QCOSTARICA – Placing at risk the health of Costa Ricans is what one could say the Caja Costarricense de Seguro Social (CCSS) does best. And now, the institution that has been a clear example of inefficiency in everything it does is planning to sell medicines.
The fact is that, if the Caja starts selling medicines as its pilot plan intends, it could not only distort the market, but also affect dozens of pharmacies and, worst of all, put the country on the brink of a drug shortage, which would result in an increase in prices.
Weeks ago, the Caja announced a pilot plan to sell 123 products to private clinics, pharmacies, and the general public. The plan is to lower the price of drugs by up to 90%.
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However, coming from a government agency that does nothing well, what do you think of will be the results?
“It seems crazy to me that the CCSS gets into the business of selling medicines,” are the words of former (perennial) presidential candidate, political consultant and former legislator, Otto Guevara.
“The CCSS does not do well what in theory it should do well, which is to provide us with a pension system that allows people to retire with a pension amount to cover all their needs.
“Nor does it provide us with adequate medical insurance and force us to contribute to a medical expense sharing system. Now it intends to get into a private business selling medicines?
“I think everything is going to go wrong; Inventory management is going to be something absolutely disastrous, like everything the State does when it gets involved in business activities,” said Guevara.
Guevara proposes that the government open discussion to remove the State from the provision of hospital medical services and outsource these services, as has already been done since the 90s with several cooperatives and some Ebais, through management contracts.
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The question being asked by experts and politicians is whether the CCSS project the beginning of a monopoly in the medicine market by the State?
Some tend to agree that the CCSS can distort the market. And given the history of the institution, do a poor job of managing inventories, which would generate a shortage and an increase in prices, as has happened with equipment, preventive management and including the purchase of medicines.
Hands down, the CCSS is an example of inefficiency everywhere you look.
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Allowing the CCSS to enter the medicines market is the General Health Law that is and old law and broad, allowing the CCSS to get involved in areas that do not correspond to it.
The parallel importation of medicines is what the country requires, so that the import license for a drug does not fall solely on a distributor, but rather any pharmacy or interested party can do so, eliminating the monopoly that exists today for the distribution of medicines for those who obtain said permit.
The other measure that would considerably help lower the price of medicines is related to approval. For example, a medicine already with approval from the United States Food and Drug Administration FDA), or international counterparts such as the European Medicines Agency (EMA), the Japan Ministry of Agriculture, Forestry and Fisheries (JMAFF), and Health Canada, among others, those pharmaceutical products should be able to be marketed in Costa Rica without any problem since the protocols followed are much stricter.
To reduce prices, competition must be increased. By increasing competition, prices will be reduced for everyone.
Lower prices should also lead to lower the sale of contraband medicines. In January, La Rerpublica reported that sales of contraband medicines in Costa Rica increased 300% in 2023, a situation representing a significant danger to public health.
“The risks of consuming smuggled medicines are quite extensive. We start with the fact that the medicine does not contain an active ingredient, so it does not provide the desired medical effect. This means that the person’s illness or discomfort can be aggravated , which could potentially cause permanent damage or, in extreme cases, lead to death,” warns Dr. Andrés Guzmán, representative and Prosecutor of the College of Pharmacists of Costa Rica.
Additionally, these medications may contain unidentified substances that, in some cases, may even be toxic to the body. The consumption of such products puts people’s health at risk in a way that goes beyond the lack of adequate treatment; It can generate serious and irreversible consequences.
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