Major pro-patient organizations, which are part of the Alliance for Access to Medicines (APAM), today urged the Fiscal Control Board (JCF) to comply with Law 82-2019, which oversees the operation of the Pharmacy Benefit Managers in Puerto Rico, more commonly known as PPE.
According to members of the Alliance, the JCF “has hindered the implementation of the aforementioned law on the island for nearly two years and claims that the issue is an area occupied by the federal government. This has delayed its implementation. which is harmful to thousands of patients. “
“Suspending the application of this legislation is a major blow to patients, as this regulation is essential for thousands of citizens’ access to medicines. It also has an impact on the government’s coffers as the state stops generating significant amounts, through licenses, from entities that generate millionaire profits on the island, ”said María Cristy, Alliance spokesman.
PPE are the entities contracted by insurers to manage and determine pharmacy benefits. “These companies have great power in the marketplace as they are the ones who determine the approval or refusal of a drug and thus directly affect the medical treatment of patients. The lack of regulation and supervision of such an important part of the chain has led to a crisis in patients’ access to medicines. This pattern has occurred in other jurisdictions, but more than 40 states have already implemented regulations and it has been effective in both objectives, in ensuring access to medicines and in creating transparency in the processes, resulting in significant savings in drug costs, ”said Leticia López, executive director of the Puerto Rican Association for Assistance to Psoriasis Patients and a member of the Alliance.
For his part, Alex Ramírez, of the Puerto Rican Epilepsy Society and also a spokesman for the Alliance, explained that the United States Supreme Court, through an opinion of the Honorable Judge Sotomayor, unanimously opposed the Association PBMs, who attempted to challenge the constitutionality of Arkansas Law 900, which regulates these companies in that state, for alleged interference with ERISA law.
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“The Supreme Forum found that the regulations governing the operation of PPE, in this case Law 900, were not unconstitutional, it did not violate federal regulations, thus ensuring that the states regulate and supervise the operation of these companies. implement. The finding went on to state that the mandate in the law that PPE should reimburse pharmacies for the cost of purchasing the drug was not an unconstitutional clause, nor was it mandated by the ERISA law, like the PPE they were trying to argue, Said Ramírez.
For the members of the Alliance, the Council’s refusal to recognize the law passed at the local level is unacceptable, as they understand that it is undue interference with the constitutional powers of the legislature, and when there is an overriding interest and with a view to ensuring access to health for citizens. “This becomes more relevant when the lack of supervision adversely affects the quality of life of many patients. We then wonder what the Board’s real objective is with this position and what factors lie behind this intransigence. On the one hand, the Council approves renewals and millionaire increases of the contracts of the PPE providing services to the Government Health Plan (PSG), even without mediating competition in these services since 2013, and on the other hand they question a law so important in the health issue, as it would allegedly have a fiscal impact, without any evidence or data to prove such an assumption, ”stressed APNI’s Celia Galán (Support for Parents of Children with Disabilities).
The group of organizations thanked the government for its efforts to defend such important legislation and pointed out that the decision of the US Supreme Court at the local level is very important as it leaves the Council without arguments in its attempt to override the approved legislation . “There are public policy issues, especially those related to health, where economic considerations must be handled responsibly and not based on speculation. The quality of life of our citizens is at stake with this law, and the least we hope is that any accusation against it is based on empirical evidence and not mere speculation. The experience in other states completely contradicts the panorama raised by the administration, it is also different from the reality in Puerto Rico, where the government has economic projections of income and savings based on the approved regulations, ”noted Cristy on.
The Drug Access Alliance is made up of the American Cancer Society, Alzheimer’s Association, Association for Aid to Psoriasis Patients, APNI (Support for Parents of Children with Disabilities), Puerto Rican Lung Association, Renal Council of PR, Puerto Rican Diabetes Association, Puerto Rican Rican Epilepsy Association, among others.