Article type
Year
Abstract
Background: the purpose of the Financial Protection System for High Cost Diagnoses and Treatments, also known as the 'Ricarte Soto Law (RSL)', is to provide coverage for certain high-cost health technologies to all beneficiaries of the healthcare systems in Chile. One element of the prioritization process is that providers must submit formal price offers, which are valid if it is decided to include this technology in RSL. In addition, purchases are centrally managed by the Chilean National Health Service (CENABAST), which may have a favorable impact on the evolution of the public cost of these interventions.
Objectives: to quantify the evolution of the annual public cost per patient of health technologies included in RSL during the period in which this law has been in force.
Methods: the period considered varies for different technologies according to the date of entry into force of the different RSL decrees. In the calculation of annual cost per patient, we used the doses that a representative patient would need and the purchase price of the public health sector. To determine the number of doses, the source of information was the posology of the medicines. On the other hand, public prices correspond to those of the 'Mercado Público' for the period prior to the technology's entry into RSL, and in the subsequent period we used the purchase prices of CENABAST.
Results: there is a decrease in the public cost of technologies once they are part of the RSL. First, the offers of the evaluation process consider a decrease in the price of interventions. In addition, the negotiations carried out by CENABAST over time show a downward trend in the price. In this regard, the sharp drop in prices experienced by technologies into which new suppliers enter is highlighted.
Conclusions: the entrance of a technology to the RSL implies a lower annual public cost per patient for these interventions. This is explained by the negotiation process and the purchasing power of CENABAST. On the other hand, for providers, the decrease in prices is attractive, since it increases the likelihood of inclusion in RSL and of having a number of 'captive' patients given the RSL guarantees. Finally, it poses a dilemma that for certain technologies where the public cost has decreased - ostensibly due to the entry of new competitors - as to whether they should continue or not in a system such as the RSL, which is designed for high-cost interventions.
Patient or healthcare consumer involvement: the decrease in public costs is beneficial for patients, producing savings that allow the incorporation of new technologies, with an increase in coverage for new patients.
Objectives: to quantify the evolution of the annual public cost per patient of health technologies included in RSL during the period in which this law has been in force.
Methods: the period considered varies for different technologies according to the date of entry into force of the different RSL decrees. In the calculation of annual cost per patient, we used the doses that a representative patient would need and the purchase price of the public health sector. To determine the number of doses, the source of information was the posology of the medicines. On the other hand, public prices correspond to those of the 'Mercado Público' for the period prior to the technology's entry into RSL, and in the subsequent period we used the purchase prices of CENABAST.
Results: there is a decrease in the public cost of technologies once they are part of the RSL. First, the offers of the evaluation process consider a decrease in the price of interventions. In addition, the negotiations carried out by CENABAST over time show a downward trend in the price. In this regard, the sharp drop in prices experienced by technologies into which new suppliers enter is highlighted.
Conclusions: the entrance of a technology to the RSL implies a lower annual public cost per patient for these interventions. This is explained by the negotiation process and the purchasing power of CENABAST. On the other hand, for providers, the decrease in prices is attractive, since it increases the likelihood of inclusion in RSL and of having a number of 'captive' patients given the RSL guarantees. Finally, it poses a dilemma that for certain technologies where the public cost has decreased - ostensibly due to the entry of new competitors - as to whether they should continue or not in a system such as the RSL, which is designed for high-cost interventions.
Patient or healthcare consumer involvement: the decrease in public costs is beneficial for patients, producing savings that allow the incorporation of new technologies, with an increase in coverage for new patients.
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