Medical supplies under state procurement have been delayed. The patient died. How to prevent this from happening again?
[ad_1]
Despite the war, last year’s procurement figures at SE “Medical Procurement of Ukraine” were among the best. At the same time, the delivery of medicines to the regions was unprecedentedly slow. Because of this, thousands of seriously ill patients who did not have access to the necessary treatment suffered. Medical procurement-2022: a spoonful of honey Last year, despite a very difficult time for our country, the mechanism for the purchase of drugs under managed access contracts became operational. He allowed the state to purchase innovative medicines at below-market prices, and this can be considered a real victory. In addition, in connection with the military aggression of Russia against Ukraine, the procurement of antiretroviral therapy, diagnostics of HIV infection, anti-tuberculosis drugs, diagnostics of tuberculosis, replacement supportive therapy was handed over to international donors. This relieved the state budget and helped many patients to get their medicine on time. In addition, SE “Medical Purchases of Ukraine” received humanitarian aid and was thus able to save about UAH 20 million. In total, last year, the state-owned enterprise “MZU” contracted medicines for UAH 4.8 billion (within the 22 areas analyzed by “Patients of Ukraine”). The amount of savings achieved by the state-owned enterprise on these purchases amounted to about UAH 693 million. Part of the money immediately went to cover the lack of funds for purchases due to the devaluation of the hryvnia (by 35% for 2022). The rest returned to the state budget according to the usual procedure for such cases. It was not possible to purchase only 4% of the proven amount of drugs or 31 items for the State Enterprise “MZU”. And this is the best indicator of the implementation of the procurement plan since the State Enterprise “MZU” began conducting centralized procurement. (Read more about the results of medical procurement in 2022 in the analytical report “Patients of Ukraine” at the link). A tub of tar. Why did the patients not receive their medicine on time? But buying medicine is only part of the job. You still need to get the goods and deliver them to medical facilities. And this was the biggest problem last year at SE “MZU”. Even when logistics chains destroyed by the war have already been repaired or new ones built. At the end of 2022, the most acute shortage of drugs was felt by patients with oncological diseases. In most cases, these were expensive drugs that needed to be taken regularly. “Patients of Ukraine” has repeatedly recorded patients’ complaints about the unavailability of state-guaranteed drugs in social networks and on our “Health Number” hotline. For example, the targeted drug Trastuzumab for the treatment of patients with breast cancer was supposed to be delivered to Ukraine in early November 2022. In fact, the medicine began to arrive in small portions to medical institutions only in January 2023. A similar situation was with the chemotherapy drugs Oxaliplatin, Paclitaxel and Capecitabine. Due to the lack of these vital drugs, patients had to postpone treatment for 3-6 months. In the treatment of oncology, these are catastrophic terms and sometimes incompatible with life. We also learned that one of the patients with a rare disease died because she could not get a vital medical product for the operation in time. Valentina suffered from torsion dystonia for the past 15 years. People with this disease are almost bedridden and 100% need outside help. In 2020, Valentina underwent surgery with a primary stimulation system, which actually got her back on her feet. In 2022, the neurosimulator in her brain was to be replaced with another one. However, due to disruptions in the supply of state medical procurement, Valentina never received the neurostimulator. The patient died at home, suffering from symptoms of the disease, which returned with even greater force… But let’s be honest: at the end of last year, there were almost no problems with the delivery of any goods to Ukraine. There were no empty shelves in stores, the assortment of pharmacies was almost not pre-war. And this is what we are saying about commercial deliveries, which were served at customs points in order of priority and without any preferences. And now let’s remember how Ukraine literally imported weapons from all over the world in the shortest possible time last year. On our side, there were no problems with delivery times. The state imported anything from any country – the main thing was only to find the necessary goods. And at that time, medicines for cancer patients were lying in warehouses in Poland, and the suppliers of SE “MZU” for some reason could not deliver them to Ukraine. And the neurostimulator for Valentina was lying at customs for months… How to solve the problem? In fact, the reason for the huge delays in the supply of medicines was not only that the suppliers did not fulfill their obligations conscientiously, and the managers of SE “MZU” did not control their work. Ukraine has learned how to effectively purchase medicines, but it still does not objectively know how to analyze the remains on the ground, control the terms of delivery to hospitals, and collect the really urgent need for medicines from the regions. More specifically: Regional health facilities are still submitting reduced drug requirements, although they should be submitting the true 100% requirement for the year. SE “MZU” and the Ministry of Health should work with them separately in this regard; It is still unclear how many leftover medicines and medical products there are in medical facilities in our country. Although SE “MZU” has an analytical tool MedData for this purpose, which could significantly simplify the analysis of the remains. Starting from the residues, it is possible to monitor the constant availability of medicines in hospitals; SE “MZU” still delivers medicines to hospitals too rarely, in some places – once a year, although the situation in the country is changing so quickly that in some places the need in one hospital increases several times literally in weeks, while in other medical facilities it completely disappears due to the occupation or destruction of hospitals; Well, in the end: as I wrote above, concluding a contract with a supplier is half the battle, you still need to make him deliver the goods on time. Of course, during the war, the logistics discipline of many companies can falter due to objective circumstances. But this is exactly what buyers should take into account and constantly monitor the execution of contracts. And it is better to set all deadlines – procurement, delivery and distribution of medicines – a couple of months earlier than they are used to. All this can be fixed. That is why our team, together with the patient community and the Ministry of Health, worked on the draft resolution of the CMU “On amendments to the Procedure for the use of funds provided for in the state budget to ensure the implementation of medical measures of individual state programs and complex measures of a programmatic nature.” Currently, this project of changes is being approved by relevant ministries and departments. If the Government supports the project of changes, then finally all the problems described above will be solved. And SE “MZU” will be able to report not only on effective purchases, but also on effective supplies of medicines. And thousands of Ukrainian lives will be saved. Inna Ivanenko, executive director of BF “Patients of Ukraine”, specially for UP. Life Publications in the “View” section are not editorial articles and reflect exclusively the author’s point of view.
[ad_2]
Original Source Link
