PHP6 - Evaltuation of The National Drug Formularium and Electronic Catalog For The Indonesian UHC

Abstract

Indonesia has been using social health insurance scheme since 1968 limited to civil servants and then to small portion of private employees since 1993. In January 2014, the expansion to cover all people by establishing a single payer, the National Health Insurance Corporation, was started. By March 2017, the universal health coverage (UHC) covers 174 million people, making it are the largest single payer in the World. In addition, it is also the largest scheme applying capitation payment to primary health care and diagnosis related groups for outpatients and inpatients care nationwide. OBJECTIVES. To ensure medically necessary drugs are delivered to the members, the National Drug Formularies and the E-Catalog are developed. The E-catalog is the fair competitive public procurements for drugs. The main goal of the UHC is to ensure equitable access and all people can get the essential drugs. In this study, we evaluate how far the essential drugs are accessible. METHODS. To evaluate how far the UHC ensure no out of pocket for drug expenses, we conducted evaluation of procurement and disbursement system of essential drugs. We applied mixed methods of qualitative and quantitative studies. We evaluate trend of procurements of generic and non generic drugs by hospitals via e-catalog. Over four-year e-catalog, the proportion of branded drugs increased as the UHC prudently increased branded drugs to ensure the UCH budget is adequate. Of 422 people surveyed, 31% still paid out of pocket in hospitals and 10% paid out of pocket in primary care. The E-catalog is good method to ensure equity, however improvements are needed to ensure essential drugs are delivered to patients in needs.