ADSE oncology price table: what changes on 1 October 2026

The ADSE oncology price table (in Portugal) that takes effect on 1 October 2026 replaces the version ADSE lists as in force until 30 September, the file dated 1 February 2026. The update is a revision of the contracted-network price list, not a new legal instrument.

ADSE is the health subsystem that covers Portuguese public employees, and it pays contracted private providers from that table. In this update, we reflect on the the two ADSE communiqués of 22 and 27 September 2026, and the published contracted-network workbooks. Counts and price changes below are calculated from those two files. They are not figures ADSE stated in prose.

What takes effect

From 1 October 2026, the Tabela de Preços e Regras de Regime Convencionado replaces the version ADSE lists as in force until 30 September, the 1 February 2026 file. ADSE says the medicines update, and the parallel update of intraoperative medical devices, was sent to private providers in August. It describes this as a regular review, normally twice a year, to track products on the market and their cost.

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Oncology drugs in hospital chemotherapy sit under code 6636, “antineoplastic and immunomodulatory medicines” (cytotoxics, hormones and anti-hormones, and immunomodulators). Maximum unit prices are in Table 22 of the workbook. The October file adds a column, “Necessidade de AP”. In the February file, prior authorisation was marked only by “(A)” in the product name. In the October file the two markers match on every line.

Published files:

• October table, in force 1 October 2026 (adse.pt workbook)
• Previous table, in force until 30 September 2026 (adse.pt workbook)

Prices: what ADSE says

ADSE’s 22 September communiqué says the update is not an arbitrary cut in support for beneficiaries. It is a periodic reset of amounts paid to providers against market prices.

For oncology medicines, the amount paid to private providers is based on the Preço de Venda Hospitalar (PVH) supplied by Infarmed. ADSE describes the PVH as the reference price paid by Portuguese public hospitals. A commercial margin set in law is added. ADSE says every price change in the table notified in August comes from an updated PVH, that commercial margins were not changed, and that prices fell only where the hospital acquisition cost fell. Some prices rose and some were unchanged.

ADSE says keeping table values that no longer match acquisition costs would open a gap between what it pays and what providers bear, and that the update sets reimbursed values to match the market and supports responsible use of public resources. It says beneficiary access is not put at risk, and that the change is not a case-by-case alteration of access conditions.

In Table 22 itself, the beneficiary copayment cell is empty on every code 6636 line in both the February file (391 lines) and the October file (398 lines). The ADSE charge equals the maximum unit price. That is consistent with ADSE’s claim that the listed oncology prices are not a new charge on the beneficiary. It does not, by itself, say anything about whether a private hospital will continue to provide the drug at that price.

Prior authorisation: what ADSE says

The 27 September communiqué answers the Expresso headline “ADSE passa a exigir autorização prévia nos tratamentos ao cancro”. ADSE says that report is false and does not match the medicines table taking effect on 1 October.

ADSE says prior authorisation for some oncology medicines has always existed, because of the complexity of the treatments and to check clinical safety and suitability. At each table revision, the Departamento de Consultoria Clínica decides which medicines keep or gain that requirement. ADSE’s own figures: of 198 medicines that already required prior authorisation, the requirement was removed for 7; 7 new medicines were added, of which 5 require it. ADSE says the October update is a regular table revision, not a one-off change in access conditions.

What the ADSE oncology price table shows

Code 6636, counted by CHNM line:

All 391 February CHNMs remain in the October file. Seven lines lost the prior-authorisation mark: osimertinib 40 mg and 80 mg, peginterferon alfa-2a, azacitidine 100 mg, radium-223 dichloride, paclitaxel 5 mg/ml powder, and infliximab 100 mg. No existing line gained the mark.

Seven CHNMs are new. Only one is marked for prior authorisation: glofitamab 10 mg/10 ml. The other six are tamoxifen 10 mg, anakinra, pomalidomide 1 mg, talazoparib 0.25 mg, luspatercept 75 mg, and triptorelin 22.5 mg.

That file count is 198 – 7 + 1 = 192. It does not match the communiqué’s “7 new, of which 5 require prior authorisation”, which would leave 196. Both documents are ADSE’s. The workbook is the operative price list; the communiqué is the only place ADSE states the 7-and-5 split.

On prices, again from the two files, unweighted across the 391 common CHNMs: 119 maximum unit prices fell, 14 rose, 258 were unchanged. The unweighted mean change is -3.8% (median 0). Among the 119 cuts, the mean cut is -14.8%. The range is -71.6% (cabazitaxel 20 mg/ml) to +148.7% (fruquintinib 1 mg). Other large cuts include tildrakizumab (-51.4%) and lenalidomide 20 mg (-50.7%). This is not a volume-weighted average of what ADSE spends, and ADSE does not publish an average oncology cut.

What ADSE does not say

ADSE does not say that every oncology medicine now needs prior authorisation, that beneficiary copayments have been introduced for code 6636, or that private hospitals will stop treatment. It also does not publish a 10% average oncology price cut, a count of 192 out of 398, or any estimate of access risk. Those figures in the press are either outside ADSE’s communiqués or, in the case of 192 of 398, a count of ADSE’s own spreadsheet that its 27 September note does not reproduce.

Source: ADSE, Tabela de Preços e Regras de Regime Convencionado, 1 October 2026. Comparisons use the 1 February 2026 file ADSE lists as in force until 30 September 2026.