Wink for prepaid and social works: the Government put a limit on discounts for the purchase of medicines

The Minister of Health, Carla Vizzotti.  Photo: NA
The Minister of Health, Carla Vizzotti. Photo: NA

The Ministry of Health changed the way in which prepaid and social works apply discounts on the purchase of medicines, to put a cap on what companies must contribute for a list of medicines for chronic patients. From now on, the 70% coverage that financers are obliged to pay will have a maximum amount equivalent to that proportion of a reference price. And if the patient chooses to buy the same drug in a more expensive presentation, he will have to pay more for that option.

The portfolio led by Carla vizzotti this morning published resolution 27/2022 in the Official Gazette. In the text, the way in which discounts of prepaid and social works are applied in the purchase of certain medicines is modified. The annex lists 85 active components, typical of drugs for chronic conditions, which are covered by the regulations.

Until yesterday, social and prepaid works were obliged to cover 70% of the prescription drug regardless of the price paid. Based on the generic law, health professionals must prescribe the name of the drug and at the pharmacy the patient can choose between different laboratories that make the same drug.

Medications for chronic conditions listed in the annex to the resolution will have a discount of no more than 70%.  Photo: REUTERS
Medications for chronic conditions listed in the annex to the resolution will have a discount of no more than 70%. Photo: REUTERS

The result of that scheme was that there was insufficient incentive to go for the cheapest drug or for labs to compete on price, they point out in the sector.

With the new regulation, reference prices will be established for each of the active components in question. If the beneficiary buys a medicine whose final price is below the reference price, he will have to pay 30% of its value. If, for example, he opted for another presentation whose price was identical to the reference price, the discount would be of the same magnitude. But if, in a third hypothetical case, he opted for a more expensive presentation than the reference, he would only have 70% of the reference value as a discount and not the final value. That is, you would pay more than 30% of the value.

A) Yes, the 70% discount becomes a discount of a maximum of 70%. The app is not for all drugs, but for a specific list published as an annex.

“For us, the funders, the drug is gaining prominence year after year in the pie of health costs because they are not regulated. Five years ago they were 20% of the health pie and today over 30% ”(Lilloy)

Private financers, prepaid and social works, were protagonists days ago in a pull in the sector for what, they argue, is a delay in updating the rates they charge.

For January, prepaid had programmed a 9% increase in fees that ended up being applied to the letter. But, arguing financial problems, they announced that they were not going to transfer the quota increase to the prices they pay to providers (clinics, diagnosis and other benefits). The response of the providers was to announce the reinstatement of the co-payment: that the users had to pay an extra 9% for the benefits.

The Government mediated in the matter and did so against prepayments and social works. The copayment never materialized and the 9% increase had to be passed on to the providers. With this, the Government reduces at least one cost of the financing sector.

The Secretary of Internal Trade, Roberto Feletti, in the center.
The Secretary of Internal Trade, Roberto Feletti, in the center.

“For us, medicines are gaining prominence year after year in the health cost pie because they are not regulated. 5 years ago they were 20% of the health pie and today they are over 30%. The other reason is the incorporation of new drugs, which reach hundreds of thousands of pesos. Of that 30%, half is explained by these new drugs, “he said. Ricardo Lilloy, member of the Argentine Health Union.

The Chief of Staff of the Ministry of Health of the Nation, Sonia Tarragona, and the Secretary of Internal Trade, Roberto Feletti, held last week a virtual meeting with representatives of the pharmaceutical industry chambers and federations to reach a consensus on the next measures to improve access to medicines through the implementation of reference prices and the promotion of prescription by generic name.

The strategy includes different lines of action such as the opening of the formulary to guarantee free choice without limitation by brand or commercial presentation; improve geographic accessibility to medicines; the single prescription model (both in paper and electronic format) and the possibility of a prolonged prescription of up to three months for the treatment of prevalent chronic diseases to promote adherence; and the establishment of reference prices.

During the meeting, Tarragona explained that, according to the proposal, The reference prices will be updated on a monthly basis according to the percentage increase in the simple average of the wage index and the consumer price index. prepared by the National Institute of Statistics and Censuses (INDEC). The information will be published every month on the website of the Ministry of Health of the Nation.


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Helen Hernandez is our best writer. Helen writes about social news and celebrity gossip. She loves watching movies since childhood. Email: Phone : +1 281-333-2229

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