Since January 1, Colombian healthcare providers operating under the government-backed private EPS (Care Delivery Entities) scheme have been provided with an expanded list of medications and procedures that must be covered by these entities and which will be reimbursed by the government for eligible patients.
In 2020, 184 medical formulations and 22 health procedures were covered, but Resolution 2292 of 2021, issued by Colombian Ministry of Health December 23, adds 654 additional medical procedures to the reimbursement list. The Colombian Ministry of Health says 97% of coded procedures performed in Colombia are now covered, along with 309 clinical laboratory tests.
Added to the list are procedures for the management of hearing loss, dental care and oral rehabilitation, advanced radiotherapy for the management of cancer, procedures for the management of cardiovascular and respiratory diseases. , neuropsychology procedures, organ transplants, care of eye diseases and in utero fetal interventions.
The active pharmaceutical ingredients covered have increased from 459 to 1059, representing almost 35,000 unique drug codes (CUMS), covering 89% of all unique drug codes prescribed in Colombia.
To download the full resolution (in Spanish), click here.
“Drugs are included for pathologies that have a significant impact on the health status of the Colombian population, such as high blood pressure, kidney disease, as well as pharmacological options for different types of cancer: gliomas, sarcomas, myelomas , lymphoma, leukemia, melanoma, skin cancer. , breast cancer, lung cancer, head and neck cancer, colon and rectum cancer, among others,” said Deputy Minister of Social Protection María Andrea Godoy Casadiego (pictured below). -above).
The Deputy Minister said the expanded list now includes more drugs for respiratory, skin and cardiovascular diseases, more contraceptive options for women, drugs for pain management, osteoarthritis, mental illnesses, drugs for use in ophthalmology, immunodeficiencies, antibiotics, as well as pharmaceutical formulations for populations such as children and the elderly, and more fixed-dose combinations that improve treatment compliance and allow fewer doses.
Covered Medical Marijuana
Medical marijuana derivatives are included in the expansive resolution for the first time, meaning the Colombian government mandates EPS coverage for prescribed CBD and THC cannabis derivatives. THC-based psychoactive drugs remain strictly regulated.
Some private insurance had already started to cover certain cannabis-based treatments.
“We have worked with insurance companies across the country to include this drug in their administrative systems. In 2021, 60% of our products were sold under agreements with two major insurers. Today, all insurance companies are mandated to cover medical cannabis in Colombia, with less paperwork and hassle for patients,” said Álvaro Torres, CEO of the cannabis products company. Khiron Life Science Society. ( (TSXV: KHRN), (OTCQB: KHRNF).
Along with its subsidiary, Zerenia Clinics, Torres says the company filled more than 57,000 prescriptions for 16,000 individual patients after Colombia allowed (but did not mandate) drug coverage under insurance plans. sickness.