Two Dominican High-Cost Lists Overlap by Only 44 Products. FOMAC Would Be a Third.
- The Dominican Republic’s National Social Security Council (CNSS) held a working session on 10 August 2026 to evaluate a proposal from the health superintendency, SISALRIL, to create a High-Cost Medicines Fund (FOMAC) inside the country’s Family Health Insurance scheme.
- FOMAC is defined as a specialised, capitalisable account under supervision, using joint purchasing and economies of scale. It would cover 13 medicines initially, spanning adult and paediatric cancers, rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis and spinal muscular atrophy.
- The proposal answers CNSS Resolution 624-02, approved in October 2025, which gave SISALRIL three months to deliver a costed structure built around medicines prioritised by the Ministry of Public Health. It remains under evaluation.
- SISALRIL reported in June 2026 that FOMAC would begin with 14 medicines, five of them for childhood cancer. It said in November 2025 that the insurance catalogue already listed 120 high-cost medicines by active ingredient, and the separate High-Cost Medicines Programme a further 115, with 44 overlapping.
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The country already covers this. SISALRIL counted 120 high-cost medicines in the insurance catalogue and 115 in the separate programme, overlapping by 44. FOMAC would be a third list, starting at 13.
- The list shrank before the fund existed. June: 14 medicines, five for paediatric oncology. August: 13. Attrition began before anyone approved a budget, and the resolution gives the priority-setting to the Ministry, not to SISALRIL.
- Capitalisable is a cap, not a promise. Five therapy areas on one ring-fenced account, one of them spinal muscular atrophy, where a single patient can outrun a year of oncology. Ring-fencing converts a coverage question into a queue.
- Joint purchasing points outward, not inward. Scale will not come from domestic volume, so watch for a regional reference price. Whether FOMAC absorbs the existing programme or sits beside it is unresolved: its director attended the 10 August session.
Read the original source (CNSS, via El Día) →