By Tatiana Santiago, G1 São Paulo
February 8, 2017, 11:46 a.m.
The São Paulo City Hall has partnered with 12 pharmaceutical companies to provide free medicines used in the municipal health network. Up to 165 types of medicines, which are in short supply in the public system, will be donated by the laboratories. The medicines are expected to arrive at pharmacies starting February 20.
Initially, the donation is expected to take place over a two-month period as emergency aid to supply the public network and replenish the stock of many health units from scratch.
This is yet another partnership between the municipal administration and the private sector. Since taking office, Mayor João Doria (PSDB) has formed partnerships for cleaning the Estaiada Bridge, renovating the bathrooms at Ibirapuera Park, receiving vehicles for the Marginal Segura program, and revitalizing Raposo Tavares Park, among others. At least 10 programs or actions have already received private investment.
The announcement was made on Wednesday afternoon (8) by Mayor João Doria and Municipal Health Secretary Wilson Pollara.
"We will make 381 million doses of medication available for two months, as an emergency measure, representing a factory price of R$ 120 million. The price that the city would pay for these products is much lower, considering that the minimum prices set by the City of São Paulo are equivalent to R$ 35 million," said Dória.
The state government has granted an exemption from the Tax on Circulation of Goods and Services (ICMS) for the medicines that will be donated. These medicines are subject to a tax of 12% to 18%.
"There is a fiscal problem, a tax problem, not only taxes to be paid with taxes that have already been collected on this production. These taxes already collected can be reimbursed by the industry as long as these donations are made to the state. We already have an agreement with the state that donations made to the state are immediately transferred to the municipality within the scope of this project," said Pollara.
The State Finance Department has not yet calculated the amount, in reais, that it will lose by waiving the ICMS. The government depends on the city to report the amount of medicine to make this calculation.
According to the City, in private pharmacies, medicines can only be sold if they are more than one year past their expiration date. With 11 months and 29 days until expiration, they must be incinerated. In the municipal health network, the requirement is that the medicine be delivered to the population with an expiration date within the period of use.
"We are donating products that are six months to one year old, and we are donating products that are more than one year old. This will depend on each company. There are even products that have a maximum shelf life of 12 months. So, it must be made very clear that it is not like this: 'oh, the industry, since it is going to destroy them, it is better to donate them. That's not quite how it works. It's an effort by the industry. An effort that has never been made in the past. There has never been a call for the industry to participate in this type of effort," said Nelson Mussolini of Sindusfarma.
According to Telma Salles, president of Progenéricos, the City's responsible requirement is that medicines with a shelf life of less than six months or one year should not be donated. According to her, the industry does not work with high inventories and does not have medicines to throw away or medicines in its inventories. "What we are donating to the City Hall is within the expiration date and would be the same product that we would put in the pharmacy or at the point of sale," she said.
Private pharmacies
Another partnership between the municipal administration and the private network consists of supplying all the medication that is currently distributed in the pharmacies of the UBSs (Basic Health Units) and AMAs (Outpatient Medical Assistance), in private pharmacies such as Drogarias Onofre, Drogasil, and Drogaria São Paulo. According to Dória, the new operation, called Remédio Rápido (Fast Medicine), will involve not only laboratories but also pharmacies. "It's a bold, unique project. It's never been done before. There are tax issues we are analyzing, but by the end of March, we will be making this announcement."
The measure should save public funds on the purchase and distribution of medicines, as patients will be able to collect them from various pharmacies throughout the city. As a result, pharmacies in municipal health centers are expected to close. Doria said on Wednesday that, with the change, the city should save around R$ 500 million per year in logistics and allocate this money to the purchase of medicines.
The municipal secretary of Health, Wilson Pollara, said that the current purchasing system through bidding makes the process difficult, as there may be challenges from defeated companies and, after the contracts are signed, there are also logistical difficulties and possible delivery failures on the part of the companies.
“The system is the problem. Purchasing is difficult, logistics are difficult. We are finding other options. The postal service is already being used in some cases. Another option is to use pharmacies in some regions, giving people a card or ticket so they can pick up their medicine,” Pollara said last month.
The model is similar to the Popular Pharmacy program, created by the federal government in 2004.