FROM '93 TIL INFINITY?
President Santos appointed economist Alejandro Gaviria as the new Minister of Health and Social Protection in September 2012.
Gaviria's priority has been to create health reform that would introduce the next episode of Colombia's payer system, following
the introduction of Law 100 in 1993, which extended health coverage to nearly all of the country's population.
Francisco de Paula Gomez, Executive President, AFIDRO
This Law created a mixture of private and public health insurance providers, or Entidades Promotoras de Salud (EPS). While
this system brought about near-universal health coverage, some argue that the EPS has evolved over the last twenty years into
a business, rather than being a basic right guaranteed to all Colombians. Many accuse the EPS of corruption and mishandling
Mr. Rodrigo Arcila Gomez, Executive Director ANDI
Gaviria attributed the system's financial stress to an increase in recobros, or requests for reimbursement of drugs and treatments
not included in the Plan Obligatorio de Salud (POS), which lists all medications to which Colombians are entitled. Insurance
providers have struggled to reimburse patients for these treatments, and lack of resources reached a breaking point in 2009
when the Colombian government declared a Social Emergency Crisis and passed a number of tax laws in 2010 to save the system.
However, this did not build a long-term solution.
Tecnoquimicas is permanently commited to applying the latest tecnologies and highest standards in its manufacturing processes.
(Soft gel capsule production area).
Colombia's health system operates under two schemes, contributory and subsidized. Forty percent of the Colombian population
holds formal employment and receives health insurance through the contributory scheme that is paid for by both employees and
employers, granting access to private hospitals.The remaining 60 percent of the population, who do not hold formal employment,
are subsidized by the public health system, which is generally of lesser quality.
Michael Himmel, General Manager Andean Region, Takeda
One of the biggest changes Gaviria has proposed is the replacement of the EPS with a single-payer publicly funded "Fondo Unico."
The contributory and subsidized systems were combined in 2012, and both would operate under the Fondo Unico. "With this new
fund, we need to have the best control of resources possible, which will re-establish the legitimacy of the system. It can
be seen as a 'fund of investment'," said Gaviria. Another change could replace the POS with "Mi Plan," which would remove
many financially crippling items from the POS such as cosmetic and aesthetic treatments.
Mario Sturion, General Manager North Latin America Cluster, Janssen
"The Law 100/93 allowed some functions of the State to be delegated to the private sector," said Gaviria. "This ruling essentially
created a virtual fund. Twenty years later, one can see that it is not sustainable anymore. We realized that the State has
to take on some functions."
Sales Development of the Colombian Pharmaceutical Industry
According to Rafael Romero Piñeros, President of the Seventh Commission of the Chamber of Representatives, which addresses
a number of social issues including health, a purely publicly funded program would allow resources to be directly reinvested
into services such as primary care and disease prevention. The system had previously essentially existed as a triangle: "the
patient was paying for a service and then charging it back to the State," commented Romero. "That intermediate step will cease
to exist, and therefore corruption will disappear. The success of the reforms will depend on the strength of the government
and the collaboration of many different actors."
Rolf Hoenger, General Manager Roche
LICENSE TO PILL
As part of the ongoing restructuring of Colombia's healthcare model, the National Institute of Food and Drug Surveillance
(INVIMA), Colombia's food and drug regulatory body, has undergone major transformation. The Institute was certified in 2010
as one of five National Regulatory Authorities of Regional Reference by the public health institution Pan-American Health
Organization in Latin America. "This positions INVIMA as a national regulatory authority within the international sanitary
environment," noted Dr. Blanca Elvira Cajigas de Acosta, director general of INVIMA.
Norton Oliveira, General Manager MSD
INVIMA enforces standards set by the Ministry of Health. Biotechnology regulations, which have never existed in Colombia before,
have been discussed for years but never fully implemented by the Ministry. Francisco de Paula Gomez, president of the Association
of Research and Development of Pharmaceutical Laboratories (AFIDRO), says that this has been a long time coming. "We are talking
about a sanitary regulation and the minimum set of regulations must be enforced according to the prerequisites of the World
Health Organization (WHO)," he said. "I believe that in order to promulgate growth in this area, there needs to be a greater
number of companies and medicines in the market, particularly innovative biotherapeutic medicines and high quality biosimilars,
and not just some questionable medicines whose origins are in some process of biotechnology."
Mauricio Botero, General Manager Sanofi