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Drug costs and citizen complaints in unison

Specialist in criminal litigation; She is a member of the Criminal and Procedural Law Commission of the National Bar Association. He was deputy deputy of the Republic.

Moses Bartlett QuielAttorney

It is time for the authorities to take action on the apathy and lack of responsible and timely management of the most sensitive issues affecting citizens

Much has been said for a long time about the high cost of drugs in the country. What is your analysis of the subject?

The issue of high drug prices is suffocating Panamanians, it is a situation that affects health and causes death. It is more complex than what was envisaged, it has been made worse by the negligence and the political management that government after government has given to a very serious situation. It is time for the authorities to take action on the apathy and lack of responsible and timely management of the most sensitive issues affecting citizens.

In your opinion, what is the reason for this reality of high drug prices in the country?

Multiple factors. The heart of the problem lies with the Social Security Fund and the Ministry of Health, institutions responsible for the drug shortage. In the case of the CSS, its administrative shortcomings are a direct cause of the shortages and, consequently, of the increase in drug prices. In addition, the country has very few laboratories, supply or distribution is concentrated in three or four companies, and there is a lack of state regulation to guarantee competition.

The government has announced the creation of a drug price analysis commission. How do you analyze this government response?

The government creates commissions as a method of distraction, which reveals a lack of leadership; in the countryside they had plans and solutions for everything, in government they have no idea or capacity for anything. What was the dialogue for the Social Security Fund? Which of the dialogues resulted in the establishment of immediate and medium-term mechanisms to take the resolution of national problems seriously? Experts in the field point out that the drug price analysis commission is only a curtain to hide the failure of the CSS dialogue. I think this new commission will end because of the same irresponsible excuse of this frustrated dialogue, lack of political capital. I wonder if they got that capital back or is the vice president’s personal political capital enough to solve the problem?

A bill to regulate drug prices is being debated in the National Assembly. What do you think of the initiative?

The National Assembly is working on the unification of four proposals, the one that proposes that the Ministry of Health and the Social Security Fund can directly import the purchase of medicines and medical supplies to supply pharmacies and hospitals in the public sector and reduce prices, using health records from the United States and the European Union; one which proposes the creation of the Superintendence of Medicines and another which proposes to create the regime of the single price of medicines under the supervision of the State. The first thing I suggest is clarity and distinction between health care and drug supply under the responsibility of the state, i.e. the public sector, health services provided by the private. The proposals must lead to concrete and real mechanisms to understand what tenders mean for direct purchases or imports, and the first question that arises is whether companies and purchases made by government entities are reliable or not. Also understand that international companies or laboratories have representatives in Panama who are those who participate in tenders, which the State pays late, which allows manufacturers and intermediaries to charge interest when they assume expenses and that, without meaning or being understood as a justification for the exaggerated prices applied to medicines in our country, the markets of neighboring countries are more numerous in terms of population. The creation of the General Superintendence of Medicines seems like a good idea, but I have some reservations, it could be another bureaucratic structure, unless it is designed to encourage laboratories and regulate the market, it would however be viable to illustrate as an example, the Public Services Authority ended up defending interests, even illegitimate ones, to the detriment of the interests of citizens.

What measure do you propose to solve the problem of high drug prices?

The State must have the human being, citizen, as the central axis of health policy, therefore of medical attention and the supply of medicines. I continue to think that the core is in the shortage of drugs at CSS and MINSA, even with the appearance of being provoked, which generates high prices. In this sense, immediate measures should be taken, which go through the creation of sufficient funds and reserves to buy medicines next month with cash and advance payments, as has been done with vaccines to face the the pandemic. You cannot wait for the results of the tables, the discussions, the approval and the sanction of the bills, that requires willpower, efficiency and transparency. In the medium term, generate and stimulate a clear and growing policy of free competition, an open market that puts an end to monopoly, regulate disputes and appeals against acts of invitation to tender, and sanction them when they reveal that they are excessive, abusive exercise of the right and impose exemplary fines considering the fact that these actions directly generate damage to the health and life of the associates.

He was vice-president of the National Bar Association, social communicator and former state spokesman during the government administration of Martín Torrijos.

Drug costs and citizen complaints in unison

Alfonso FraguelaAttorney

There is a vulgar and obscene lack of control where corporations and transnationals know that people will have to resort to it, because there is no other alternative

Much has been said for a long time about the high cost of drugs in the country. What is your analysis of the subject?

The high cost of medicines has become one of the main social problems facing citizens. Let us remember that when someone faces an illness he is struck by reality when he goes to a pharmacy in search of a product that relieves or cures him, to continue his life. But we must not forget also the elderly and all those who are forced to consume a product for life. This reality becomes the masterpiece of terror, when your family budget can be compromised, causing other collateral problems, forcing the person to choose between buying medicine to improve their health or meeting their monthly expenses. In many cases, these people who do not have the resources resort to raffles, raffles or charity to improve their health.

In your opinion, what is the reason for this reality of high drug prices in the country?

Supply and demand. There is a vulgar and obscene lack of control where corporations and transnationals know that people will have to resort to it, because there is no other alternative. In many cases, they sign agreements where they undertake not to sell medicines at a lower cost, so as not to put an end to the hegemony and the oligopoly that exist between them. All of this has the company kidnapped, with no possibility of an end or end, to allow access to these products.

The government has announced the creation of a drug price analysis commission. How do you analyze this government response?

It is a late measure, which comes in the middle of an electoral tournament at the door, to seek to arouse a certain empathy among citizens, to say that the social need is met. Control and the straitjacket on expensive drugs did not appear now. This has been around for years, ensuring a comfort zone for the corporate sector that exercises the “win-win” policy.

A bill to regulate drug prices is being debated in the National Assembly. What do you think of the initiative?

Timely and fair, if the medicines to be regulated will be the same of good quality that are sold in pharmacies, for the consumption of patients. If what is sought with this law is to flood the country with generic drugs, then it will be a joke for the Panamanian people. And the excuse they could point to is that the high import costs, so how do they explain the costs that there are in other neighboring countries, where they come from recognized pharmaceutical companies at very, very away from the armed robbery we pay for in Panama.

What measure do you propose to solve the problem of high drug prices?

Look for alternatives, which crystallize a noticeable decline in the country’s business sector, or allow the opening of the market so that, through e-commerce, citizens have access to these products tax-free, since it is is a health and human rights issue.