What is the Austrian Code of Reimbursement (EKO)?

The Austrian Code of Reimbursement (the “EKO”, Erstattungskodex) is a code issued by the Austrian Federation of Social Insurances (the ”Dachverband”). The EKO includes medicinal products that have been authorised in Austria, are eligible for reimbursement and are reliably available. The medicinal products listed in the EKO are expected to have a therapeutic effect and to provide benefits for patients, based on the current state of scientific knowledge and on experience in Austria and abroad.

Objectives of the EKO

The Austrian Code of Reimbursement (the “EKO”, Erstattungskodex) is a code issued by the Austrian Federation of Social Insurances (the ”Dachverband”). The EKO includes medicinal products that have been authorised in Austria, are eligible for reimbursement and are reliably available. The medicinal products listed in the EKO are expected to have a therapeutic effect and to provide benefits for patients, based on the current state of scientific knowledge and on experience in Austria and abroad.

Development of the EKO

Any authorised distributor of a proprietary medicinal product that is authorised and available in Austria can submit a reimbursement application for the inclusion in the EKO. After assessment of the eligibility for reimbursement, a pharmacological, medical-therapeutic and economic assessment is conducted. An independent advisory board, the Pharmaceutical Evaluation Board (the “HEK”, Heilmittel-Evaluierungs-Kommision) supports the Dachverband, which in turn makes its reimbursement decision based on the recommendations of the HEK.

Procedure

The procedure for inclusion of new proprietary medicinal products in the EKO is initiated upon request of an authorised distributor of a medicinal product. All documents required for the reimbursement decision have to be submitted by the distributor. Based on established methods and the current state of scientific knowledge, the relative (i.e. comparative) benefit of a proprietary medicinal product in terms of its pharmacological, medical-therapeutic, and economic value are assessed, followed by negotiations with the respective distributor. Based on the evaluations and the negotiation result, the independent HEK issues its recommendations and the Dachverband then decides if and under which conditions a proprietary medicinal product should be included in the EKO.

Fig. 1: Overview of the reimbursement procedure of a proprietary medicinal product for the inclusion in the EKO

Structure of the EKO

The EKO consists of three sections: the Green section, the Yellow section and the Red section.

The Green section (G) of the EKO contains proprietary medicinal products that can be prescribed without limitation, or can be prescribed under specific conditions without approval of the chief physician and medical supervisor.

The Yellow section (Y) of the EKO contains proprietary medicinal products that have a significant additional therapeutic value for the patients and have not been included in the Green section of the EKO for medical and/or economic reasons. The costs will only be covered by the social insurance institutions when their use is approved a priori by the chief physician and medical supervisor (RE1). Certain proprietary medicinal products in the Yellow section do not require a prior approval of the chief physician and medical supervisor but an ex post follow-up check to ensure the product is used within the permitted use. These proprietary medicinal products are labelled RE2.

The Red section of the EKO contains proprietary medicinal products for which a reimbursement application for the inclusion in the EKO has been filed. They are indexed in the Red section for a limited time period – until the final decision of the Dachverband. The costs of the medicinal products in this section will only be covered when their use is approved a priori by the chief physician and medical supervisor.

Fig. 2: Sections of the EKO

Number of proprietary medicinal products in the EKO as per January 1, 2026

Fig. 3: Number of proprietary medicinal products as per January 1, 2026

Please note: Proprietary medicinal products can be mentioned in several areas. The total amount therefore is not a sum of the separate values.