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5 frequently asked questions about centralized drug purchasing

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By: Diana González-Bravo
MD, Epidemiologist
MBE researcher
Neuroeconomix

You have heard about the centralized purchase of medicines, you have read the communications of the Ministry of Health on the subject, but are you still not clear about what it is, how it is done or what it is for?
It is not an easy subject and therefore it is controversial. Here we provide you with a series of questions and answers to help you clarify the concept and see the bigger picture.

The centralized purchase of medicines has benefited the Colombian health system on multiple levels, has generated strategic international relations (with PAHO and its revolving fund), has strengthened the population's access to high-cost treatments and has fostered the  saving of SGSSS resources. In addition, Colombia has become a benchmark at the Latin American level, to adopt the same mechanism of access to high-cost drugs.

It is important that this innovative mechanism, implemented in the country, with so many advantages and benefits, be of common knowledge and understanding, since all Colombians are the base and support of the health system.

 

Frequent questions:

 

  • What role does PAHO play in centralized drug purchasing?

PAHO, through its revolving fund half the purchase of vital medicines, available at a high cost for the health systems, obtaining them at a lower price, thus managing to continuously supply the demand of different countries, with effective and safe medicines for the treatment of pathologies with high morbidity and mortality.

 

  • What are the selection criteria for the molecules to buy, taking into account their diversity?
  1. Molecules NO included in the Health Benefits Plan (PBS)
  2. Molecules that represent a high impact on the health system budget
  3. High prevalence of the disease to which they are going to serve as treatment
  4. Diagnosis given by a horizon scan

 

  • What is the horizon scan? Who will be responsible for this happening?

The horizon scan is a diagnostic process, in which difficulties or opportunities related to prices, marketing and access to medicines and health technologies are identified. NOT yet marketed in the country, which have obtained approval from other international agencies, with the aim of predicting behavior and proposing early solutions. This responsibility will be the Ministry of Health and Social Protection, the National Institute for Food and Drug Surveillance (Invima) and the Institute for Technological Evaluation in Health (IETS) (Decree 433 of 2018).

 

  • What are the criteria for prioritizing the molecules to buy, taking into account their importance and diversity?
  1. Treatment should be: completely new for the proposed indication, or that replace an existing therapeutic alternative or that is a treatment complementary
  2. The molecules must have high clinical potential, safety and efficacy
  3. Economic and financial potential
  4. Potential to generate high impact on public health, disease burden, prevalence

 

  • What are those aspects to improve in the centralized purchase of medicines?
  1. Do shopping of more medications
  2. Achieve the equity in the coverage of the contributory and subsidized regimes
  3. Enlarge the legal regulations that regulate the mechanism for the acquisition of drugs called “Gateway” (Law 1753 of 2015, article 71, through which the centralized negotiation of medicines, supplies and devices is regulated and article 88 of Law 1438 is modified of 2011; Article 72, which dictates and provides the guidelines for health records of drugs and medical devices)
  4. To integrate all actors in the health system (patients, doctors, government entities, pharmaceutical industry) to achieve a common goal: to improve access to high-cost medicines

References

Ministry of Health and Social Protection. Decree 433 of 2018

Ministry of Health and Social Protection. Law 1753 of 2015

Ministry of Health and Social Protection. Law 1438 of 2011

 

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