Implementación de precios de venta al público de referencia para optimizar el gasto en medicamentos en una obra social provincial argentina

Introduction. Medicines constitute one of the major determinants of health costs. Their adequate management is a challenge to funders for guaranteeing equitable access and financial stability of the system as a whole. Objective. To analyze the situation of a provincial social insurance in which medicines represent 35.14% of the assistance spending. Methods. Reference pricing as a tool for optimization was used. This tool defines a maximum amount of funding, following a criterion of qualitative and quantitative chemical equivalence, with identical pharmaceutical form, dose, mode of application, and presentation, without restricting the list of medicines available to both doctor and patient. Results. One of the main determinants of the price of the medicines is given by their variability according to the brand. In establishing the reference pricing, it was shown that 88.07% of waivers were higher than that. If reference price had been applied the savings would have been US$795 279,78 in the period of the study. This could have been used for strategies of priority coverage like cardiovascular diseases or asthma. Conclusions.Optimization of spending on medicines makes it possible not only to reduce spending per se but also to decrease the out-of-pocket spending of affiliates. Consequently, this could improve treatment adherence and disease control, representing a virtuous circle leading to better health results for the beneficiary affiliates.