INTERNATIONAL AND KAZAKHSTAN EXPERIENCE OF UNIFIED DISTRIBUTION OF DRUGS
We are presenting to your attention a publication from a series of analytical reviews of the Single Distributor SK-Pharmacia LLP within the framework of the National Health of the Nation project.
The pandemic has shown how acute and urgent the issue of drug provision can become in emergencies, when certain drugs are suddenly required in large quantities. Healthcare is the second largest expenditure area for governments (over 9% of GDP). The level of drug safety of the country depends on how effectively the system of public procurement of drugs is built, the key factor of which is the continuity and sufficiency of drugs for all citizens, including in conditions of exponential demand. To reduce purchase prices in the world, various mechanisms are used: long-term contracts, direct negotiations with manufacturers, risk-sharing, centralized / joint purchases – all of them can be considered as promising tools for modernizing the existing system of public procurement and drug supply.
One of the most important tools for the prevention of shortages can be a transition to a centralized procurement system, which should facilitate the planning and interregional distribution of medicines according to needs, strengthen the negotiating position of the state in matters of price reduction and increase the coverage of patients by the state.
Global procurement initiatives World procurement practice shows that centralized procurement as an important social function in the world is carried out, as a rule, by organizations that are part of or associated with authorized bodies in the field of health care. In Argentina, India, New Zealand, Estonia, centralized procurement at the state level is carried out by the Ministry of Health.
In reference models, similar to those of the Republic of Kazakhstan in a number of important criteria, centralized procurement is carried out by state structures or procurement agencies subordinate to state structures. In Australia, centralized procurement of medicines is carried out by the Purchasing Agency under the Australian Health Authority;
in Denmark, by the Procurement Agency, subordinate to regional authorities, like Norway;
in Serbia, by the National Compulsory Health Insurance Fund, which is subordinate to the state;
in Saudi Arabia – by the Purchasing Agency, financed from the state budget and the profit generated by the agency due to the mark-up on drugs;
In the United States, the pharmaceutical distributors that are the leaders in the world wholesale – McKesson, AmerisourceBergen and Cardinal Health have consolidated more than 90% of the sales of the American market and about 45% of the sales of all pharmaceutical products in the world.