The Court of Accounts of the Republic of Moldova (CoARM) presented on June 7, within the Public Finance Control Committee, the conclusions of the follow-up audit report on the implementation of the recommendations approved throughout the Decision No. 1 from January 31, 2019 regarding the "Performance Audit Report of the implementation of the Action Plan of the National Diabetes Prevention and Control Program for 2017-2018 (I semester).
The CoARM’s team reported on the measures taken by 18 entities of different levels, involved in the implementation of the audit recommendations. The level of achievement of the audit recommendations was 65%, namely: fully implemented - 20 recommendations, partially - 31 recommendations, and 4 recommendations were not implemented.
The elaboration and approval of strategic policies in the field of health, as a result of the implementation of the audit recommendations, were oriented towards the protection of the population from financial risks, contributing to the reduction of the burden for people with diabetes, with the state assuming these expenses.
Starting in 2022, around 119,000 people with diabetes were to have access to self-monitoring devices and insulin analogues. However, compensation for insulin analogues has been implemented since July 1, 2022. These actions facilitated national access to insulin analogues and medical devices, according to the needs of the persons with diabetes, increasing treatment adherence.
Also, based on the recommendations of the Court of Accounts, the Ministry of Health jointly with the National Medical Insurance Company (NMIC) have undertaken a set of systemic and complex measures aimed at reducing the financial burden of people affected by diabetes. Thus, about 100 thousand adult patients with diabetes benefited from medical devices (tests, glucometers and lancets), in the amount of 23 million lei. Likewise, 800 children with diabetes were provided with sensors and insulin pens. At the same time, MMAIF financed the expenses for the compensation of injectable and oral antidiabetic preparations, prescribed and issued for about 16 thousand unique beneficiaries, in the amount of 292 million lei.
With reference to the benefit of insulin-dependent people from efficient treatment with insulin analogues, the audit established that 2700 people with type I diabetes or 82% (out of 3250 people evaluated) had access to this type of treatment.
In the context of the changes in the legal framework, in July 2022 people with diabetes benefited from insulin analogs that were compensated from the mandatory healthcare insurance funds. Thus, from MMAIF, 7385 people were insured with insulin analogues (15.1 million lei), with tests - 21 958 people (6.7 million lei), with lancets - 14 685 people (452.2 thousand lei).
Also, in order to implement the recommendation of the Court of Accounts, the State Fiscal Service carried out thematic controls, regarding the situation of the sale of insulin analogues with the obtaining by an economic operator of illegal income in the amount of 0.5 million lei. As a result of the verifications regarding the commercial surcharge applied to pharmaceutical products, the State Fiscal Service applied sanctions to the economic operator, in the amount of 62 thousand lei.
At the present time, the Court of Accounts indicates that, out of 9 recommendations submitted during follow-up audits, 3 recommendations have been implemented. In the case of 5 recommendations that refer to the development of a national program for the coming years, the Ministry of Health informed that they will be taken into account in the development of the new national program for the prevention and control of diabetes.
The Chairperson of the Public Finance Control Committee, Tatiana Cunetchi, emphasized the fact that the topic of diabetes is very important for society, thanking the Court of Accounts for its efforts and stressing the importance of continuous monitoring of the state of affairs in this field.