La urgente implementación de la Ley de Cáncer
Siendo el cáncer una de las principales causas de muerte en nuestro país, desde hace muchos años existía una clara necesidad de contar con una Ley de Cáncer que pueda incorporar mejoras en la gestión de esta enfermedad. Es así que, en agosto de 2021, a raíz de una iniciativa congresal y con la conformidad del ejecutivo, se promulgó la Ley General de Cáncer.
Esta Ley incluye muchos temas positivos. Uno de ellos es que promueve una descentralización de los servicios oncológicos mediante la creación de una Red Oncológica Nacional. Esto lograría que menos pacientes de provincia tengan que trasladarse a Lima para buscar los mejores tratamientos para el Cáncer. Un punto adicional es que fomenta el acceso a tratamientos innovadores, permitiendo que se den compras más eficientes como las de riesgo compartido con la farmacéutica o descuentos por volumen a través de los Mecanismos Diferenciados de Adquisición (MDA´s). Otro tema importante de esta Ley es el enfoque en el paciente, ya que permite que el Estado no solo evalúe los tratamientos por criterios económicos sino por el impacto directo en el paciente. Finalmente, la Ley de Cáncer garantiza la cobertura universal, gratuita y prioritaria de los servicios de salud para todos los pacientes oncológicos, indistintamente del tipo de cáncer. Esto incluye servicios de promoción, prevención, control y atención oncológica. De esta forma, se incluyen otros tipos de cáncer en la cobertura y además se promueve un mejor diagnóstico
Sin embargo, a pesar de todas estas ventajas, ha habido demoras en la implementación de la Ley y su Reglamento. Por ejemplo, el Reglamento tardó en publicarse 5 meses más de lo que fue previsto en la Ley. Luego de ello, las disposiciones complementarias que figuran en la Ley no han sido cumplidas en su totalidad hasta la fecha. Si bien es cierto recientemente se han dado avances como la publicación del Manual Multicriterio y de los umbrales de costos, aún hay temas pendientes como la publicación del manual de MDA´s o los documentos normativos para la creación de la Red Oncológica Nacional.
Estas deficiencias en la implementación afectan directamente al paciente, el cual no puede acceder a tratamientos de calidad. Consecuentemente, la productividad del país se ve mermada. Adicionalmente el Estado incurre en mayores gastos probablemente por encontrar más casos en estados avanzados, que son mucho mas costosos para el sistema de salud.
Un ejemplo de cómo esta demora afecta al paciente es la falta de acceso a tratamientos innovadores. En el Perú, muchas veces para que un medicamento innovador oncológico esté disponible para el tratamiento de los pacientes deben pasar cerca de 18 años [1]. Esto debido principalmente a que el estado no compra estos tratamientos innovadores de última generación ya sea por demoras innecesarias en el registro sanitario o sobre todo por un proceso de evaluación de las compras de medicamentos que hace el estado enfocado en contención de gastos. La ciencia sigue avanzando y el Perú sigue comprando los mismos medicamentos de hace 20 años, a diferencia de lo que ocurre en otros países. Los MDA´s representan una alternativa que ha demostrado en otros países (como el caso de Uruguay) que se puede generar un mayor acceso a tratamientos innovadores mediante eficiencias operativas y de gestión logradas por mejores formas de compra. Sin embargo, cada día de retraso en la implementación de la Ley de Cáncer, se pierde una ventana importante de acceso a tratamientos innovadores debido a la imposibilidad de aplicar estos MDAS´s sin la oportuna implementación.
Adicionalmente, las deficiencias en la implementación pueden afectar la asignación eficiente de recursos en salud ya que, si continuasen las demoras, existiría el riesgo de que el presupuesto asignado a cáncer durante 2023 no se pueda ejecutar al 100%. Consecuentemente por la falta de ejecución presupuestal podría haber una reducción presupuestal en el siguiente año, como ya ha pasado anteriormente. Sería lamentable que, una vez más, existiendo recursos, estos se dejen de utilizar por ineficiencias de gestión. En una situación en la que muchos pacientes mueren por falta de acceso a tratamientos adecuados es imprescindible que se asegure una rápida implementación a fin de que se logre un óptimo proceso presupuestal
Desde que se promulgó la Ley en agosto de 2021 han pasado cerca de 1.5 años y aún no se cuenta con la implementación. ¿Cuánto más tendrán que esperar los pacientes?
[1] (Apoyo 2019, Acceso a Medicamentos Innovadores).
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03/11/2023
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02/11/2023
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02/11/2023
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02/11/2023
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02/11/2023
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02/11/2023
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02/11/2023
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01/11/2023
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01/11/2023
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01/11/2023
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01/11/2023
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31/10/2023
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31/10/2023
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30/10/2023
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30/10/2023
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30/10/2023
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30/10/2023
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29/10/2023
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29/10/2023
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29/10/2023
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29/10/2023
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29/10/2023
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28/10/2023
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27/10/2023
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27/10/2023
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27/10/2023
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26/10/2023
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26/10/2023
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26/10/2023
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25/10/2023
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25/10/2023
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25/10/2023
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25/10/2023
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25/10/2023
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24/10/2023
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24/10/2023
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24/10/2023
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24/10/2023
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23/10/2023
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23/10/2023
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22/10/2023
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22/10/2023
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21/10/2023
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21/10/2023
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21/10/2023