On March 15, a regular meeting of the public working group at SK-Pharmacy LLP was held, where they discussed the issues of centralizing the medical equipment procurement on the basis of the Single Distributor SK-PHARMACY LLP and systemic issues of medicine supply.
The public working group at SK-Pharmacy includes representatives of civil society and the business community, deputies and industry experts. On this platform of the Single Distributor, questions from civil society are regularly raised and urgent problems in medicine provision of the population are openly discussed in order to make the necessary recommendations.
Recall that the Head of the State instructed to switch to a centralized medical equipment procurement on the basis of the Single Distributor, following the example of the medicines and medical devices procurement.
The participants of the meeting were presented with the measures taken to switch to the central medical equipment procurement in the Republic of Kazakhstan. 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 amounted to 83%, and the level of wear and tear - 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 with medical equipment. 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 medical equipment procurement on the basis of SK-Pharmacy LLP in two stages.
At the 1st stage, it is planned to implement the following activities:
In the future, the Program for medical equipping in priority areas until 2025 will be approved with the identification of funding sources.
At the 2nd 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 procure medical equipment 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 procurement of medical equipment, 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 production of medical equipment 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.
The next issue on the agenda of the meeting was the issue of systemic problems of medicine provision within the framework of the guaranteed volume of free medical care and the compulsory health insurance system. The President of the Republic of Kazakhstan, as well as the Government, pays great attention to the issues of uninterrupted medicine supply. Currently, certain positive results have been achieved in the industry, however, it should be noted that there are a number of problems that are not dependent on the Single Distributor, such as: pricing, the absence of a Unified classifier of medicines and medical supplies, the integration of information systems of state bodies, etc. In this regard, the Single Distributor identified a number of systemic problems with proposed solutions.
The meeting participants discussed optimal models for the functioning of healthcare systems in a pandemic, noted common approaches to improving the uninterrupted provision of the population with essential medicines. All proposals and appeals voiced by members of the public working group following the meeting are entered into the so called "Book of Problematic Issues".
The agenda also considered the risks in medicine provision associated with the situation in the world.
For 2022, the Single Distributor within the framework of the guaranteed volume of free medical care and in the compulsory health insurance system procured medicines and medical devices in the amount of 93% of the declared annual requirement. Of which, about 59% falls on domestic production, 23% are supplied from European countries, only 2% from Ukraine and the Russian Federation, the remaining 13% are procured from other countries.
It is worth noting that the Single Distributor annually procures and concludes contracts for the supply of medicines in advance, and medicines for the next year are procured this year. Thus, the provision of medicines to the country occurs in advance.
One of the important conditions for the procurement of medicines is the delivery schedule, and the need for the availability of medicines in the warehouses of the Single Distributor in December, shipment to polyclinics and hospitals will begin in January.
Shipment of medicines to medical organizations to provide patients is carried out in a timely manner in accordance with the schedules. Medicines are regularly delivered to hospitals, as well as to medical organizations for outpatient medicine provision of the population.
At the same time, the Ministry of Health of the Republic of Kazakhstan and the Single Distributor, taking into account the current crisis situation in the world, are working with suppliers on the timely delivery of medicines. All measures are being taken and risks are being worked out to prevent disruption of deliveries to the Republic of Kazakhstan from European countries, Ukraine, the Russian Federation, and Belarus.
The Single Distributor makes every possible effort to provide medicines to medical institutions on time and in the required volume. The issue of immediate ensuring the availability of medicines for the population is under the special control of the Government of the Republic of Kazakhstan.
In order to ensure uninterrupted supply, the Single Distributor has taken a number of measures to create strategic stocks of medicines, personal protective equipment in the warehouses of the Single Distributor for the treatment of coronavirus infection and prompt shipment, depending on the epidemiological situation.
Another important measure was the formation of an irreducible stock of up to 25% of the total number of procured medicines and medical devices for socially important diseases. Which, in turn, will allow – uninterrupted medicine supply, mitigation of the risks of incorrect planning, prompt response to the needs of medical supply in case of emergency.
The Single Distributor constantly monitors the availability of medicines in the warehouses of the Single Distributor, and the balance in medical organizations. On a weekly basis, information is provided to the Ministry of Health of the Republic of Kazakhstan.
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