in govt hospital, if there is a certain drug that is usually used, pharmacotherapy committee will talk about the usage of that drug -> will try to place the drug in the formulary; if not, topic nomination to the HTA

unified supply chain information system to address current PSCM (Procurement and Supply Chain Management challenges

Future state: integrated procurement framework available, cost effective, uniform warehouse management, synchronized distribution and reverse logistics, master list of inventories or stock keeping units (SKUs), end-to-end supply chain data visibility, and integrated information system

EO No. 49 s. 1993 mandated the use of the PNDF in all public procurement, effectively limiting the medicines that may be procured by government entities

imposition of maximum retail price through the office of the president

an arrangement between one or more buyers and multiple suppliers, defining the terms under which individual contracts, or call-offs, can be made during the life of the agreement - sets the groundwork for the future award of contracts, without guaranteeing volume or spend

aims to achieve savings and efficiency by aggregating demand and streamlining the tender process

composed of public health, epidemi9ologu, pharmacuetical policy,law, clinical, and economic experts to provide technical advice and guidance to the DOH in implementing measure to promote and ensure access to affordable quality drugs and medicines for all consumers in the Philippines

members of the council shall be co-terminus with the SOH subject to reappointment by the new SOH

the biochemical similarity of two (or more) drugs that share the same active ingredient(s) and desired outcome(s) for patients

chair of the council shall hold his/her position not exceeding three years unless he/she relinquished his/her position for reasons beyond his/her control

EO No. 155 imposing MRP on 34 drug molecules or 71 drug formulas

used to guide all national and lcoal government health facilities in the efficient sourcing of pharmaceutical products in the public sector

practice of using the price(s) of a pharmaceutical product in one or several countries in order to derive a benchmark or reference price for the purposes of setting and negotiating the price of the product in a given country

asian countries: Thailand, Malaysia, Vietnam, India, Indonesia

lowest bid price or through external reference pricing (ERP) with countries of similar income status

Central Office Bids and Awars Committee (COBAC)

lack of APIs and there are economic downturn; hence, expensive drugs

senior citizens and persons with disabilities are entitled to a 20% discount and VAT exemption (12%) on retail medicine purchases

drugs came from india, and pakistan because there ingredients are cheaper which drives the domestic manufacturer to close down

expanded the list of VAT-exempt transactions to include sale of drugs and medicines prescribed for diabetes, high cholesterol, and hypertension, which helps reduce their retail prices

provided value-added tax (VAT) exemption to certain health products including, drugs for hypertension, cancer, mental illnesses, tuberculosis, kidney diseases, diabetes, high cholesterol and covid 19 medicines and medical devices

There is a need to revist ERP and MWP/MRP formula

required for DOH hospitals/DOH-retained hospitals

required for other government agencies but not as strict

executive order released from time-to-time from the office of the presdient

gives the list of molecules that are subject to the MRP

medications belong to the formulary of an institution

medications that can be part of formularies in government institutions should be part of the PNF

highlighted that we have different additional procurement methods

20-25% every year for medicine, vaccines and health technologies.

. This law revises the previous Government Procurement Reform Act (RA 9184) to enhance transparency, competitiveness, efficiency, accountability, and value for money in public procurement processes in the Philippines

It aims to ensure that national and local government health facilities can source pharmaceutical products at fair and reasonable prices

includes the supplier to the facility and distribution within the facility

RA 11223, RA6675, RA9502, RA7432/9994 Expanded Senior Citizen Act, RA 7277/10754 Expanded Benefits and Privileges of PWD, RA 10963 TRAIN Law, RA 11534 Corporate Recovery and Tax Incentives for Enterprises Act

RA6675, RA9184, RA 11223

procures it for itself (phase of distribution), then transfers it to various institutions

discusses and includes a commonly used medication in the formulary

importance: gives guidance and structure, resource optimization, transparency and accountability, risk management, compliance, efficiency and effectives

Philippine Government Electronic Procurement System

A meeting is held to clarify any concerns or questions from prospective bidders regarding the procurement requirements23.

Typical process: Verification (if the medication is listed in ppmp approved) -> Requisition (request to the procurement office, specifying the medication and required quantity) -> Approval (procurement office reviews the request) -> Procurement process -> Distribution

Prospective bidders are screened to ensure they meet the necessary qualifications and requirements

The submitted bids are evaluated based on pre-determined criteria to determine the most advantageous offer for the government

The bid that appears to be the most advantageous is further scrutinized to verify the bidder’s capability and compliance with the requirements23.

The contract is awarded to the bidder who meets all the requirements and offers the best value for money23.

Delivery of drugs -> receiving and inspection (QA) -> inventory management -> internal distribution -> monitoring and replenishment -> reporting and accountability

isang beses lang priprocure ang drugs sa isang tao -> expiry

Depends on what kind of service delivery you are trying to provide whether public health, specialty care and primary care

In reality, BHS do not follow the proper procurement process

should be knowledgeable to the medicines being procured

introduces price-ceilings and capped price adjustments post-award

standardized procurement processes and forms

This can be done without a framework agreement but without this agreement, the supplier can only get their payment once all materials have been delivered to the government

adopted open and competitive bidding as primary mode of procurement

mandated the use of an electronic procurement system to ptomote transparency and competition

ex. gov set price of 150k for computer and specs are provided (even the specs is not worth the price)

Problem: In govt, dapat muna matapos yung contact bago mabayaran. Kaya nabblacklist ang govt offices kasi matagal pa bago mabayaran kahit andiyan naman ang pera

if smal -> the have to buy small quantities -> more expensive but they have to base the price on DPRI

because of generics act law, it causes the most significant decrease in price

procurement spending is bigger in LGUs than DOH

stems from situations where importing is more economically cheaper than manufacturing the drug in the country

example during covid, this is to increase access to medicines

since the medicines are transferred to different stakeholders -> price increases once it reaches the patient

PPMP contains equivalent price per good or services

sets the price for the MRP and procurement of DOH of the HT

Purchase order contains price per piece and how many pieces will be bought

meet the market authorization holder to negotiate price

Does not account for inflation and public health emergencies

Oftentimes, the price set by the supplier is already, which makes it hard for them to lower based on the price of the DPRI which becomes the problem

patented medicnes need to ahve a set price to avoid expensive drug pricing

entails the comparison of teh drug price within the Philippines

rate/price paid by a hospital when buying medicines

lowest between median of asian countries, and minimum of developed countries

sets only maximum allowable prices of medicines procure by the govt, which helps prevent overpricing but does not directly influence market competition or consumer behavior

reason why we can't use the cheapest price for asian countries

rate/price paid by the patient when buying medicines

mark-up adjustment (MUa) depends on MWP value

DPRI provides benchmark prices for products, which helps in setting realistic and competitive ABC for procurement of medicines. By referencing the DPRI, procuring entities can ensure that they procure medicines at reasonable prices.

but not always the case as the presence of a price regulatory board and an established HTA

unlike in the PHL -> decentralized -> more expensive

through Pharmaceutical and Healthcare Association of the Philippines (PHAP)

the price shall be lower or the same as GMAP, but not all medicines are in GMAP, only the expensive ones

voluntary price reduction through negotiation between DOH and pharmaceutical companies, especially for medicines for cancer, mAbs and other expensive medicines

Which means there is indirect cost increase due to the overall increase in excise taxes on fuel and other goods which indirectly raise operational costs for pharmaceutical companies which might be passed on to consumers in the form of higher prices for non-exempt drugs

in distribution and transport, there is increased in fuel costs which has contagion effects on operational costs leading to an increase of prices in medicines

the only way to reduce the price of these medicines is through MRP

retailers and wholesalers will increase their mark-ups