E-DRUG Subject: Bulk Purchase Schemes (BPS): Summary
Summarised Comments are:
1. Definition:
Several collaborative drug procurement processes could be described as
BPS and could include government-initiated-revolving-fund; pooled
procurement; NGO sponsored or managed, international sale (e.g. IDA
etc). The underlying philosophy in all appears to be equity of access to
quality essential drugs at a price the people can afford.
2. Published Information:
The Eastern Caribbean BPS is the best known and has offered to send
information for my MPH project. The Fiji BPS operates succesfully (and
even makes a profit) in Fiji and is offering collaboration for Small
Island States (SIS) within the Region. In sub-saharan Africa the
Association des Centrales d'Achat de Medicaments Essentials (and no
doubt others) is active in joint procurement. Annual reports and
financial statements in general, do not seem to be available due to
their confidentiality. There is a lack of readily accessible published
information which I hope my project will address. Could some of the
Chinese pharmacists with whom I discussed E-drug last year tell us
something about collaborative procurement in China?
3. Key Issues:
The solution seems to be professional procurement practices (what I call
infrastructure capacity building) as simply aggregrating the buying
process could produce an even less satisfactory outcome! It is
appropriate to analyse needs, and then to develop different strategies
in accordance with government policy or legislation. Identifiable
components (e.g. vaccines, intravenous infusions,
high-expense-low-demand products, anti-TB drugs) which address the local
need may present an appropriate focus for initial collaborative bulk
procurement, on a pilot basis.
4. Rational Drug Use (RDU)
BPS for anti-TB drugs utilise the WHO DOTS strategy to link procurement
with RDU. A limited essential list in itself can guide drug selection,
but no-one yet seems to have incorporated comprehensive information
sharing or academic detailing into existing BPS (whatever the type). For
those interested in evidence-based antihypertensive therapy (thanks
Peter) see http://www.camtech.net.au/malam/NZ/healthy.htm=20
5. Development Issues
The importance of grass roots development and stakeholder involvement
(rather than an imposed model) is emphasised.
Regards,
Murray
Murray Bailey
Pharmaceutical Development Consultant
Sydney, NSW, Australia
Tel/Fax: 61 2 9310 3365
Mobile: 61 414 310 338
Email: bailey_m@bigpond.com
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