Pharmaceutical Services Unit Essential Medicines Management Mo H

Pharmaceutical Services Unit Essential Medicines Management Mo. H Procurement of Essential Medicines Presented by Mildred Mulenga Pharmacist, Mo. H 1

Pharmaceutical Services Unit Essential Medicines Management Outline: �Objectives �Mo. H Budget for EMs �Procurement Cycle �Factors that influence medicines prices �Overview of Procurement Methods �Good Pharmaceutical Procurement Practices �Organization and Management of Procurement Unit 2

Pharmaceutical Services Unit Essential Medicines Management Objectives: �To present the Mo. H Medicines Budget �To describe the procurement cycle for EMs �To present an overview of Mo. H Procurement Systems 3

Pharmaceutical Services Unit Essential Medicines Management Introduction �Pharmaceutical procurement system is major determinant of availability and total health costs �GRZ Medicines budget is K 590 million (per capita ZMW 47. 20) � 18. 4 % of total GRZ Health budget 4

Pharmaceutical Services Unit, DCCDs National Essential Medicines Budget Objectives q ↑ availability and accessibility to all EMs and medical supplies in all health facilities 5

Pharmaceutical Services Unit, DCCDs National Essential Medicines Budget Key Strengths for 2013: q 112% ↑ increase of drug budget from ZMK 270 Billion (2012) to ZMK 594 billion q 248% ↑ for ARVs & 20% increase for EMs, TB, Laboratory, RHCs kits, vaccines, Cancer, Blood Products and 540% ↑ for medical supplies. q ZMK 120 Billion for ACTs 6

Pharmaceutical Services Unit, DCCDs 2013 Budget Key Issues: q ZMK 28 Billion for medical and surgical supplies still inadequate in view of the high cost centers of imaging, sutures, implants, and renal consumables q New products ACTs under GRZ budget need identification of reliable and consistent supply sources q Huge medicine budget require timely procurement processes to ↑ budget absorption rates and lead times ↓ 7

Pharmaceutical Services Unit, DCCDs 2013 Budget Key Implementation Plan Issues q Need for timely procurements of all supplies under Yellow Book q Regular review of EMLs to improve selection q Implement all supply chain strengthening activities to improve availability of Ems q Implement all rational use of medicines activities as planned 8

16. 1 19. 3 40 20 Blood Transfusion Commodities (↑ 20%) Medical and Surgical Supplies (↑ 540%) Cancer Drugs (↑ 20%) Laboratory Reagents (↑ 20%) Hospital Essential Medicines (↑ 20%) Anti-Retroviral Drugs (↑ 248%) ACTs (↑ 20%) Vaccines and Immunization Supplies Tuberculosis Drugs (↑ 20%) RH Commodities (↑ 20%) 0 28. 8 60 4. 5 80 10. 0 12. 0 140 5. 4 6. 5 120. 0 160 6. 2 7. 4 8. 9 25. 8 31. 0 50. 2 100 District Essential Medicines (↑ 20%) 2012 2013 76. 2 91. 5 120 78. 0 93. 6 2012/2013 National Medicines Budget 180 9

Pharmaceutical Services Unit, DCCDs 2012 National Essential Medicines Budget District Essential Medicines 28% Hospital Essential Medicines 27% Blood Transfusion Commodities 6% Medical and Surgical Supplies 2% Cancer Medicines 4% Laboratory Supplies 2% Reproductive Health Commodities ARVs 2% 18% TB Medicines 3% Vaccines ACTs 9% 0% 10

Pharmaceutical Services Unit, DCCDs Hospital Essential Medicines 15% District Essential Medicines 16% Cancer Medicines 2% Laboratory Supplies 1% Reproductive Health Commodities 1% TB Medicines 1% Vaccines 5% ACTs 20% Medical and Surgical Supplies 5% Blood Transfusion Commodities 3% 2013 National Essential Medicines Budget ARVs 29% 11

Pharmaceutical Services Unit Essential Medicines Management 2013 National ARV Drug Budget US$35 m , 25% US$45, 4 m 33% USG GF GRZ US$58, 3 m, 42% 12

Pharmaceutical Services Unit Essential Medicines Management Features of Effective Procurement Process �procure right medicines �high quality �lowest possible price �timely delivery �Transparent & written procedures �separation of key functions �Reliable payment & good financial management �Product quality assurance programme �Performance monitoring 13

Pharmaceutical Services Unit Essential Medicines Management Mo. H Procurement Cycle �Review medicines selection �Quantification �Reconcile needs and budget �Select procurement method �Locate and select suppliers �Specify contract terms �Monitor order status �Receive and check medicines �Effect payment �Distribute drugs �Collect consumption data 14

Pharmaceutical Services Unit Essential Medicines Management Factors influencing Drug Prices & Total costs �Unit Prices �Purchasing models �Visible & hidden costs 15

Pharmaceutical Services Unit Essential Medicines Management Overview of Procurement Methods �Open Tender (ICB or NCB) �Restricted Tender (closed/selective) �Competitive negotiations �Direct Procurement 16

Pharmaceutical Services Unit Essential Medicines Management Good Pharmaceutical Procurement Practices: �Procurement by Generic name �NEML �Bulky procurement �Formal supplier Qualification (screening) �Competitive procurement �Orders based on reliable needs �Reliable payments 17

Pharmaceutical Services Unit Essential Medicines Management Good Pharmaceutical Procurement Prices cont. �Transparency and written procedures �Separation of key functions �Production quality assurance (WHO certification & post marketing surveillance) �Monitoring (auditing systems in place) 18

Pharmaceutical Services Unit Essential Medicines Management Organisation and Management of Procurement System for EMs at Mo. H �Independent unit with Head PSU �Chief Procurement Officer, Pharmaceuticals 19

Pharmaceutical Services Unit Essential Medicines Management Responsibilities in the Procurement Process �PSU �ZPPA �MTCs (Medicines and Therapeutics Committees) 20

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