IHS Global Insight Perspective | |
Significance | Costa Rica's CCSS has updated its official drug list, including 13 new drugs and eliminating 11. |
Implications | The new list focuses upon bringing new therapeutic treatments as well as high quality products for beneficiaries. |
Outlook | Looking into the future, the CCSS is expected to follow on with its current strategy of development which focuses upon the provision of cost-effective treatments. As such, the official list will continue at the centre of the sector's pattern of demand; however, individual requests will continue shaping a rising consumption trend within the scheme, particularly in relation to high-cost treatments for conditions such as cancer. |
Costa Rica's Social Security Institute (Caja Costarricense del Seguro Social, CCSS) has published the new official drug list (LOM, La Nacion, Ochodigital). This list incorporates 13 new therapeutic treatments as well as higher quality products, and eliminates 11 medications (for example aspirin 500 mg). At the moment, there are a total of 453 drugs, 552 active ingredients and 662 different drug presentations incorporated in the LOM. These products cover treatments for 97% of the diseases that affect the Costa Rican population.
Mirta Roses, director of the Pan-American Health Organisation (PAHO), considers these changes as key developments to position the scheme as a point of reference for others in the region. Meanwhile, Dr. Balmaceda Arias, director of CCSS, believes they reflect the CCSS' commitment to maintain the service's universality, accessibility, and equality.
New Treatments and Significant Updates
The CCSS's Pharmacotherapy Committee is responsible for overseeing the inclusion and exclusion of drugs in the LOM. For this, the committee engages in a lengthy process of investigation to determine the benefits and costs of the treatments.
Looking into the latest changes, the new medications incorporated into the list include hypromellose (2.5%), hypromellose (2%), carvedilol (6.25 mg), clopidogrel (75 mg), etanercept (25 mg), gadopentetate dimeglumine, sodium hyaluronate, imatinib (400 mg), pancreatin, rituximab (10 mg/ml), pneumococcal polyvalent vaccine, tirofiban (0.25 mg/ml), and fusidic acid (2%). Meanwhile, the products that were eliminated include ciprofloxacin (250 mg), lidocaine chlorhydrate (5%), lidocaine chlorhydrate with dextrose (7.5%), phenobarbital (15 mg), iothalamate meglumine (30%), iothalamate meglumine (60%),griseofulvin ultramicronised (250 mg), acitretin (10 mg), acetylsalicylic acid, aspirin (500 mg), meperidine chlorhydrate (100 mg), and cocaine chlorhydrate. In addition to the official list, there were a total of 788 medications approved for individual use (individual patients requested specific treatments). These represent 73% of total applications which summed 1,073. The majority of these treatments correspond to oncology products (33%).
Each year the CCSS distributes around 66 million medications, which indicate around four drugs per consultation. Estimates suggest that by the end of this year, the CCSS would have invested a total of 101 billion colones (US$201.7 million) in vaccines and drugs.
Outlook and Implications
The LOM's regular adjustment process is in accordance with the need of the local population, as well as scientific advancements and innovation within the market. While the process of inclusion and exclusion undergo strict procedures, the CCSS works strongly to maintain the effectiveness and efficiency of the system by engaging in a constant process of renovation and revision.
Looking into the future, the CCSS is expected to follow on with its current strategy of development which focuses upon the inclusion of cost-effective treatments that benefit patients and maintain the finances of the scheme in a healthy state. This reflects a long-term approach of expansion, which takes into account the purchasing power of the institution as well as the specific necessities of patients in the country. As such, the official list is expected to continue as an important tool to control expenditure and consumption patterns; however, individual requests will continue shaping a rising consumption trend within the scheme, particularly in relation to high-cost treatments for conditions such as cancer.
In addition to central purchases, CCSS medical units spent around 30 billion colones on purchasing drugs, vaccines and diagnostic products each year. Up to mid-2010 there were 1,306,969 workers that benefitted from the CCSS health services. However, a total of 36,655 new workers were recently incorporated as direct beneficiaries.