ISSUES OF CENTRALIZATION OF THE MEDICAL EQUIPMENT PROCUREMENT WERE DISCUSSED WITH THE MEDICAL AND EXPERT COMMUNITY

Централизация закупа медицинской техники - Centralization of medical equipment procurement 

On March 17, 2022, the medical and expert community discussed the issues of centralizing the medical equipment procurement on the basis of the Single Distributor SK-PHARMACY LLP.

The event was chaired by the First Vice Minister of Health of the Republic of Kazakhstan M.YE. Shoranov, where representatives of industry associations, the Department of Medicine Policy and the Department of Economics and Finance of the MHRK, SK-Pharmacy LLP, National Center for Medicines RSE on the PVC, National Center for Health Development named after A. S. Kairbekova RSE on the PVC.

The meeting participants were presented with the measures taken to switch to the central procurement of medical equipment in the Republic of Kazakhstan. For a detailed study of issues on the centralization of the medical equipment procurement, the initiated measures were discussed by the Single Distributor at the sites of the working group, the public working group, which includes representatives of civil society and the business community, deputies and industry experts. In addition, the discussion was held with the regions, represented by the health departments and medical organizations of the country.

Recall that the Head of the State instructed to switch to a centralized procurement of medical equipment on the basis of the Single Distributor, following the example of the medicines and medical devices procurement. In 2021, the President instructed the Ministry of Health of the Republic of Kazakhstan to conduct an inventory of the available medical equipment in the country. According to the results of a large-scale inventory, the level of equipment of healthcare organizations with medical equipment was 83%, and the level of wear and tear was 49%.

Also, as part of the inventory, the Ministry modified the information system for managing medical equipment, created an interactive map of equipping medical facilities. This tool allows you to monitor the current state of equipment in the context of regions and medical organizations.

Currently, the main problems of the medical equipment supply system are insufficient equipment and a high level of wear and tear of the existing equipment fleet, price dispersion when procuring medical equipment locally, the lack of affordable mechanisms for leasing medical equipment, and the insufficient development of domestic production of medical devices.

To solve these problems, it is planned to carry out a centralized procurement of medical equipment on the basis of SK-Pharmacy LLP in two stages.

At the 1^st stage, it is planned to implement the following activities:

Ø the EFIS information system will be modified to automatically collect applications from local executive bodies for the medical equipment procurement for the current year and integrate it with the procurement web portal of the Electronic Finance Center of the Ministry of Finance;

Ø amendments to the legal acts regulating the organization and conduct of the medical equipment procurement;

Ø development of a mechanism for the unification of technical specifications for procurement;

Ø conducting centralized electronic procurement of medical equipment in the current year

Ø completion of the analysis of the need for medical equipment by 2025.

In the future, the Program for medical equipping in priority areas until 2025 will be approved with the identification of funding sources.

At the 2^nd stage, it is planned to implement measures to study with domestic and foreign manufacturers of medical equipment the issues of localization of production, develop mechanisms for long-term contracts, introduce into the practice of procuring mechanisms for life cycle contracts and medical equipment procurement for complex equipment in priority areas on a turnkey basis.

All this will ensure transparency in planning the medical equipment procurement, increase the level of equipment with the necessary medical equipment, and reduce its cost by consolidating procurements and unifying terms of reference. The quality of after-sales service and staff training will also improve, and the share of domestic producers in the medical equipment market will increase.

For the purpose of high-quality treatment of patients and the creation of favorable conditions for equipping medical institutions with modern diagnostic and treatment-and-prophylactic equipment, the Single Distributor identifies and works out problematic issues of medical equipping, including equipment planning, the efficiency of using medical equipment, training specialists (medical and technical personnel of healthcare organizations), improvement of service maintenance and repair.

Also, the world practice for the medical equipment procurement, including centralized ones, was 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, and Japan, has been studied.

The primary task is to analyze the existing fleet of medical equipment and form a verified need for medical equipment based on equipment standards. This task implies a qualitative monitoring of the demand for the requested medical equipment and the readiness of healthcare organizations to use it, the timely replacement of outdated equipment with current models. This will allow for high-quality planning and effective procurement of medical equipment in healthcare organizations.

Particular attention is paid to the comprehensive maintenance of medical equipment and ongoing training of medical personnel. This will significantly increase the volume and quality of medical services provided to the population and reduce the costs of their provision through the effective use of medical equipment by healthcare organizations.

In addition, it is planned to work out the issues of localization / contract manufacturing of medical equipment in the Republic of Kazakhstan in the short term using the mechanisms of long-term contracts, off-take contracts, leasing mechanisms, and life cycle contracts.

Also, 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, which will lead to an increase in the efficiency of using procured medical equipment by reducing equipment downtime during repairs, increasing availability of medical services to the population.

This project will be implemented using the mechanism of long-term contracts for a certain period, which involve the provision of a guaranteed volume of procurements to localized companies. The development of localization of the medical equipment production opens up broad prospects for both the healthcare system and business.

Currently, a substantive study of the issues of localization of production with foreign and domestic manufacturers of medical equipment is underway. As a result of this work, an advisory list of equipment for localization in Kazakhstan will be formed, which will be worked out in detail by the medical and expert community, with regional health departments and medical organizations.