2024-08-24 22:51:37
The National Institute of Social Services for Retirees and Pensioners (Pami) recently announced a series of changes to its drug coverage program. Among other things, the changes resulted in many medications being covered as occasional and over-the-counter medications, meaning members would have to pay higher prices.
The modifications will mainly affect those drugs considered non-essential for the long-term treatment of disease, while other drugs, particularly those needed to treat chronic and oncological conditions, will now be fully covered.
Fernando Ducoin, treasurer of the College of Pharmacists of Cordoba, expressed concern about recent reductions in drug coverage for members. “What they do is provide coverage to members,” he said, explaining that approximately 1,100 end-use products will be rolled over to the retail price of pharmaceuticals (PvP) and receive a 40% discount on top of that. .
“They have introduced medicines such as Tafilol, Actron, Vitamin D, Calcium, but also some antibiotics,” Ducoin explained to La Voz. He warned that this situation makes it more complicated for retirees to obtain medicines because ” They don’t have access to it because of their low income.”
This decision by the entity and this ongoing formulary change involves drugs with high commercial turnover rates. They in the pharmaceutical industry assure that they have seen “a reduction in drug units because grandpa ended up not taking them anymore after seeing the amount he couldn’t pay.”
It is worth clarifying that retirees who no longer use certain medications must consult the LGU (Local Governing Unit) of PAMI so that each specific case can be evaluated and benefits can be granted again. This procedure must be completed by presenting a digital prescription from your doctor (justifying the order), medical history and your membership card.
Meanwhile, official Pami sources confirmed the rationale for the changes: “We found that some people have pharmacies at home and take their medications very irregularly, which is neither good nor convenient for their health.” They added: ” Some of these drugs are contraindicated for permanent or long-term use.”
If a member needs a medication that is not fully covered and does not have the necessary financial resources, Pami has established social subsidy procedures or exceptions to obtain the needed medication. Official sources assured that “no one will be left without redress in the event of failure to pay”, underscoring the agency’s commitment to all retirees and pensioners across the country.
This social subsidy allows you to receive up to four additional medicines with 100% coverage, for a total of nine completely free medicines.
All coverage changes
According to an official statement, the new measures were implemented to ensure more efficient use of resources and ensure the financial sustainability of the institute. Pami, which currently has more than 5,300,000 members, decided to prioritize investment in medicines that treat more serious diseases. This results in 100% coverage of new drugs, such as those used to treat cancer, diabetes and cardiovascular disease.
However, not all changes are good for members. Some drugs that were previously fully covered now require a copay. Medications such as certain antiparasitic drugs, corticosteroids and antibiotics, which were previously 100% covered, will now be priced at around 30% of the retail price.
In addition, coverage for other drugs will be reduced by 40%. Despite these changes, Palmy assured that members will continue to be guaranteed access to essential treatments and that they will still be able to obtain fully covered medications when deemed necessary.
In this context, Parmy stressed that it remains the only social work agency that provides 100% coverage of all five medicines to all its members. The measure also includes discounts of up to 100% on medicines needed for the long-term treatment of epidemics such as HIV, hemophilia, organ transplants and hepatitis. In addition, new molecules are included in the institute’s formulary to treat a variety of diseases, including lung, ovarian, breast and other serious diseases, with full coverage.
In addition to the changes noted above, “PAMI Price” policies will continue, an additional benefit that provides non-affiliated institutions with prices up to 30% below retail prices for drugs that are not fully covered.
This allows members to purchase medications that are not 100% covered at a more affordable price. For example, antibiotics such as nystatin can be purchased by PAMI members for $1,367.84, while members of other social or prepaid insurance companies must pay $3,236.33.
On the other hand, the National Medical Products Administration (ANMAT) has adjusted the sales classification of certain drugs from prescription sales to over-the-counter sales.
This affects benefits and discounts previously available for purchasing these medications. In April 2024, Anmat began evaluating 22 active medicines for possible conversion to over-the-counter medicines. In May this year, the “prazole” series of drugs (omeprazole, lansoprazole, pantoprazole and esomeprazole) were approved for the treatment of this condition and can be sold without a prescription.
Recently, Anmat authorized the free sale of six specific drugs, subject to certain concentrations and drug forms. These include combinations of vitamin A with allantoin and vitamin E, boric acid and zinc oxide, amorolfine and acyclovir, variously presented. For example, cream or lotion products based on retinol, allantoin, and tocopherol are sold without a prescription as long as they contain up to 600,000 IU of vitamin A, 0.2500 g of allantoin, and 0.0500 g of vitamin E acetate. These changes are designed to promote safe treatment of common conditions such as dermatitis, minor skin irritations, and recurring cold sores.
One of these changes to Pami’s vademecum is a drug such as Tarifil 1g, which was previously available to all retirees completely free of charge. It is now classified as an over-the-counter drug, no longer covered by full coverage, and does not require a prescription to purchase.
Despite these changes, Anmat decided to maintain prescription sales of other medicines due to the need for proper medical diagnosis and the risks of unsupervised use. These include silver sulfadiazine and betamethasone, as well as other compounds with systemic antibacterial activity, which will continue to be restricted to sale under prescriptions on file.
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