By John McPhaul
San Juan District Sen. Juan Oscar Morales Rodríguez warned Monday about the intention of the Puerto Rico Health Services Administration (ASES by its acronym in Spanish) to include, without a public process or procedure, the Walgreens pharmacy chain in the service network of the government health plan, better known as Plan Vital, before the end of December.
“We have learned that ASES is in the process of opening the Plan Vital network to the entry of the Walgreens drugstore chain, which would be a death blow to our community pharmacies,” Morales said. “Doing this, just days before the end of this government administration and without an open and transparent process, is not the right thing to do and we strongly oppose it. I call on the governor to revoke the ASES’s authorization, if they are actually doing this process to include Walgreens.”
“The Vital Plan covers more than 1.3 million beneficiaries and in the case of pharmacy services, these have received their services, mostly, through community pharmacies and efficiently so for more than two decades,” the senator added. “Including a chain like Walgreens would cause a complete dislocation and put thousands of direct and indirect jobs at risk, as well as the solvency of hundreds of these community pharmacies. I hope that these rumors are just that, hallway talk and not a change of position without consulting anyone.”
ASES Executive Director Roxanna Rosario said during a government transition hearing later on Monday that despite the fact that in November a so-called adequacy study was conducted, at the moment no decision has been made to allow Walgreens to be a Vital Plan provider.
The pharmacy coverage designed and implemented under the Vital Plan is managed by a pharmacy benefits manager, or PBM, which operates a pharmacy network within the government health plan so that insured people can search for their medications within the network.
According to the latest data, there are some 850 pharmacies registered to do business on the island.
On Nov. 22, 2022, the Senate unanimously approved House Joint Resolution 410, which ordered ASES to stop any process or consideration regarding the opening, modification or conversion of the current pharmacy network within the Vital Plan. The measure reiterated the current public policy of keeping the existing pharmacy provider network within the government health plan unchanged.
Morales’ concern over the possible changes in the pharmacy network was echoed by United Retailers Center President Dr. Ramón Barquín III on Monday.
“The large chains that were once part of the Plan Vital decided to abandon the poorest sectors of Puerto Rico,” Barquín said in a written statement. “Since then, we have noticed a significant difference in service between large chain pharmacies and community pharmacies. This [potential move] essentially benefits those who in the past turned their backs on the people, exacerbating the government’s problems in managing the Vital Plan.”
“We ask the government not to negotiate terms that harm the work carried out by community pharmacies, which have proven to be a fundamental pillar in the health of our people,” he added
Barquín emphasized his support for free enterprise and the dynamics of supply and demand, but stressed that the values and principles that distinguish Puerto Rico as a supportive and loyal society should not be compromised.
“Small and medium-sized community pharmacies have shown unwavering loyalty, even in adverse circumstances,” he said. “Currently, we are talking about more than 850 community pharmacies that generate 14,000 direct jobs and more than 5,000 indirect jobs, serving nearly 1.3 million patients. Many times these pharmacies have to wait months to receive payments, but they still continue to offer their services to citizens in the most difficult times.”
Barquín also stressed that “these pharmacies are not part of large multinational commercial networks, but rather operate mainly under cooperative structures deeply committed to public health.”
The Retail Business Association of Puerto Rico (ACDET), meanwhile, urged the Financial Oversight and Management Board on Monday to intervene to guarantee free competition and avoid restrictions on access for patients of the Vital Plan to pharmacies such as Walgreens. The ACDET’s position is that the proposals of the Independent Pharmacies Association seek to limit competition, with the result of making medicine more expensive and restricting the freedom of patients.
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