CNSS approves 100% coverage for high-cost medications in Dominican Republic

The National Council of Social Security (CNSS) has approved 100% coverage for 13 high-cost medications through the High-Cost Medication Fund (FOMAC). This measure is designed to support patients facing 16 catastrophic diseases, including breast and lung cancer, autoimmune diseases, rheumatological conditions, childhood cancer, acromegaly, and spinal muscular atrophy.

Under this initiative, medications financed directly by FOMAC will be provided with 100% coverage, requiring no copayments or moderate fees from affiliates. The fund aims to strengthen access by utilizing joint purchasing mechanisms and economies of scale to reduce waiting lists and ensure treatment continuity.

For pediatric cancer care, the fund incorporates new benefits such as specialized diagnostic tests, PET-CT studies, screenings, specific retina therapies, biopsies, and necessary follow-up evaluations. The proposal, developed by the Superintendency of Health and Labor Risks (SISALRIL), establishes FOMAC as a specialized, capitalizable fund integrated into the Family Health Insurance (SFS) system.