The resolution published on Monday that enables prepaid companies and social works with closed plans to demand that prescriptions for medicines or medical orders are made by primer professionalshas been in force since yesterday. How was this going to be controlled? Nobody was clear. In the midst of these doubts, the Government announced that it will issue a clarifying rule to explicitly limit the measure to the high cost medications.
The concrete fact is that no one can prohibit a patient Go to any doctor, whether certified or not, and the professional will write you a prescription. Once the interested party has that document in their possession, they go to the pharmacy. In that instance would be bounced If the doctor is not on the registry and his plan is closed?
Sources from the Argentine Pharmaceutical Confederation were doubtful. They said they didn’t know How was this control going to be implemented?. Pharmacies have in their system the discounts that correspond to each member, but not – with exceptions from some social works – the list of doctors for each prepaid plan.
What would happen then if the pharmacy receives a prescription that is outside the norm? Would the prepaid closed plan or social work not recognize it as valid and eventually not pay the pharmacist the part of the bonus that corresponds to him? Apparently, none of this will finally happen.
From one of the main prepaid companies in the country, however, they had said that they were already working to implement those controlssince with common prescriptions – those that are not for high-cost medications or some chronic treatments – patients They should not go through companies to authorize them. “We are looking at the mechanisms,” was the response.
Finally, most recipes would not be affected by the resolution after the announced modification.
But the Government always maintained that the spirit of the new norm aims to control the prescription of high-cost medications -which do have direct control of the entities-. However, the text as it stands puts all medications in the same bag. Does not discriminate. And in the prepaid companies they admitted that the official resolution also served in the broadest sense, to avoid abuses.
Now, based on the doubts that arose, the Superintendency of Health Services (SSS) announced that the rule in question “will be expanded in the coming days, mentioning the set of diseases defined as high-priced or catastrophic, among which are serious oncological diseases, rare diseases, transplants, spinal muscular atrophy, ALS and fibrocystic diseases, among others.
In this sense, the SSS said that the new measure “does not represent no modification in the medications, treatments or medical care of the vast majority of Argentines who use the health system.
They target laboratories that “operate”
A source from the prepaid industry pointed out what he considers the heart of measurementsomething that many maintain but no one can prove: “The industry operates by encouraging doctors, who do not appear in the book, to prescribe certain medications. This is the core that seeks to attack the official decision. “Professionals who are not hired by prepaid companies are more operable by the industry, via foundations, patient associations or directly with laboratories that pay per patient.”
After this series of doubts fueled by the resolution itself from the moment of its publication in the Official Gazette, Government sources said that a new one will be issued clarifying resolution of the first to narrow down the issue, in short, only high cost drugs.
It would not be the first time that this Government elaborates some initiative on the fly. Without going any further, what just happened with the monotributistas and the possibility of free choice of an Insurance Agent – prepaid or social work -. That freedom ended last Monday when a decree clarified that there would be a special registry of entities that will accept this population whose limited contribution to the system is not enough to cover the cost of the Mandatory Medical Plan.
