Interview: Emilio Sardi Aparicio
How does the Statutory Health Law impact investment in the sector?
EMILO SARDI APARICIO: A direct effect of the implementation of the law is that investment should increase, since it mandates a wider provision of health services and technologies. However, investment growth will depend on having an adequate legal framework that promotes competition and innovation, and allows for the strengthening of local research, training, manufacturing and technological capacities.
Since the law states that, starting in 2017, the health system is expected to have all-inclusive coverage – including medicines – the Mandatory Health Plan has a limited list of medicines that will cease to exist. It is expected that there will be fewer limitations to access. The government will have to increase health care spending and regulate the prices paid by the social security system, particularly those in monopolistic high-cost markets.
This new plan could be sustainable, as long as demand does not go beyond what is economically feasible and if there is transparency within management at health institutions and stronger information systems. It is also important that clinical decisions are always based on scientific evidence.
What progress has Colombia made in increasing the supply of affordable and high-quality medicines in the last five years?
SARDI: Colombia is among those countries with the broadest access to medicines worldwide, both in the health care system and commercial markets. This has been made possible by increased public and private health spending, and the consolidation of the pharmaceutical industry. Having both national and foreign capital firms competing in the market has resulted in price reductions.
In the social security system 97.6% of the population already has health insurance and can access medicines prescribed according to a benefits plan that is very comprehensive. Access is increasingly moving towards the goal of being universal in terms of people and medicines. The system is subsidised by the state for the low-income and informal sectors – which account for almost half of all insured people – and is otherwise paid for by contributions from employers and workers.
The private market is also highly developed, with over-the-counter and prescription medicines offered in a wide network of chain drugstores, retail stores and independent pharmacies. Regarding quality, the National Institute of Food and Drug Monitoring is strengthening its quality control capacities to ensure compliance with the highest standards.
In regards to affordability, the challenge has been the price of patented medicines and other monopolistic markets where the state, in order to ensure the system’s sustainability, has started to implement price regulation schemes.
In your opinion, what steps should the health care sector take to reduce the current deficit and enhance future growth?
SARDI: Public funds, both from taxes and employers’ contributions, have been and will continue to be the main funding source for Colombia’s health sector. It is estimated that the system has a deficit of around $1bn and requires around $700m more in order to attain the broader coverage outlined in the new health care plans. It is not an unbearable figure for a country like Colombia.
The state will have to redistribute its budget in order to overcome the deficit, taking funds from areas that do not have such a high impact on social development as health does. Enhancing the fight against the corruption and administrative negligence that has affected our health system for so many years is another priority for the country.