Starting January 2026, Azerbaijan will introduce phased ambulatory drug coverage within the framework of the Mandatory Health Insurance (MHI) system. The first phase will focus on cardiology, covering medicines used in the treatment of cardiovascular diseases. Next phase is planned to second half of 2026 and will cover gastroenterology diseases.

In December 2025, the State Agency of Mandatory Health Insurance announced the launch of ambulatory pharmaceutical coverage for cardiovascular conditions under the MHI system. The initiative aims to improve access to essential therapy, particularly for patients with arterial hypertension.

The decision was presented during a working meeting with pharmaceutical companies and pharmacy organizations dedicated to improving mechanisms of ambulatory medicine provision. Participants were informed about the principles, implementation stages, and organizational aspects of the new model.

Legislative and Regulatory Framework

Ambulatory drug coverage is implemented in accordance with:

• the Law of the Republic of Azerbaijan “On Mandatory Health Insurance” (as amended);

• subordinate Rules developed following legislative amendments, regulating:

• inclusion of medicines and medical devices in the Services Package;

• formation of the Positive List;

• procedures for calculating and approving the conditional reimbursement amount;

• decisions and regulatory acts approved by the Agency and the Cabinet of Ministers within the scope of the MHI Services Package.

These documents establish a unified, transparent, and standardized approach to ambulatory drug provision within the mandatory health insurance system.

Key Principles of Ambulatory Drug Coverage

The ambulatory drug coverage model is based on the following principles:

• social and economic prioritization, focusing on diseases with high prevalence, mortality, and disability risk;

• rational use of medicines;

• assurance of quality, safety, and clinical effectiveness of pharmaceuticals;

• adherence to evidence-based medicine principles;

• transparency in procedures for inclusion in the Services Package and the Positive List;

• economic efficiency and sustainability of the insurance budget;

• reduction of out-of-pocket expenses for patients receiving ambulatory treatment;

• continuous professional development of physicians and pharmacists involved in the system.

Criteria for Inclusion of Medicines in the Services Package

Medicines are included in ambulatory coverage based on a set of criteria, including:

• use in diseases that, over the past five years, have demonstrated high mortality or disability rates;

• proven clinical efficacy and safety;

• compliance with international clinical guidelines;

• availability of reimbursement practices in health insurance systems of developed countries;

• pharmacoeconomic justification;

• alignment with current patient needs.

At the first stage, the Services Package includes medicines affecting the cardiovascular system, particularly antihypertensive drugs.

Positive List and Reimbursement Mechanism

The Positive List is formed through an established procedure that includes:

• submission of applications;

• expert evaluation;

• decision-making on inclusion or rejection;

• approval of the conditional reimbursement amount.

The reimbursement amount is calculated by the Agency based on reference pricing, approved in accordance with established procedures, and applied to the agreed retail price. This mechanism serves as the basis for transparent financial settlements with contracted pharmacy organizations.

Practical Implementation

Dispensing of medicines will be carried out:

• via electronic prescriptions;

• through pharmacies contracted with the Agency;

• with subsequent transparent financial settlements and control mechanisms

The launch of ambulatory drug coverage for cardiology represents a significant step in the development of Azerbaijan’s mandatory health insurance system, improving access to cardiovascular treatment and contributing to the long-term sustainability of the national healthcare system.

Consult with Us for More Information

If you would like to better understand how the new ambulatory drug coverage may impact pharmaceutical companies, distributors, or pharmacy networks, or need support with market access strategy, positive list inclusion, pricing, or reimbursement modeling, our team will be happy to assist.

Contact us to schedule a consultation and receive tailored insights on regulatory pathways, timelines, and practical implementation under Azerbaijan’s Mandatory Health Insurance system.