Health in DR: Fund for high-cost medications with full coverage approved
News that positively impacts the well-being of thousands of Dominicans has been confirmed: the approval of the High-Cost Medication Fund (FOMAC). This initiative, promoted by the Superintendence of Health and Labor Risks (SISALRIL), seeks to guarantee timely access to vital treatments, eliminating the financial barriers that have historically affected patients with catastrophic illnesses.
The new fund will allow Family Health Insurance (SFS) members to receive 100% coverage on an initial catalog of 13 essential medications. Most importantly, this benefit will not require copayments nor be subject to annual caps, significantly alleviating out-of-pocket expenses for Dominican families.
Conditions covered by FOMAC
The program is designed to address high-complexity conditions that require continuous and expensive treatments, among which the following stand out:
- Breast cancer and lung cancer.
- Various types of childhood cancer, such as acute lymphoblastic leukemia, Hodgkin’s lymphoma, retinoblastoma, Wilms’ tumor, low-grade glioma, and Burkitt’s disease.
- Rheumatoid arthritis, psoriasis, and inflammatory bowel disease.
- Acromegaly and spinal muscular atrophy.
It is an advancement that benefits and strengthens the health protection of the population, being the manifestation of a right that has been achieved and materialized.
Miguel Ceara Hatton, Superintendent of SISALRIL
Sustainability and project execution
According to official information, the funding for this fund will come directly from the resources of the Family Health Insurance. It is important to clarify that this mechanism will not imply additional deductions from workers’ salaries nor will it require extraordinary contributions from employers.
The National Social Security Council (CNSS) has stipulated that the FOMAC must become operational within a maximum period of one year. In addition to facilitating access to drugs, the fund will contribute to decongesting waiting lists at the Ministry of Public Health’s High-Cost Medications Directorate, ensuring the continuity of treatment throughout the entire care cycle.
An institutional consensus
The creation of FOMAC is the result of an unprecedented collaborative effort in the health sector. The design of this structure involved the technical participation of multiple entities, including the Ministry of Public Health, the Social Security Treasury (TSS), the Information and Defense Directorate for Affiliates (DIDA), as well as the support of the Ministry of Finance. Likewise, the visions of medical societies, the pharmaceutical industry, and patient associations were integrated to ensure a transparent and effective implementation.
SISALRIL will maintain a constant supervisory role to ensure that the rights of affiliates are respected and that execution deadlines are met, marking a historic milestone in the social protection of the Dominican Republic.
