The Ricarte Soto Law Promises Relief for the pocket, but can it deliver for all who qualify?

SANTIAGO – Medicine expenses are a major concern for Chileans. The Ricarte Soto Law was enacted in 2015 to mitigate such expenses related to certain diseases. Since then, the number of beneficiaries under the law has grown exponentially, but participation is uneven due to a lack of specialists and other problems.

A recent national health survey shows that Chileans spend about CLP$60,000 (US$84.50) per month on medicines, with older adults spending about CLP$63,000 (US$88.65) per month or about 10% of their monthly income.

It is this socio-economic reality that led to the 2015 drug law, better known as the Ricarte Soto Law, in honor of the Chilean journalist who was one of the law’s main promoters.

Ricarte Soto Law

In January 2015, then-President Michelle Bachelet signed bill 20,850, the Ricarte Soto Law, which according to the Ministry of Health seeks to “ensure the financing of diagnoses and treatments based on medicines, medical devices and high-cost foods with proven effectiveness, which often have unattainable costs for people and their families.”

To take advantage of these benefits a person must satisfy two requirements: the person’s pathology must be covered by the law and the person must be in the pension health system in Chile—that is, a contributor to Isapres, Fonasa, or the “Armed Forces and Order.”

According to data from the Ministry of Health and the Fondo Nacional de Salud (National Health Fund aka Fonasa), the number of patients under the law has grown exponentially: in the first year of implementation, a total of 3,987 patients entered it, with 1,670 in the Metropolitan region. In its second year, these numbers climbed to 8,013 and 4,150, respectively; and, in its third, to 12,903 and 6,703. As of March this year, the total is now up to 14,391.

New diseases

Although the law initially covered only 11 pathologies, it has been extended to others since then. Moreover, on July 1, 2019, nine high-risk and high-cost diseases were also added to the law. This means that 27 diseases are now covered under the law, including Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), multiple sclerosis, primary immunodeficiency disease, lupus, ulcerative colitis, and HER2-positive breast cancer.

Santiago is not Chile

Available data shows that the Metropolitan region has the largest concentration of beneficiaries, currently 51% of the total, followed by the Biobío region with a little under 12% and the Valparaíso region with about 8%.

More distant regions currently have only minimal participation. For example, combined, beneficiaries from the Arica and Parinacota, Aysén, and Magallanes regions do not even make up 2% of the total.

Lack of specialists

Mónica Zúñiga, a nurse with Sótero del Río Hospital, who is also the person in charge of the Ricarte Soto Law in the southwestern area of the Metropolitan region, told Chile Today that the lack of participation in general, and the even greater lack of participation in the regions that are more distant from the capital, is “due to the lack of specialists” in the country, as only a specialist can add a patient as a beneficiary under the law, and the lack of specialists outside the Metropolitan region is even more pronounced.

A long wait

Another problem, Zúñiga explained, is that many patients with high-cost diseases migrate from the private system to the already-saturated public system, because the coverage is better under the public system. The result is extended wait times, even though the application process is only supposed to take 60 business days.

Human and economic benefits

An example of beneficiaries under the law is Francis Rocha, 34, who is a patient at Sótero del Río Hospital and suffering from pulmonary hypertension, among the covered diseases. She told Chile Today it took about a year and a half to obtain benefits: “they gave me an appointment for exams with a long wait, and whenever I went, I needed more exams, so I had to wait a long time.” But now that the wait is over, Rocha said, everything has changed with the help received under the law, “Now with the medication I am doing very well. I know it won’t cure me, but it maintains a quality of life that allows me to live.”

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