By John McPhaul
jpmcphaul1@gmail.com
Senator Juan Oscar Morales Rodríguez of San Juan District raised concerns on Monday regarding the Puerto Rico Health Services Administration’s (ASES) plans to incorporate the Walgreens pharmacy chain into the government health plan service network, known as Plan Vital, without any public involvement, before December concludes.
“We have discovered that ASES is preparing to expand the Plan Vital network to allow the entry of the Walgreens pharmacy chain, which would severely hurt our local pharmacies,” Morales stated. “To undertake this action just days before the conclusion of this government administration, and without a transparent and open process, is inappropriate and we are firmly against it. I urge the governor to cancel ASES’s permission if they are indeed moving forward with this inclusion of Walgreens.”
“The Vital Plan serves over 1.3 million beneficiaries, and pharmacy services have primarily been delivered through community pharmacies effectively for over two decades,” the senator further commented. “Adding a chain such as Walgreens would disrupt the system entirely and jeopardize thousands of direct and indirect jobs, in addition to risking the financial viability of countless community pharmacies. I sincerely hope these speculations are mere gossip and not a decision made without proper consultations.”
During a government transition hearing later that same day, ASES Executive Director Roxanna Rosario stated that while an adequacy study was conducted in November, no conclusion has been reached regarding allowing Walgreens to participate as a Vital Plan provider.
The pharmacy benefits designed and executed under the Vital Plan are overseen by a pharmacy benefits manager (PBM), which creates a pharmacy network within the government health plan enabling insured individuals to find their medications through participating pharmacies.
Current statistics indicate that approximately 850 pharmacies are registered to operate on the island.
On November 22, 2022, the Senate unanimously passed House Joint Resolution 410, mandating ASES to halt any actions or considerations concerning the opening, modification, or alteration of the existing pharmacy network within the Vital Plan. This initiative reaffirmed the public policy of maintaining the current pharmacy provider network in the government health plan without changes.
Morales’ apprehensions regarding potential modifications in the pharmacy network were mirrored by Dr. Ramón Barquín III, President of the United Retailers Center, on Monday.
“The large chains that were once integrated into Plan Vital have chosen to abandon the poorer communities in Puerto Rico,” Barquín expressed in a written statement. “Since that time, we have observed a notable decline in service quality between big chain pharmacies and community pharmacies. This [potential move] primarily benefits those who previously neglected the people, exacerbating the government’s difficulties in managing the Vital Plan.”
“We call on the government to refrain from making negotiations that would undermine the efforts of community pharmacies, which have proven to be essential pillars of our people’s health,” he added.
Barquín underscored his commitment to free enterprise and the interplay of supply and demand, but stressed that the values and principles that define Puerto Rico as a caring and loyal society must not be compromised.
“Small and medium-sized community pharmacies have demonstrated steadfast loyalty, even during challenging times,” he noted. “At present, we refer to over 850 community pharmacies that provide 14,000 direct jobs and over 5,000 indirect jobs, serving nearly 1.3 million patients. Frequently, these pharmacies have to wait months for reimbursements, yet they continue to provide their services to citizens in their most challenging moments.”
Barquín also emphasized that “these pharmacies are not part of large multinational corporate chains, but instead predominantly function under cooperative structures that are deeply loyal to public health.”
Meanwhile, the Retail Business Association of Puerto Rico (ACDET) urged the Financial Oversight and Management Board on Monday to step in to ensure free competition and prevent restrictions on Vital Plan patients’ access to pharmacies like Walgreens. ACDET maintains that the suggestions made by the Independent Pharmacies Association aim to restrict competition, which would result in higher medicine costs and limit patient freedom.
