Argentina's largest health system works to lower drug costs

Argentina is the testing ground for what is believed to be the world's first experiment of its kind to both cope with rising drugs costs and also improve services to senior citizens and disabled persons, two of the country's most vulnerable population groups.

The National Institute of Social Services for Retirees and Pensioners (NISSRP) ("Instituto Nacional de Servicios Sociales para Jubilados y Pensionados") is Argentina's single largest health system. Among other services, the NISSRP provides outpatient drug coverage and cancer treatment medications to its more than 3.3 million beneficiaries, including retired workers, pensioners with a disability such as a physical or mental disorder, war veterans, and the dependents of these beneficiaries.

As rising prices for prescription medications began to take their toll on both the NISSRP and its beneficiaries, through the beneficiaries' copayment obligations, the NISSRP turned its attention to the country's drug companies. Aware of the economic clout of this group, in 1997 the NISSRP approached the pharmaceutical industry and successfully negotiated an agreement with a consortium of more than 200 enterprises to transfer to them the risk of increasing pharmaceutical costs in exchange for a fixed monthly payment by the NISSRP.

Argentina is believed to be the first nation in the world to ever test this type of risk contract as a way to control drug expenditures. The preliminary results of this experiment--a comparative analysis of NISSRP beneficiaries' consumption trends in 1996, before the agreement went into effect, with those for 1999, two years following the arrangement's initiation--are featured in an English-language article in the April 2003 issue of the "Revista Panamericana de Salud Pblica/Pan American Journal of Public Health," a journal published by the Pan American Health Organization (PAHO). (The article can be viewed for free on the PAHO Web site (http://www.paho.org) by searching for

Contact: Mara Luisa Clark
Pan American Health Organization

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