Health Sector Group Intern Presentation On Access and Pricing of Medicines For Noncommunicable Disease
Health Sector Group Intern Presentation On Access and Pricing of Medicines For Noncommunicable Disease
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Outline
Context and issues
Methodology of the study
Findings
Malaysia
Indonesia
Philippines
Enablers and Barriers
Actions for ADB
Limitations of Study
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Context and Issues
NCDs
Quality of Medicine
The perfect supply chain
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2012
(WHO 2014) NCDs need Medicines
56 million
deaths
38 million
NCD-related
Malaysia (2008)
Considerable threat to
Compromised Safety human lives 5 of 31
Ideal Supply Chain System
QUALITY ASSURANCE (QA) CREDIBLE WHOLESALERS /
DISTRIBUTORS
CREDIBLE MANUFACTURERS - Good Distribution Practice
- Good Manufacturing Practice - Timely Delivery
Two-tier system:
Tax-financed public sector
Fee-for-service private sector
Pharmaceutical expenditure:
Per capita (PPP): US$ 198.8 (19.1% of Total Health Expenditure per Capita)
45.7% Privately financed
LP Other pharmaceutical
Pharmacy Logistics companies (Local or
Unit, Hospital MNCs) Pharmaniaga
Distribution
District Health Companies contracted
Outpatient Pharmacy, Office distributors
Hospital
In-house Transport
IDDS service Pharmacy Unit,
In-house Primary Care Clinics
transport /
Pharmacy Value-added Service
Courier Service
Pharmacy Value-added
Consumers
Service
Legend
Drug Order and Circulation
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Drug Distribution
Malaysia Private Procurement and Supply System
Consumers
Legend
Drug Order and Circulation
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Supply System Performance: Malaysia
CONTINUOUS QA
(registration)
DIVERSE distribution means
MINIMAL competition
CONTINUOUS QA
FREE PRICING (private)
1
MARKET NO regulation on mark-up
2 3 4
PROCUREMENT DISTRIBUTION DELIVERY
FUNDS
Pharmaceutical expenditure:
Per capita (PPP): US$ 109 (34.7% of Total Health Expenditure per Capita)
85.7% Privately financed
MoH
Develop Ceiling Price for
tender and negotiation.
Compile national estimation of
medicine needed (Rencana LKPP (e-Catalogue)
Kebutuhan Obat/RKO)
Approved
within 7 days
Pharmaceutical companies
e-Purchasing Wholesalers/Distributors
(Local and MNCs)
BPJS
Pharmacy
District Health Pharmacy Unit, Installation,
Office Puskesmas Public Hospital
Legend
Drug Order
Price Negotiation
Pharmacy Unit, Drug Distribution
Puskesmas Reimbursement
Consumers 15 of 31
Medicine Base Price for medicines not in e-Catalogue
Price, smallest unit (Rp)
No. Drug Name Packaging
Region 1 Region 2 Region 3 Region 4 Region 5
1 Tab. Ramipril 10mg Strip/Blister 1.013 1.064 1.165 1.216 1.266
Tab. Telmisartan
2 Strip/Blister 3.045 3.045 3.045 3.045 3.045
40mg
Tab. Telmisartan
3 Strip/Blister 5.409 5.409 5.409 5.409 5.409
80mg
4 Tab. Valsartan 80mg Strip/Blister 832 874 957 998 1.040
Wholesalers/Distributors
Wholesalers/Distributors
2 3 4
PROCUREMENT DISTRIBUTION DELIVERY
FUNDS
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Source: http://www.pom.go.id/new/view/direct/lwsispom
Philippines: Key Facts
GNI per capita (PPP): US$ 3580
Pharmaceutical expenditure:
Per capita (PPP): US$ 109.4 (33.3% of Total Health Expenditure per
Capita)
85% Privately financed
Pharmaceutical companies
Wholesalers/Distributors
(Local and MNCs)
Consumers
Legend
Drug Order and Circulation
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Supply System Performance: Philippines
STRICT PRE-REGISTRATION QA
NO COORDINATION between
LACK impact from pricing policies programmes and logistics
MINIMAL competition DELAY up to a few months
1 UNKNOWN frequency of site audits
MARKET LACK of public health pharmacist
function
2 3 4
PROCUREMENT DISTRIBUTION DELIVERY
FUNDS
Enablers Barriers
DIVERSIFY distribution LACK specialisation
means Provision
Reach remote places Regulation/Monitoring
Calculate costs based on
evidence LACK supervised dispensing
INTEGRATE logistics Safety compromised
management information LIMIT professional autonomy
system
Provide information
PROMOTE competition
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KEY MESSAGES
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Acknowledgements
Dr Eduardo Banzon
Dr Klara Tisocki
Dr Douglas Ball
Dr Soccoro Escalante
Interviewees
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