptimal but there are promising recent evolutions. A new model of antiretrovirals distribution is being tested, aiming at increasing access to these drugs. Access to orphan drugs is steadily increasing in Portugal. An alternative model of financing has been developed for Hepatitis C medicines, aiming at ensuring universal access to treatments. This model of centralised financing is expected to expand to most hospital-only medicines in 2018.Access to high cost medicines in Portugal is not ideal, but overall, it may be considered that recent changes and mechanisms in place may improve access in the near future.engAccess to medicinesAntiviralsHigh-cost medicinesImmunomodulatorsOrphan drugsPortugalbook part