Plan AUGE

One of the pillars of the sector reform is the AUGE system that establishes universal access and explicit guarantees, opportunity, quality and financial protection for 56 pathologies of mayor prevalence that are behind the rate of mortality and disability in Chile. The explicit guarantees in this plan include the guaranteed treatment of these afflictions, with access endorsed by financial protection that implies a co-payment of no more than 20 % in accordance with the patient’s income. The health problems included in the AUGE consider all the medicines defined in the protocols or clinical guides (in their different levels of assistance, both for the public sector and the private one (ISAPRES). The definition of the treatment included in the protocols is made considering the scientific evidence validated on a global scale, the national experience on the subject endorsed by scientific societies and local clinical evidence.

In order to carry out a global health Reform, what is expected and needed to gain access to safe, effective and top-quality medicines is the participation and commitment of manufacturers / importers of medicines in the production / import of these under a generic denomination. If the country gained access to medicines under generic denomination it would mean that it would also be possible to extend the access to the pharmacological therapies included in AUGE. CENABAST as a government body that brings under one management all the public sector demand and the standardisation of acquisition management, fulfiling a special function as regards the essential medicines, due to the particular characteristics of this market (inelastic demand and oligopolic offer). According to the WHO and OMC (Seminar on Differentiated Fixing of Prices and Essential Medicines Financing, 2001) the programs of scale acquisitions are a very useful mechanism assuring the access to and financing of essential medicines.

In this context, CENABAST is required to assure the access to medicines through distinct functions associated with its role: to obtain accessible prices through product participation where economies of scale are promoted; to generate tenders on the basis of requirements defined by generic product codes in such way so as to extend the available offer and to obtain a major price competition in order to extend the coverage of health initiatives (initiative on the existing inequality and inefficiency in the system); to provide advisory services to the establishments in the area of demand planning and programming thus encouraging network supply management and strengthening this way the health network around the commitment to the rational use of medicines and medical supply promotion, and to guarantee equality of access to the users most removed from urban centres.