The main pro-patient organizations, which make up the Pro-Access to Medicines Alliance (APAM), today urged the Fiscal Control Board (JCF) to abide by Law 82-2019, which oversees the operation of Benefit Managers of Pharmacy in Puerto Rico, better known as PBMs.
According to Alliance members, the JCF “has been obstructing the implementation of the said law on the island for almost two years, alleging that the issue is a field occupied by the federal government. This has had the effect of delay the implementation of this law, which is detrimental to thousands of patients. “
“Suspending the application of this legislation is a severe blow to patients, as this regulation is essential in the access to medicines of thousands of citizens. It also has an impact on the coffers of government, as the “The state has been failing to generate substantial amounts, by way of licenses, of entities that generate millionaire profits on the island,” said Maria Cristy, spokeswoman for the Alliance.
PBMs are the entities hired by insurers to administer and determine about pharmacy benefits. “These companies have great power in the market because they are the ones who determine the approval or refusal of a drug, thus directly affecting the medical treatment of patients. Having such an important component of the chain devoid of regulation and control, has caused a crisis for patients in access to medicines.This pattern has been experienced in other jurisdictions, but already more than 40 states have implemented regulation, and has been effective in both objectives, in safeguarding the “access to medicines and by establishing transparency in the processes, which has resulted in substantial savings in the cost of medicines,” said Leticia López, executive director of the Puerto Rican Association of Aid to Psoriasis Patients and member of the Alliance.
For his part, Alex Ramírez, of the Puerto Rican Society of Epilepsy and also spokesman for the Alliance, explained that the United States Supreme Court, through an opinion issued by the Honorable Judge Sotomayor, and in determination unanimously, it ruled against the Association representing the PBMs, which sought to question the constitutionality of Arkansas Act 900, which regulates these companies in that state, for allegedly interfering with the ERISA Act.
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“The Highest Forum determined that the regulation on the operation of PBMs, in this case Law 900, was not unconstitutional, it had no interference with federal regulation, thus guaranteeing that states will implement regulation and control over the operation. The determination went further, stating that the mandate contained in law for the purposes that PBMs must reimburse pharmacies for the cost of acquiring the drug was not an unconstitutional clause, nor did it inflict the ERISA Act, as PBMs seek to argue, “Ramirez stressed.
For the members of the Alliance, the JSF’s refusal to recognize the law approved at the local level is unacceptable, as they understand that it is an undue interference with the constitutional powers of the Legislature, and where there is an urgent interest and responsibility to the state, to the heads of safeguarding access to health of citizens. “This becomes more relevant, when lack of supervision is adversely impacting the quality of life of many patients. We then wonder, what is really the goal of the JSF with this stance and what factors are behind this intransigence. On the one hand, the Board authorizes renewals and multimillion-dollar increases in the contracts of the PBMs that offer service to the Government Health Plan (PSG), despite not having intervened competition in these services since 2013, and of on the other hand they question such an important law on the issue of health, to allegedly have a fiscal impact, with no evidence or date to prove this assumption, “stressed Celia Galán of APNI (Support for Parents of Children with Disabilities).
The group of organizations thanked the government for its work in defending such important legislation and pointed out that the determination of the EU Supreme Court is very important at the local level as it leaves the JSF without arguments in the its attempt to disable approved legislation. “There are public policy issues, especially those related to health, where economic considerations must be handled responsibly and it is not based on speculation. The quality of life of our citizens is at stake with this law and the less than we hope that any allegation against it is based on the empirical date and not on mere speculation.Experience in other states has been completely contrary to the panorama raised by the Board, it is also different from the reality in Puerto Rico , where the government has economic projections of revenue and savings, in accordance with the approved regulation, “Cristy pointed out.
The Pro-Access to Drug Alliance is made up of the American Cancer Society, Alzheimer’s Association, Psoriasis Patient Support Association, APNI (Support for Parents of Children with Disabilities), Puerto Rican Association of Children Lung, PR Renal Council, Puerto Rican Diabetes Association, Puerto Rican Epilepsy Society, among others.