The company serves 14,000 SUS patients, but says it will not renew contracts with the public network unless there is a readjustment of the amount paid for the session
The DaVita network of dialysis clinics said it will not renew contracts with the public network and stop serving new patients in the Single health system (SUS) if state governments or the Ministry of Health do not cover losses the company claims it has with therapy until October. Today, the value of the dialysis session paid for by SUS is 53% lower than the actual cost of the procedure, according to the Brazilian Association of Dialysis and Transplant Clinics (ABCDT). The treatment is used to replace the functions of a failing kidney.
The network is the largest in the country in the sector and satisfies 15% of the total demand for SUS for dialysis: there are about 14 thousand patients with chronic renal failure. During this week, the company notified 13 of the 15 states in which it operates the request for economic recovery. “If this does not happen we communicate that we will not renew the contracts with SUS and we will have to immediately reassess the acceptance of new patients because there is a huge queue, which we will no longer be able to supply if there is no conclusive answer”, said the director Bruno Haddad, managing director of the DaVita group.
The price paid by SUS today is R $ 218, a value that was adjusted after five years with no increases in December last year, but the network claims that the real cost per session is R $ 303. “There was a symbolic readjustment in 2021 that paid off nothing at all. Costs went up a lot. Inputs, exchange rate changes, inflation, 10% per annum wage adjustments and the aftermath of the pandemic. It is impossible to recover without a For this reason, DaVita can no longer subsidize this reality of the SUS, “says Haddad.
ABCDT estimates a total delay of about R $ 31 million per month in the provision of services to the public network of São Paulo alone.
The network is the largest in the country in the industry and meets 15% of the total SUS demand for dialysis. Photo: Taba Benedicto / Estadão
In São José do Rio Preto, in northwest São Paulo, DaVita serves about 250 SUS patients who could be suspended from treatment in less than three months when the state’s contract with the network expires. “The decision will be, if the government does not respond, unfortunately stop participating, not renew contracts and focus only on private patient care from now on,” says the administrator, who asks the state government to contribute with R An additional $ 84.76 in the value of the session paid by the Ministry of Health to prevent the suspension of services.
Contacted, Sao Paulo’s Executive Secretary of Health, Eduardo Ribeiro, said he was in dialogue with the dialysis network, which runs 36 clinics and serves 5,000 patients in the region. “Far from having a definition, mainly of this type,” he said of the possibility that the secretariat covers the amount requested by DaVita.
Today only Rio de Janeiro, Santa Catarina and Mato Grosso do Sul cover the costs required by the sector. The position of the National Council of Secretaries of Health (Conass) is that the therapy should be fully funded by the Ministry of Health.
co-payment
“We reiterate Conass’s position that the financing of renal replacement therapy is exclusively federal, and that states do not hesitate to discuss the co-financing of the SUS, also because they are already doing it in a robust way,” explains Ribeiro.
In 2021, for example, while São Paulo invested an average of R $ 460 per capita in the SUS, the Ministry of Health invested R $ 323 per capita in state health, according to data from the Information System on public health budgets. Siop).
In addition to informing the States, DaVita also sent a letter to the Ministry of Health with a deadline for response until 23 September, asking for a position on a possible restoration of the dialysis deficit in the public network. “The absence of a return with a proposed rebalancing within the aforementioned deadline will result in the immediate impossibility of welcoming new patients, as well as the impossibility of renewing expiring contracts, in addition to the appropriate legal provisions”, reads the letter signed by Haddad, who has not yet received an answer.
When asked on Thursday 15, before DaVita’s ultimatum, if he plans to readjust the amount paid for dialysis in SUS, the Ministry of Health replied to the Estadio which “transfers financial resources to all states and municipalities on a monthly basis for the cost of hospital procedures and services, including hemodialysis procedures”.
“In 2021, over R $ 63.1 billion was transferred to state and municipal health funds. In 2022, up to August, over R $ 36.3 billion was transferred,” the statement read. The folder also underlined that the “funding of the SUS is tripartite, with the participation of states and municipalities”.
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Source: Terra
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