Drug Procurement System Research Articles

Analysis and discussion on the pharmaceutical centralized procurement implementation - a case study of a large provincial hospital in China.

Unaffordable medical treatment and inflated drug prices have become a challenging issue for lawmakers worldwide. To reduce the financial burden and standardize the pharmaceutical market, the Chinese government has issued several detailed regulations, including the measures of drug recruitment and procurement in one and volume purchasing to not only ensure the high quality of approved drugs but also lower the cost of the production and sell procedure. In this work, to have a thorough overview of the enforcement of these regulations, we attempted to critically analyze the data of our hospital's centralized procurement of drugs from 2019 to 2022. We identified some concerns, such as the difficulty in determining the "quantity" of drug procurement, out-of-stock of collectively procured drugs, difficulty in managing the preallocation of associated funds, incomplete centralized procurement systems, etc. Therefore, it is essential to promote a multidimensional strategy, including the combination of the medical insurance reform and drug centralized procurement policies, strict controlling of the forecast quantity of drugs to ensure stable drug supply, improvement of the relevant policies for retaining the surplus of centralized procurement drug medical insurance funds, secureness of the drug procurement system platform, and available reference and guidance for subsequent centralized quantity procurement of drugs.

Policy Change in the Context of Multiple–Streams Theory–Take China’s Centralized Drug Procurement Policy as an Example

As an important theory of policy process analysis, multiple–streams theory provides a highly explanatory analytical framework and perspective for exploring the dynamics of policy change. This paper uses multiple–streams theory to analyze the history of china’s drug procurement policy changes, found that the china’s drug procurement policy has gone through four development stages. Each change in drug procurement policy is due to a particular problem that is highlighted, focal issues enter the policy agenda when problem streams, policy streams and politics streams are highly coupled and the issue window opens, then the policy changes. This paper provides an outlook on the key directions of china’s drug procurement policy, in order to provide useful reference for the study of multiple–streams theory and the study of china’s drug procurement system.

PERANCANGAN SISTEM INFORMASI PERSEDIAAN OBAT BERBASIS WEB PADA APOTEK BANTARJAYA BEKASI

Based on the results of researchers' observations of the Bantarjaya Pharmacy, especially the drug procurement system, this research was carried out. The drug procurement process at the Bantarjaya Pharmacy is currently out of control and faces various challenges. Among them, there are often inconsistencies between recorded drug data and drugs that are actually available, and reports are still made manually, so that data recording becomes incorrect and ineffective. Expired but not easily identifiable drugs is another problem that often arises. The researcher came to the conclusion that the Bantarjaya Pharmacy needed a good drug supply system to make it easier for officers to collect drug data, both incoming and outgoing, as well as for stock verification. The waterfall method, data collection techniques, observations, interviews, and literature studies are used in the design of this drug supply information system. The design of a computerized drug supply information system can be an ideal way to overcome the problems that exist at the Bantarjaya Pharmacy which used to still use a manual approach. Because Bantarjaya Pharmacy can operate more effectively and efficiently if there is a computerized system.

Pattern Analysis of Drug Procurement System With FP-Growth Algorithm

The Medan Marelan Health Center is one of the health centers in the city of Medan. The supply of medicines is considered necessary so that these medicines can still be available at any time with various types and functions. In order not to experience difficulties in distributing medicines and anticipating the supply of medicines in the Puskesmas, research was carried out using the Data Mining method. In this study, a test will be carried out on the Association Rule which is used as a solution to problems with the pattern of the drug procurement system, and will display information about the value of support and confidence from each Data Mining process. Tests in this study using Weka Software to determine the procurement of drugs that are often needed. Information obtained from the stages of the FP-Growth Algorithm is to produce patterns in the procurement of medicines, and an itemset combination pattern has been formed using the FP-Growth Algorithm method so that the results of this study can be used in drug supply effectively and efficiently.

Analysis of e-catalogue drug prices in the era of Universal Health Coverage in the Indonesian pharmaceutical industry

Context: Since the implementation of the Universal Health Coverage (UHC) policy in Indonesia, the drug procurement system has changed to using the e-catalogue system. The impact of this policy change on the pharmaceutical industry in Indonesia is unclear and has not been widely studied. Objectives: This study analyzes the impact of the UHC policy on drug pricing by the pharmaceutical industry in Indonesia. Methods: This study collects data from 3 pharmaceutical industries that won the e-catalogue drug tender. Data on drug prices produced by these 3 industries in 2013 were taken from the Drug Price Ceiling List, while drug prices in 2015 and 2018 were obtained from the e-catalogue drug list. The drug price data is compared from year to year to see the trend of change and the magnitude of the change. Data were analyzed using a price index calculation adapted from the concept of Median Price Ratio (MRP) calculation to compare drug prices in 2013 with drug prices per each region in 2015 and 2018 in the Microsoft Excel Office application as a measuring tool. Results: There was a change in drug prices from the era before UHC (in 2013) and after the UHC era (in 2015 and 2018). There are drugs that have increased in price and some have decreased in price. The price increase ranged from 0.01–6.15 in 2015 and 0.01–6.46 in 2018. The price decrease ranged between 0.04–0.75 in 2015 and 0.01–0.83 in 2018. Conclusion: Drug prices from before the UHC era (2013 and 2015) to after UHC (in 2018) experienced a change in the form of an increase or decrease in price.

Risks in the Drug Procurement System: Current Issues

The public procurement segment is one of the components of the pharmaceutical market in Russia. Procurement of medicines and medical devices is the top sector of public procurement, both in terms of their number and the amount of contracts concluded. The procedure for concluding state contracts itself is spelled out in sufficient detail in the regulatory documents, but, despite this, risks may arise when concluding a state contract both for a potential applicant for a state order and for a state customer. The purpose of the study is to determine the possible risks when concluding a state contract of a healthcare institution for medicines and medical devices and ways to reduce them.

Trend Price Analysis of Drug Before and After the Implementation of E-catalogue at the Hospital

In 2013, Ministry of Health, Republic of Indonesia, launched a new change to drug procurement system, namely e-catalogue, to ensure the availability and affordability of medicines. This system replaces the previous auction drug procurement system. The purpose of the change into e-catalogue system is to facilitate the drug procurement in hospitals without the need to conduct complex negotiation with producers, to reduce the occurrence of mark-ups or inflating drug prices, to equalize drug prices, to support BPJS (Badan Penyelenggara Jaminan Sosial) activities, and to prevent difficulties in drug distribution in all regions in Indonesia. This study aims to get an overview and magnitude of the impact of e-catalogue application on changes in the price of drugs registered and not registered in e-catalogue at Jakarta Islamic Hospital Cempaka Putih. This research is a longitudinal time series study. The data collection was conducted retrospectively in the period of 2011-2015 taken from procurement data, purchase invoices, and e-catalogue prices from hospital pharmacy installation, which were then categorized based on similar drugs in the hospital. The result shows a decrease in the price of drugs on both e-catalogue drugs (generic, trade names and patents) and non e-catalogue drugs (generic, trade names). On the class of therapy, the biggest price reduction occurred in e-catalogue medicine, such as in antineoplastics, intravenous solution, diabetes, Anti-ashma & COPD, and psycholeptics therapy. Meanwhile, on the category of non e-catalogue, price reduction occurred in systemic antibacterials, antineoplastics, analgesics, cardiac theraphy, and A-acis A-flat A Ulcerants therapy. The magnitude of drug prices reduction ranges from 1% to more than 90% both on e-catalogue drugs and non e-catalogue drugs. On the e-catalogue drugs, the highest price reduction (82.36%) occurred in generic and patent drugs, while on non e-catalogue drugs, reduction occurred in drugs with trade names. The price reduction trend in drug prices based on both type of drugs and therapy class shows a significant decrease in drug prices in the period after the implementation of e-catalogue at Jakarta Islamic Hospital in Cempaka Putih, with a decrease of more than 80%.

Engaging Actors for Integrating Health Policy and Systems Research into Policy Making: Case Study from Haryana State in India

Background & objective: Good examples of evidence generation using Health Policy and Systems Research (HPSR) in low and middle income countries (LMIC); and its application in policy making are scarce. In this paper, we describe the experience of establishing a system of HPSR from the Haryana state in India, outline how the HPSR is being utilized for policy making and programmatic decision making, and analyse the key factors which have been critical to the implementation and uptake of HPSR.
 Methods: Multiple methods are employed in this case study, ranging from unstructured in-depth interviews, review of the program and policy documents, and participatory notes from the meetings. The steps towards creation of a knowledge partnership between stakeholders are outlined. Four case studies i.e. development of a plan for universal health care (UHC), nutrition policy, centralized drug procurement system and use of RAPID appraisal method highlight the use of research evidence in agenda setting, policy formulation and policy implementation respectively.
 Results: Our analysis shows that the most important factor which contributed to Haryana model of HPSR was the presence of a dedicated and motivated team in National Rural Health Mission (NRHM) at state level, many of whom were researchers by previous training. Overall, we conclude by highlighting the need for establishing an institutional mechanism at Central and State level where health service administrators and managers, academicians and researchers working in the field of health system from medical colleges, public health schools, management and technology institutions and social science universities can identify health system research priorities. Increased budgetary allocation for HPSR is required.

A cross-sectional survey of the models in Bihar and Tamil Nadu, India for pooled procurement of medicines.

In India, access to medicine in the public sector is significantly affected by the efficiency of the drug procurement system and allied processes and policies. This study was conducted in two socioeconomically different states: Bihar and Tamil Nadu. Both have a pooled procurement system for drugs but follow different models. In Bihar, the volumes of medicines required are pooled at the state level and rate contracted (an open tender process invites bidders to quote for the lowest rate for the list of medicines), while actual invoicing and payment are done at district level. In Tamil Nadu, medicine quantities are also pooled at state level but payments are also processed at state level upon receipt of laboratory quality-assurance reports on the medicines. In this cross-sectional survey, a range of financial and non-financial data related to procurement and distribution of medicine, such as budget documents, annual reports, tender documents, details of orders issued, passbook details and policy and guidelines for procurement were analysed. In addition, a so-called ABC analysis of the procurement data was done to to identify high-value medicines. It was observed that Tamil Nadu had suppliers for 100% of the drugs on their procurement list at the end of the procurement processes in 2006, 2007 and 2008, whereas Bihar's procurement agency was only able to get suppliers for 56%, 59% and 38% of drugs during the same period. Further, it was observed that Bihar's system was fuelling irrational procurement; for example, fluconazole (antifungal) alone was consuming 23.4% of the state's drug budget and was being procured by around 34% of the districts during 2008-2009. Also, the ratios of procurement prices for Bihar compared with Tamil Nadu were in the range of 1.01 to 22.50. For 50% of the analysed drugs, the price ratio was more than 2, that is, Bihar's procurement system was procuring the same medicines at more than twice the prices paid by Tamil Nadu. Centralized, automated pooled procurement models like that of Tamil Nadu are key to achieving the best procurement prices and highest possible access to medicines.

The Politics of Drug Price Control Policy in China: Regulation, Deregulation and Re-regulation

This study examines how the dynamic interaction of institutions, interests and ideas has shaped the drug price control policy in China over time. It argues that since the 1980s, the common interests of drug manufacturers, drug wholesalers, hospitals and doctors to seek profits have driven them to collude together, thereby making the drug price control policy ineffective. In order to stop collusion between these parties and reduce drug prices, this study suggests that the government should implement drug price control policy in coordination with other health care reforms. Health care reforms include implementing the zero-markup policy for drugs at hospitals, improving the remuneration system of doctors, improving the transparency and openness of centralized drug procurement system, cracking down on commercial bribery and rooting out malpractice in the pharmaceutical industry and hospitals. This study provides the most updated information about high drug prices and drug price control policy in China.

Planning for Chronic Disease Medications in Disaster: Perspectives From Patients, Physicians, Pharmacists, and Insurers

Recent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves. A mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers. Most prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients' resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients' medication continuity during a disaster. To strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders.

Interactions between Global Health Initiatives and Country Health Systems: The Case of a Neglected Tropical Diseases Control Program in Mali

BackgroundRecently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc.. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007.Methods and FindingsCampaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local health systems. The campaign budget barely financed institutional strengthening. Finally, though the initiative rested at least partially on national structures, pressures to absorb donated drugs and reach short-term coverage results contributed to distract energies away from other priorities, including overall health systems strengthening.ConclusionsOur study indicates that positive synergies between disease specific interventions and nontargeted health services are more likely to occur in robust health services and systems. Disease-specific interventions implemented as parallel activities in fragile health services may further weaken their responsiveness to community needs, especially when several GHIs operate simultaneously. Health system strengthening will not result from the sum of selective global interventions but requires a comprehensive approach.

Rules & Regulations

Australia Divided Over Cloning. China Implementing Hospital Drug Procurement System. Therapeutic Cloning Only.