Propuesta de un modelo de costos desde la perspectiva del Estado para la definición del margen de reconocimiento a las IPS en Bogotá de los medicamentos oncológicos sometidos a regulación de precios

The Colombia Health System acknowledge a standard rate for the preparation of price regulated medicines supplied by the health providers’ institutions (HPI). However HPI have shown deep disagreement on the fixed rate as they argue it is not enough to cover minimum operational expenditures at the cli...

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Autores:: Gutiérrez Triana, Katherine Johanna

Tipo de recurso:

Fecha de publicación:: 2018

Institución:: Escuela Colombiana de Ingeniería Julio Garavito

Repositorio:: Repositorio Institucional ECI

Idioma:: spa

Description
Summary:	The Colombia Health System acknowledge a standard rate for the preparation of price regulated medicines supplied by the health providers’ institutions (HPI). However HPI have shown deep disagreement on the fixed rate as they argue it is not enough to cover minimum operational expenditures at the clinics, and propose that this margin should be close to 53.45% contemplating costs associated with technology, maintenance, drug insurance, medication monitoring, depreciation of equipment, among others. Currently, the National Government establishes in the regulation to recognize the value of HPI that add to the distribution chain a margin of 3.5% for those medicines greater than $ 1,000,000 COP and 7% for those medications less than $ 1,000,000 COP The methodology to establish the standard rate amount is not well known. Therefore, we propose a methodology from the government perspective based of the costing system ABC (Activity Based Costing) considering the preparation process of oncology intravenous medicines at a centralized admixtures pharmaceutical service as an input to define a global methodology. In the stages of the work, an international reference was made in which three types of instruments were found for their establishment, instrument i: percentage applied on the price of medicines, which is applied in 37.5% of the referenced countries, instrument ii: fixed value that can be associated to the characteristics of the medicine from which it is applied in 37.5% of the referenced countries and instrument iii: integration of the aforementioned instruments, applied by 25% of the referenced countries. Additionally, a revision of the regulations applied to these Institutions was carried out, in order to establish the minimum operational requirements and those feasible costs of recognition, as well as the identification and analysis of the process and procedure for the activity of the mixing plant, identifying the cost inductors per activity and the consumption of each of these, which were the inputs for the proposal proposal of the model, taking into account the experts' criteria. Finally, to carry out the validation of the model, market prices were taken as a reference and a comparison of the actual scenario of the regulation vs the proposed scenario was made, once the cost function was applied, it was obtained that the value that is currently being recognized is close to the regulated, however, it is proposed that this value does not depend on the value of the drug, but that it is a fixed value applied for the adjustment and adjustment of the drug, since regardless of its active principle, the passage through the activities carried out in the mixtures does not differ.

Propuesta de un modelo de costos desde la perspectiva del Estado para la definición del margen de reconocimiento a las IPS en Bogotá de los medicamentos oncológicos sometidos a regulación de precios

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