The new outsourcing model of outpatient pharmacies of public hospitals in Ecuador it will begin, in its first stage, at the end of this month, the Ministry of Public Health (MSP) has assured. This plan will consist of patients who go to the outpatient clinic –after receiving medical care– will receive the indications of their medications through an electronic prescription. With this document they can go to any private pharmacy to pick up all prescription medicines for free.
The first phase will start at the end of March 2022 and will be carried out in six hospitals: Eugenio Espejo and Luz Elena Arismendi, in Quito; Abel Gilbert Pontón and General Monte Sinai, in Guayaquil; Specialties from Portoviejo, and the Vicente Corral Moscoso (in Cuenca). Although the private sector has affirmed that this system is a correct step to end shortages and corruption, Miguel Palacios, executive director of the Association of Pharmaceutical Laboratories of Ecuador (ALFE), tells EL UNIVERSO that the times that the Government manages to implement outsourcing would not be adequate.
Another point that generates debate is the guarantee that must be given for payment to private pharmacies. Palacios adds that they have not been considered for the construction of the model despite the fact that the MSP has assured that it has spoken with “all” the market players.
The Government has announced the outsourcing of outpatient pharmacies in public hospitals. He states that this will improve customer service and prevent corruption. What are the objections you find in this proposal?
The national pharmaceutical industry represented by ALFE is concerned about the time that this implementation of pharmacy outsourcing could take, which is definitely a step in the right direction by the Ecuadorian State to resolve the issue of medicines.
We are aware of the legal and operational framework surrounding the project and we believe that in reality, in order to supply public network pharmacies, the products that are going to supply them need to be duly cataloged and to be the subject of winning results from the corporate reverse auction. , which is, in the current legal framework of public procurement, the way in which the State should acquire medicines.
In addition, we are concerned that as national manufacturers we have not been involved in the construction of the model, our main interest has been to cooperate with the State.
One of the challenges to this system is that it has not been well evaluated and does not have sufficient supply and demand data, although the Government affirms that they will start with a pilot in certain hospitals to make the necessary adjustments. What is the indicated or recommended time to implement a system like the one proposed?
Based on our knowledge and the experience we have managing the distribution and sale of drug products from private pharmacies, we believe that it takes six to nine months to be able to implement all the systems, all the integration of the system that may exist between the databases of the public health network of the different hospitals with the logistics operators, with us the manufacturers and the dispensers of the pharmacies.
There are different systems that must be integrated, including the electronic prescription proposed by the Government, which is nothing more than being able to digitally manage information that can be integrated into the patient’s clinical history and that additionally justifies the reason why it is prescribed through this medical history and that it quickly becomes the document that validates it and that certifies that the patient can go to any of the pharmacies and prove it.
Vice President Alfredo Borrero: The Government is going to implement drastic measures in the health sector
As we can see, there is an entire issue of awarding the product for public purchase, there is a system integration issue, there is a training issue that takes us between six and nine months.
Users, in general, have always complained about the lack of medicines in public hospitals and that they have to buy everything outside. In theory, if private pharmacies assume the delivery of these medicines, the supply problem would be solved, the Government has said. Would it really be like that?
If the outsourcing program is done properly, of course it will solve the stockout problem. What the State has bought through the outsourcing system, what it does is only make it available to private pharmacies in such a way that the different users of the public network can access that medicine.
However, for this to work like this, the State must have guaranteed a process of purchasing the products that are effectively cataloged to enter that distribution channel, it is not just any medicine, nor any brand, they are medicines that, having been catalogued, winners in the corporate reverse auction, the different pharmacies may be involved in this, and the distributors and producers must guarantee the presence of that drug.
We believe that a pharmacy outsourcing system with the clinical life history of patients should be implemented, the national pharmaceutical industry agrees. This process is going in the right direction and in this sense we have put ourselves at the orders to cooperate. What worries us is that the times that the Government has said are not what will be required and that there are some mechanisms that must be implemented, for example, the payment mechanism for pharmaceutical producers.
Payment to private hospitals by the Government for referring patients has always been a problem. The health houses complain of delays for millions of dollars. What is needed so that this is not replicated in the pharmacy outsourcing process?
We need an agile system that can group all the invoices that are going to be generated from the sale of the different pharmacies. Probably in a single monthly invoice and that the payment is prompt, since it is a relatively expensive process of distribution of medicines that we have and the companies require that repayment to continue operating and maintain their working capital.
These are the hospitals of the Ministry of Health where the new medicine supply model through private pharmacies will begin
We have proposed a scheme for a trust and some other elements that must be built in the system. In all cases, it must be made clear that we are in favor of this outsourcing and that we believe it is a step in the right direction.
How to avoid acts of corruption in the signing of agreements with pharmacies, duplicity and forgery of prescriptions or in the costs of medicines that would be sold to the State through this new mechanism?
The system itself favors control over the dispensing of medicines through external pharmacies, private pharmacies, because the electronic prescription is linked to a history of what the patient may require, a diagnosis from a clinical history, which justifies what an electronic prescription has been issued and that justifies that the pharmacy has delivered and that the State ends up paying.
Being able to automate, making this much more controllable, even the system itself is going to produce statistics and public purchasing is going to be rationalized there, it will be clear what the State is actually buying and what patients who have a justification are needing of a medical diagnosis and a database that can be easily audited, which will allow controls.
The State would only pay what was actually prescribed and someone withdrew. The issue is greatly improved because there is no longer a problem of failures in the estimation of demand that we currently have. Today the State makes a macro-purchase at an auction and there may be medications that were not used, were not sold, excess of some medications and lack of others. This is a problem that has been repeated historically. (I)
Source: Eluniverso
Paul is a talented author and journalist with a passion for entertainment and general news. He currently works as a writer at the 247 News Agency, where he has established herself as a respected voice in the industry.
