THE PRESIDENT OF THE COUNTRY INSTRUCTED:
Order of the President given at the extended meeting of the Government of 10.07.2021
“It may be necessary to centralize the purchase of medical equipment, following the example of the purchase of medicines by SK-Pharmacy. An alternative to centralized procurement may be some form of government regulation. We have to delve into this issue, study international experience and offer a transparent, efficient mechanism for the purchase of medical equipment.”
Message of the President to the people of Kazakhstan dated 09/01/2021
“We should intensify cooperation with global pharmaceutical corporations. It is important to attract investors, to ensure the transfer of technologies and the latest developments. It is necessary to expand the scope and range of off-take contracts with domestic producers. The share of medicines and medical products of domestic production must be increased
from the existing 17% to 50% as early as 2025.”
https://www.akorda.kz/ru/poslanie-glavy-gosudarstva-kasym-zhomarta-tokaeva-narodu-kazahstana-183048
Order of the President given at the expanded meeting of the Government of 08.02.2022
“It is necessary to radically revise the system of procurement of medical equipment - this is also a big problem. Since this area is highly corruptogenic. Regions systemically overestimate estimates and prices for equipment. A lot of money is spent on its maintenance. Therefore, I instruct the government to switch to a centralized purchase of medical equipment on the basis of SK-Pharmacy LLP.
THE PRESIDENTIAL ADMINISTRATION ISSUED No. 61-16 / 7947-2PAB dated April 22, 2022:
In accordance with the instruction of the Administration of the President of the Republic of Kazakhstan on the centralization of the purchase of medical equipment using the mechanism of life cycle contracts (conclusion of direct contracts, LCC, optimization of equipment standards, unification of technical specifications for the purchase of medical equipment, use of leasing mechanisms, localization of production of equipment in the Republic of Kazakhstan, etc.) to strengthen the coordination of work on the launch of a centralized purchase of medical equipment on the basis of the Single Distributor, including the issue of providing service support for medical equipment.
THE GOVERNMENT IS COMMITTED TO:
Meeting of the Investment Headquarters chaired by the Prime Minister of the Republic of Kazakhstan dated 10.09.2022
"To the Ministry of Health in the established
legislation to work out the issue of approval
Republican Program for Equipping Medical Equipment for the Next 5 Years with the Definition of Funding Sources.
https://www.primeminister.kz/ru/news/alihan-smailov-provel-zasedanie-investicionnogo-shtaba-1085837
PROGRESS AND RESULTS
In accordance with the instructions of the President, a vector was set for the transition to a centralized purchase of medical equipment based on SK-Pharmacy. An important step dictated by the economic interests of the country, as well as maintaining the level of a quality healthcare and social security system.
Current problematic issues in the field of equipping medical equipment:
SYSTEM OF CENTRALIZED PROCUREMENT OF ME
The centralization of the purchase of medical equipment is carried out in two stages. Currently, the need for medical equipment in the regions has been updated in accordance with the current program documents of the Ministry of Health of the Republic of Kazakhstan.
In the future, a Comprehensive plan for equipping the Republic of Kazakhstan with medical equipment for 2023-2027 will be approved with the identification of funding sources, which includes the use of leasing mechanisms for the purchase of medical equipment.
In general, the procedure for conducting a centralized procurement of medical equipment requires a phased preparation and an integrated approach. If we dwell in more detail at each stage, then first of all, medical organizations need to submit an application to the National Center for Expertise of Medicines and Medical Devices in order to obtain an expert opinion on the compliance of the characteristics of the technical specification for the purchase of medical equipment with at least two models from different manufacturers, with the exception of the purchase of medical equipment that has no registered analogues in Kazakhstan, which is confirmed by an expert organization.
Medical organizations purchase medical equipment worth more than 20 million tenge per unit by submitting an application to a single distributor through the information system of a single distributor in the form approved by the Ministry of Health of the Republic of Kazakhstan. After that, a tender is played on the web portal.
Based on the results of the tender, based on the protocol of results and negotiations to reduce the price of the contract between SK-Pharmacia and the supplier, a contract for the supply of medical equipment is concluded between the medical organization and the winner of the tender.
A report on each step of the process is sent to the Ministry of Health of the Republic of Kazakhstan, and SK-Pharmacia also carefully monitors the supply of medical equipment and compliance with the terms of the tender.
The mission of each participant - a medical organization, NCEMMD, SK-Pharmacy and a supplier - is full of responsibility and plays an important role in the procedure for purchasing medical equipment.
ACTIVITIES OF THE STAGE I
In order to switch to the centralization of the procurement of medical equipment, extensive measures were taken to improve and improve business processes and the procurement system as a whole, aimed at transparency, anti-corruption, and an increase in the level of procurement functioning, which will ultimately have a positive effect on the quality, competitiveness of suppliers and attract new players through expansion of the competitive environment. The issues of centralization of the purchase of medical equipment were discussed with the medical and expert communities, regions, and analytical material was released.
WORLD BENCHMARKING
In order to create favorable conditions for equipping medical institutions with modern diagnostic and treatment-and-prophylactic equipment, the world practice for the procurement of medical equipment, including centralized ones, has been analyzed.
Thus, the experience of advanced countries, in particular the United States, Malaysia, the United Arab Emirates, Korea, Australia, the countries of the European Union, Japan, as well as procurement on the terms of life cycle contracts (LCC) and the experience of localizing the production of medical equipment on the example of General Electric, Philips in RF.
As part of the centralization of the purchase of medical equipment, the production sites of domestic manufacturers of medical equipment were visited: Kazmedpribor, KazMedAspap, Aktyubrentgen, Aselsan. Their potential for localization has been studied.
LEGISLATIVE ASPECTS
A regulatory framework has been prepared for organizing a centralized purchase of medical equipment worth over 20 million tenge. Thus, amendments to the Rules for the organization and conduct of procurement, an order regulating the procedure for analyzing the technical specification for compliance with at least two models of medical equipment, an order providing for the approval of standard forms for procurement were approved.
FORMATION OF THE COMPOSITION OF EXPERTS
In order to provide potential suppliers with equal opportunities to participate in the procurement procedure, to ensure publicity and transparency of the procurement process, a procedure was carried out for collecting and registering experts on the procurement web portal of CEF JSC.
The experts analyze the compliance of the technical specification proposed by the potential supplier of the medical product in the advertisement. The total number of experts is more than 200 people.
IT INFRASTRUCTURE
Prepared IT infrastructure for the procurement of medical equipment. Thus, on the basis of SK-Pharmacy, a module for receiving applications for the purchase of medical equipment in the Unified Pharmaceutical Information System (UPIS) was developed. Moreover, it should be noted that this portal is synchronized with the procurement web portal of the Center for Electronic Finance JSC (CEF), which ensures the exclusion of paper-based procedures and the “human factor”. Demonstration to the regions, and registration of users.
START PURCHASING
Since August 2022, centralized procurement procedures have been launched on the basis of SK-Pharmacy, under which 16 tenders have been announced, as well as 6 repeated purchases for the purchase of 221 units. medical equipment, in the amount of 26.4 billion tenge.
177 units of medical equipment were purchased: the allocated amount for the purchase of medical equipment is 23.2 billion tenge.
As a result of the auction, the savings amounted to 3.1 billion tenge, which is an average of 14% (for individual lots, the savings amounted to 81% (bacteriological analyzer).
Covered 13 regions and 2 cities of republican significance. As an effect of the centralization of the purchase of medical equipment, an average of 3 potential suppliers took part in an open tender for one lot. And the duration of the automatic auction ranged from 2.5 to 14 hours.
TRAINING FOR SPECIALISTS
Based on the proposals for improvement, specific measures were taken, namely, training courses were organized and conducted for employees of medical organizations and health departments of the regions.
Training is conducted on the basis of the RSE on REM "National Scientific Center for Health Development" of the Ministry of Health of the Republic of Kazakhstan with the involvement of specialists from the National Center for Healthcare, the Ministry of Health of the Republic of Kazakhstan, the National Scientific Center for Health and Health and the SC-Pharmacy as lecturers.
The courses cover all aspects related to the purchase of medical equipment within the framework of the SOBMP and the OSMI system, from planning to filing applications for the centralized purchase of medical equipment through the unified pharmaceutical system of SK-Pharmacy. The first graduation of students of this course was carried out in December 2022, four training cycles are planned for the current year.
In addition, work is underway to develop a standardized technical specification in order to implement a uniform policy for the purchase of equipment, and experts from the regions who have completed the specified course are also involved in this work.
DRAFT SPECIFICATION TEMPLATES
A single distributor has developed a draft of technical specifications templates for use in the preparation of technical specifications by customers, which are further proposed to be used as methodological recommendations in the development of technical specifications.
Earlier, the Department of Drug Policy of the Ministry of Health of the Republic of Kazakhstan sent templates-questionnaires of standard technical specifications to the regional health departments and republican health organizations to fill in the necessary parameters of medical equipment. The data received from the regions in the context of medical equipment have been summarized and are currently sent for consideration to the NCEMMI and NRCHCD for expert study.
Subsequently, the developed templates will allow for the correct development of technical specifications for the purchase of medical equipment and the fulfillment of the established volume of medical care for medical organizations, taking into account the level of medical care and functional orientation, which would further standardize the equipment of healthcare organizations.
IMPROVING WORK WITH NCEMMI
To date, the issue of creating a methodological guide / template is being worked out with the National Center for Expertise of Medicines and Medical Devices, which will allow customers to correctly prepare technical specifications in accordance with their needs and the functional purpose of medical equipment.
In addition, as part of the preparation of expert opinions for the implementation of a centralized purchase of medical equipment, meetings are regularly held with the participation of the Ministry of Health, regional health departments, NCELSiMI, and SK-Pharmacy.
This work is carried out in order to exclude poor-quality preparation of technical specifications for the purchase of medical equipment, which in some cases is due to insufficient qualifications of representatives of medical organizations in terms of preparing this documentation.
The exclusion of poor-quality preparation of technical specifications is also due to the lack of relevant information in the public domain, in particular, instructions for the operation of registered medical equipment on the NCEMMI website. In this direction, NCEMMI is also carrying out relevant work.
IMPROVEMENT OF NLA
Currently, work is underway to amend the Decree of the Government of the Republic of Kazakhstan No. 375. In particular, the proposed changes include the direct conclusion of long-term supply contracts with a potential supplier that manufactures medical equipment, without conducting competitive procedures, if domestic producers have the necessary documents ( RU, ST-KZ, ISO 13485).
The introduction of a method of purchasing medical equipment with an extended service life is also being considered, in which the purchase will be carried out with the obligation of technical support by the supplier throughout the entire period of operation.
It is planned to purchase the following types of medical equipment using this method: a computer tomograph, a magnetic resonance tomograph, angiograph, a positron emission tomograph, an automated biochemical analyzer with a capacity of at least 1000 tests per hour, an automated immunochemical analyzer with a capacity of at least 300 tests per hour and an automated analyzer polymerase chain reaction with a capacity of at least 500 tests per day.
In addition, a rule is being introduced regarding the submission of applications for the centralized purchase of medical equipment to the Single Distributor. This sets the deadline for submission of applications by medical organizations - August 1.
This, in turn, will ensure sufficient time for the delivery and installation of medical equipment until the end of the financial year.
It will also ensure the participation of a wide range of potential suppliers, since due to the existing global shortages in the production of semiconductors and other electronic components, the production time of medical equipment is lengthening.
In addition, there is a lengthening of logistics chains, which also affects the delivery time of medical equipment.
ACTIVITIES OF THE STAGE II
COMPREHENSIVE PLAN FOR 2023-2027
To implement the second stage of centralization of the procurement of medical equipment, which includes procurement mechanisms on the terms of localization / contract manufacturing, contracts for the life cycle of medical equipment, a draft Comprehensive plan for equipping the medical equipment of the Republic of Kazakhstan for 2023-2027 has been prepared, which is currently undergoing the approval procedure by state and local executive bodies of the republic.
On behalf of the Government and the Administration of the President of the Republic of Kazakhstan, a set of needs for medical equipment for the next 5 years has been formed, taking into account the available medical equipment in healthcare organizations, the requirements of minimum equipment standards, as well as long-term plans for the development of medical organizations.
The formation of the Comprehensive Equipment Plan is carried out by comparing the available medical equipment with the minimum standards for equipping healthcare organizations, taking into account the planned write-off in accordance with the depreciation rates for fixed assets.
SOURCES OF FINANCING
In order to develop strategic approaches to equipping medical equipment and identifying sources of funding within the framework of ongoing activities to develop leasing mechanisms, a Memorandum of Understanding and Cooperation was signed between SK-Pharmacia and the Industrial Development Fund on the issue of financing the equipping of medical equipment, including projects in mechanical engineering (production of medical equipment).
In this regard, in order to support domestic producers, appropriate work is being carried out to amend the Decree of the Government of the Republic of Kazakhstan No. 846 "The concept of industrial and innovative development of the Republic of Kazakhstan for 2021-2025" indicating the terms of financing through the tools of JSC "Industrial Development Fund". This measure will stimulate the localization of foreign-made equipment, the transfer of technologies and the latest developments, as well as attract foreign investment.
In general, in order to prepare for the second stage of the centralized procurement, a set of requirements for medical equipment for 5 years was formed, a preliminary amount for equipping medical equipment for 5 years was determined in the amount of 507 billion tenge. Of these, 289 billion is allocated within the local budget, in accordance with Law No. 161-VII and the Healthy Nation National Project, as well as the National Rural Healthcare Modernization Project.
At the same time, there is a need for additional sources of financing in the amount of 217 billion tenge, which is planned to be covered from the republican and local budgets, not prohibited by the legislation of the Republic of Kazakhstan (leasing, commodity credit, PPP).
TECHNOLOGY TRANSFER
The President of the country has repeatedly noted the importance of attracting investors, ensuring the transfer of technologies and the latest developments to the industry. In pursuance of the instructions of the Head of State for the development of the pharmaceutical industry in Kazakhstan, the Single Distributor holds meetings with major players in the global pharmaceutical industry, during which their long-term plans for presence in the Kazakh pharmaceutical market and investment in the industry are discussed.
The transfer of the latest technologies to Kazakhstan will create a culture of transferring new technological competencies, producing export-oriented products, creating innovative industrial sectors, among which the pharmaceutical industry is one of the key ones.
To date, a number of meetings have been held with large companies to exchange experience in the field of the latest technologies: the German industrial association of optical, medical and mechatronic technologies SPECTARIS, the Dutch manufacturer of medical equipment Philips, the Korean global orthopedic company specializing in the production of high-quality products Corentec, the Kazakhstani service department LLP "BARK Technology" and others.
To transfer technologies to Kazakhstan, medical and pharmaceutical clusters will operate in the country, the creation of which was initiated by the Single Distributor. Their creation seems appropriate through the involvement of domestic research institutes, scientific laboratories, large medical universities, domestic production sites, the involvement of investment project support institutions, as well as the deployment of clusters in free economic and industrial zones like R&D centers.
LOCALIZATION / CONTRACT MANUFACTURING WITH VENDORS
The issues of localization / contract manufacturing with major global manufacturers are being actively worked out. Companies such as Canon, Philips, General Electric, Samsung Medison, Mindray and others expressed their interest in localizing production.
Negotiations were held with foreign manufacturers of medical equipment on the issues of localization of production, LCC: Philips, Canon, General Electric, DRTech, Mindray, Lowenstein, Roche Diagnostic.
Also, through the Ministry of Foreign Affairs of the Republic of Kazakhstan, as well as directly from the Single Distributor, requests were sent to the headquarters of about 50 foreign manufacturers to participate in negotiations, with most of which negotiations were held on the intention to develop domestic medical instrumentation in cooperation with the world's leading manufacturers of medical equipment.
Work is also underway with other vendors, manufacturers of medical equipment, such as Lowenstain Medical, Ackerman, Atom Medical and others, who are also exploring the possibility of localization in Kazakhstan.
Information was collected from domestic manufacturers of medical equipment, dossiers were formed indicating the areas of production facilities, machine park, the number of employees of enterprises, the list of manufactured equipment, as well as its cost. This information was sent to vendors to make decisions on opening production of medical equipment together with Kazakhstani enterprises.
In addition, in 2022, a trip was made to the Republic of Korea, where the experience of creating medical-pharmaceutical and instrument-making clusters was studied. As a result, 5 memorandums were signed on the location of production sites in Kazakhstan - the latest developments in the field of pharmaceuticals and medical equipment between: JW Pharmaceutical and Ordamed JSC, Samsung Medison and Ordamed JSC, GENORAY and Ordamed JSC, DOLCE LLP » and MEDICAL PARTNERS KOREA LTD, Aktyubrentgen JSC and DRTECH.
The issue of localization of production in the territory of Kazakhstan of products of such vendors as Shenzhen Mindray Bio-Medical Electronics Co., Ltd (PRC) is being worked out with Aktyubrentgen JSC; IBIS (Italy).
Cooperation with the Swiss company Roche has been worked out, within the framework of the signed agreement, cooperation is planned to introduce international experience and innovative diagnostic methods for early detection of diseases, their prevention and, accordingly, more effective treatment.
Roche expressed its readiness to provide methodological and logistical support to Kazakhstan for the introduction of new diagnostic methods, namely, to provide the necessary laboratory equipment for research projects and as grants. The company's experience can help strengthen Kazakhstan's laboratory infrastructure and ensure that it meets international standards.
In September, Philips representatives visited to get acquainted with the base and production technology of Aktyubrentgen JSC and discuss issues related to the joint production of medical equipment.
During the visit, the production workshop and key processes for the production of medical equipment were examined, issues of infrastructure, personnel policy, housing, raw materials for production, registration of medical equipment, etc. were discussed. Thus, a memorandum of strategic cooperation was concluded between the Ministry of Health and Philips.
As part of cooperation with global players in the medical devices market, during the visit of the Head of State to New York in 2022, a meeting was held with the leadership of General Electric.
An OEM agreement was signed on both sides of Aktyubrentgen and SINOVISION on the localization of the production of multislice computed tomographs. Work is underway to prepare operational documentation, finance the project, purchase units, master the production of individual units at Aktyubrentgen JSC, manufacture a prototype, test and obtain a registration certificate for a computer tomograph.
DOMESTIC PRODUCTION SITES
Issues of contract manufacturing with major global manufacturers are one of the important areas. Scaling up contract manufacturing with foreign manufacturers is a priority.
JSC "West Kazakhstan Machine-Building Company", in turn, is ready to provide its production site for the localization of medical equipment to large vendors, acting as an assembly site for foreign-made medical equipment. In the future, it is planned to conclude a long-term contract for contract manufacturing.
Now, at various stages, negotiations are underway with global vendors for contract manufacturing. Companies such as Canon, Philips, General Electric, Samsung Medison, Mindray, Sinovision, Ibis and others expressed their interest in localizing the production of medical equipment.
Also, OrdaMed JSC reached an agreement on the production in Kazakhstan of mammography systems, end products of individual medical devices for neonatology, ultrasound diagnostic systems, multifunctional patient monitors, various types of X-ray equipment and equipment in the areas of neonatology, surgery, gynecology.
Last year, OrdaMed JSC entered Memorandums with leading Korean companies GENORAY CO., LTD, JW Holdings Corporation, Samsung Medison Co, as well as with Bionet, SG Healhcare and JW Medical.
These areas are open for investment, including within the framework of concluding long-term contracts with domestic producers. Such projects will receive full support from the state.
KAZAKHSTAN BRAND
Today, domestic manufacturers need to focus on the development of their industries with an emphasis on import substitution in terms of transferring advanced technologies and increasing exports of finished products.
At the same time, along with the production of finished products, it is necessary to develop and produce pharmaceutical components and substances. To date, a measure of support in the pharmaceutical industry is provided in the form of long-term contracts.
One of the key points of the contract manufacturing mechanism is that a foreign company manufactures products on a contract basis at the production facilities of a domestic agent. As a result, the final product comes out under the brand of Kazakhstani enterprises.
EXPORT TO FOREIGN MARKETS
Продвижение экспортной продукции — важный элемент поддержки предпринимательства для Правительства РК. Задачей является развитие текущих инициатив предпринимателей и поиск новых рынков для отечественной продукции.
Глава государства подчеркивал важность активизации внешнеторговой деятельности и продвижения казахстанской продукции на зарубежные рынки, делая акцент на необходимости регулирования экспорта основных продовольственных товаров для обеспечения внутреннего рынка.
Казахстан, занимая выгодное географическое положение, является регионом переплетения стратегических интересов стран-участниц евразийского экономического пространства, Китая, Турции, европейских стран и США.
Поэтому в условиях геополитической ситуации, курс инвестиционной политики страны и все связанные с ним изменения будут иметь существенное значение для всего Азиатского региона и за его пределами.
Единый дистрибьютор проводит комплексный ряд мер по данному направлению. Так, в целях реализации программы акселерации экспорта для казахстанских производителей, направленной на наращивание экспортного потенциала и расширение внешней торговли, Единый дистрибьютор и QazTrade заключили Меморандум о взаимопонимании и сотрудничестве.
Стороны намерены развивать партнерство по созданию условий для повышения конкурентоспособности отечественных товаропроизводителей, поиска потенциальных экспортных рынков и продвижения казахстанской продукции, в том числе медоборудования на иностранные площадки.
Государством для стимулирования отечественных экспортеров к производству товаров с высокой добавленной стоимостью принят пакет поправок, предусматривающий возмещения затрат товаров с высокой добавленной стоимостью и долей местного содержания.
В настоящий момент государство компенсирует часть затрат на транспортировку товара, рекламу и участие в выставках казахстанским производителям-экспортерам.
Финансовая поддержка будет также направлена на содержание представительств, торговых площадей, складов и торговых полок за рубежом. Помимо этого, производителям компенсируются траты на процедуры по регистрации товарных знаков, получение разрешений на франчайзинг и прохождение сертификации и аккредитации.
Promotion of export products is an important element of business support for the Government of the Republic of Kazakhstan. The task is to develop current initiatives of entrepreneurs and search for new markets for domestic products.
The head of state emphasized the importance of intensifying foreign trade activities and promoting Kazakh products to foreign markets, emphasizing the need to regulate the export of basic food products to ensure the domestic market.
Kazakhstan, occupying a favorable geographical position, is a region of intertwining strategic interests of the countries participating in the Eurasian economic space, China, Turkey, European countries and the United States.
Therefore, in the context of the geopolitical situation, the course of the country's investment policy and all related changes will be of significant importance for the entire Asian region and beyond.
A single distributor carries out a comprehensive range of measures in this area. Thus, in order to implement the export acceleration program for Kazakhstani manufacturers, aimed at increasing export potential and expanding foreign trade, the Single Distributor and QazTrade signed a Memorandum of Understanding and Cooperation.
The parties intend to develop a partnership to create conditions for increasing the competitiveness of domestic producers, searching for potential export markets and promoting Kazakh products, including medical equipment, to foreign sites.
To encourage domestic exporters to produce high value-added goods, the government has adopted a package of amendments that provides for cost recovery for high value-added goods and a share of local content.
Currently, the state compensates part of the cost of transporting goods, advertising and participation in exhibitions to Kazakhstani exporting manufacturers.
Financial support will also be directed to the maintenance of representative offices, retail space, warehouses and retail shelves abroad. In addition, manufacturers are compensated for the costs of registering trademarks, obtaining permits for franchising and passing certification and accreditation.
МE SERVICE
TRAINING OF SPECIALISTS / OPENING SERVICE CENTERS AND WAREHOUSES OF SPARE PARTS
One of the requirements for localized industries is the training of technical and medical specialists of medical organizations, the opening or expansion of existing service centers, the formation of warehouses for spare parts and consumables.
All this will lead to an increase in the efficiency of the use of purchased medical equipment by reducing the downtime of equipment during repairs, and increasing the availability of medical services to the population. The development of localization of the production of medical equipment opens up broad prospects for both the healthcare system and business.
Thus, along with the localization of the production of medical equipment in Kazakhstan, the Ministry of Health of the Republic of Kazakhstan, together with the Single Distributor, is working to organize educational centers of world vendors - manufacturers of medical equipment, including GE Healthcare.
During the meetings, the issue of opening training centers in Kazakhstan was raised. GE Healthcare has announced its readiness to open a branch of GE Academy on the basis of Kazakhstani medical universities and work is underway to determine the site.
Also, the Ministry of Health, together with the Ministry of Science and Higher Education, is working to open a joint program for training biomedical engineers on the basis of Satbayev University and KazNMU named after. S.D. Asfendiyarov.
An appropriate roadmap and training plans are currently being developed.
To develop proposals for improving the quality of after-sales service, a number of meetings were held at the SK-Pharmacy site on the after-sales service of medical equipment with the participation of representatives of the Service Association:
Sapaly Med Qyzmet, KARL STORZ Endoscopy Kasachstan, General Electric, B. Braun Medical Kazakhstan, Ordamed, Medical Marketing Group, KazMedEngineering.
Since this year, work has been carried out to improve the tariff policy for medical services, which is planned to include the costs of updating fixed assets for the purchase of medical equipment, carrying out service maintenance and repairs.
ACCESS TO SERVICE CODES/PROFESSIONAL TRAINING
Changes were made to the order containing the forms of documents for the centralized procurement of medical equipment, including the technical specification.
This document included requirements for related services that provide medical organizations with all service codes for access to the software.
At the same time, a prerequisite is the training of medical and technical personnel with the issuance of a supporting document. These requirements will ensure the improvement of the situation with the maintenance of medical equipment by the own engineering staff of medical organizations.
NEW PROCUREMENT MECHANISMS - LCC
On behalf of the Administration of the President of the Republic of Kazakhstan, a draft was prepared to amend the Rules for organizing and conducting procurement, which allows introducing new procurement mechanisms, such as procurement on the terms of extended service (life cycle contracts), improving the procedure for concluding long-term contracts for the supply of medical equipment by domestic producers, contract manufacturing medical equipment.
In October, international experts were invited to the II International Forum on Medical Equipment "MedTech" to exchange experience in the implementation of life cycle contracts.
In general, the LCC mechanism will make it possible to purchase a full range of services - from one turnkey supplier: supply, installation, training, ensuring the uninterrupted operation of the supplied medical equipment throughout the normalized life of the medical equipment.
IMPROVEMENT OF THE SYSTEM FOR MONITORING AND ACCOUNTING OF MT
To improve the operation of the information systems of the Ministry of Health in terms of monitoring and accounting for medical equipment, SK-Pharmacia studied the functionality and reporting data of the “Medical Equipment Management System” information system, and also analyzed the experience of using similar systems in other countries, such as Turkey, the Russian Federation, and Korea. .
Proposals have been prepared to improve or create a new information system for monitoring and accounting for medical equipment.
These proposals are aimed at eliminating the existing shortcomings of IS SUMT, among which are: filling errors due to manual data entry; the need to introduce a new equipment standard; control over the filling of data into the system; modernization of server capacities; adding functionality for interaction between a medical organization and a service company.
CREATION OF MEDICAL AND PHARMACEUTICAL CLUSTERS
In addition, the creation of a medical and pharmaceutical cluster in the Aktobe region was initiated. As part of the project, Aktyubrentgen JSC entered into agreements on joint scientific activities with Zhubanov Aktobe Regional University, M. Ospanov West Kazakhstan Medical University and Aktobe College.
Currently, work is underway to sign a memorandum on the creation of a medical and pharmaceutical cluster in the Aktobe region, and an appropriate working group has been created.
In this direction, SK-Pharmacia signed a Memorandum of Cooperation with the Science Fund JSC, Kazakh Invest, and the Institute for Economic Research. Also, in the near future - the signing of a memorandum with "Baiterek" and a number of advanced medical universities in the country.
IMPLEMENTATION EFFECTS
The main effects of the ongoing work on the centralization of the purchase of medical equipment are equipment in accordance with the level of medical care, updating the fleet of medical equipment, ensuring the achievement of indicators of National projects, improving service maintenance, equal access to medical care for the population of all regions of the country.
Corruption risks will be eliminated and the transparency of the procedure for planning and purchasing medical equipment will be ensured, it will be possible to equip healthcare organizations with the necessary medical equipment, and reduce the availability of medical equipment with an operation period of more than 10 years.
The annual budget expenditures on capital expenditures of medical organizations will decrease due to the reduction in the cost of medical equipment. Reducing the cost of medical equipment is planned through the introduction of procurement mechanisms on the terms of the LCC, the consolidation of purchases, the averaging of technical specifications for centralized procurement, and the development of standard technical specifications for the purchase of medical equipment.
It should be noted that according to the results of the auctions, savings amounted to an average of about 14% (up to 81% for certain types of ME) of the allocated funds.
The quality of after-sales service will improve, which, among other things, will lead to savings in the funds of medical organizations for after-sales service, and ensuring the efficiency of the use of medical equipment. As the analysis showed, for maintenance and repair of "heavy" medical equipment for 10 years of operation, more than 100% of its initial cost can be spent on certain types of equipment nomenclature.
Increasing the country's human resources potential in the field of technical professions and increasing the share of domestic producers in the medical equipment market. This will allow the successful development of after-sales service and will give a good impetus to enter the international market.
Uniform methodological approaches and a technical policy in the field of procurement and provision of medical equipment will be developed through the creation of a Technical Council from the structure of the Ministry of Health of the Republic of Kazakhstan.
In conclusion, I would like to note that all the comments, emerging shortcomings and inconsistencies in the practice of recent years were taken into account, and practice, as you know, is the best experience for making improvements. Like any innovation, the initiative has found both ardent supporters and critics. And the real benefits, tangible now, and becoming increasingly important in the long term, will contribute to the achievement of the final goal - the effect that patients will see, and this is the most important KPI of the entire industry.
SK-Pharmacy is open to suggestions, ready to carry out joint systematic work with the participation of all involved and interested parties, aimed at reducing budget costs, reducing equipment downtime, as well as improving the service support of medical equipment.
For all questions and suggestions, please contact the following contacts:
Department of Medical Equipment Provision – + 77172 559247/959093,
email mail: n.palinka@sk-pharmacy.kz, a.tatiyeva@sk-pharmacy.kz
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