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Thomas Moore, Management Sciences for Health. Procurement and Supply Management (PSM) Workshop: Understanding basic drug management elements for proposal writing Bangkok, Thailand July 25-30, 2005. Introduction (1). Key GFATM documents Guidelines for Proposals Proposal Form M & E Toolkit

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thomas moore management sciences for health
Thomas Moore, Management Sciences for Health

Procurement and Supply Management (PSM) Workshop: Understanding basic drug management elements for proposal writingBangkok, ThailandJuly 25-30, 2005

introduction 1
Introduction (1)
  • Key GFATM documents
    • Guidelines for Proposals
    • Proposal Form
    • M & E Toolkit
    • PSM Assessment Tool
  • Workshop handouts
    • “Description of Interventions”
    • “Pharmaceutical Management Guide for Procurement and Supply Management plan for GFATM proposals”
    • “Tools for forecasting drug needs”
    • This Power Point presentation
introduction 2
Introduction (2)
  • Describe your drug management system
    • Use the six basic elements in the “framework” slide
    • Describe any gaps within each of the six elements in your drug management system

Examples: (1) no drug policy to govern supply and use; (2) no mechanism for good forecasting

    • Describe how you will use the GFATM funds to overcome the gaps

Note: see other suggestions on your handout “Pharmaceutical Management Guide for Writing Procurement and Supply Management plans for GFATM proposals

introduction 3
Introduction (3)
  • In GFATM budget proposal must include a breakdown of:
    • Functional areas for:
      • Monitoring and Evaluation
      • Procurement and Supply Management
      • Technical Assistance
    • Service delivery areas
    • Partner allocation
framework pharmaceutical management cycle

Selection

Management

Procurement

Use

Support

Distribution

Policy and Legal Framework

Framework: Pharmaceutical Management Cycle
policy regulations and laws 1
Policy, Regulations, and Laws (1)
  • Develop or update government TB policy
  • Develop policy for health care system reforms
    • Decentralized vs. Centralized
    • Vertical vs. integrated
    • Role of Private sector healthcare providers
policy regulations and laws 2
Policy, Regulations, and Laws (2)
  • Update drug policy for good procurement and supply management
    • Reinforce drug regulation capacity
      • National Drug Authority
    • Update Essential drugs list
    • Require use of generic vs. brand names
    • Develop regulations re: Importing, distribution, sales
    • Promote good manufacturing practices (GMPs)
suggestions for psm plan policy 1
Suggestions for PSM plan-Policy (1)
  • Personnel needs
    • Regulatory activities
    • Monitoring, inspection, surveillance, enforcement
    • Training
  • Infrastructure
    • Office space
    • Computers, software, equipment
    • Access to Quality Control laboratory facilities
    • Vehicles for distribution, inspection, enforcement
suggestions for psm plan policy 2
Suggestions for PSM plan-Policy (2)
  • Update drug laws and regulations
    • Publish standard treatment guidelines
    • Update National Essential Medicines List
    • Disseminate information to all organizational levels
    • Require good procurement practices
    • Require drug registration to promote public safety
    • Require GMP compliance by local drug manufacturers
indicators for m e policy
Indicators for M & E - Policy
  • Average time, in days, required to clear shipments of TB drugs from the port of entry*
  • Average number of days to register TB drugs
  • Percentage of TB treatment facilities that have the latest official manual of TB treatment guidelines
  • When post-marketing surveillance exists
    • Product quality complaints
    • Adverse drug reaction reporting
    • Inspection of wholesalers and retail pharmacies
    • Testing/sampling
procurement quantification forecasting
Procurement - quantification/forecasting
  • Needed for:
    • Planning, budgeting, and ordering
  • Critical issues:
    • Must first have good selection of drugs
    • Decide who will quantify - centralized vs. decentralized activity
    • Tools to use - manual vs. computerized
    • Knowledge of lead times, stock-outs, safety stock, growth, losses
    • Reconcile quantities needed with budget
options for quantification
Options for Quantification
  • Morbidity based: Base estimates on expected number of cases
  • Consumption based: Estimates based on past consumption
  • Adjusted-consumption based: Estimates based on data from another region or health service
comparison of quantification methods
Comparison of Quantification Methods

Consumption versus Morbidity

  • Consumption – need good inventory records
  • Morbidity- need patient attendance data
  • Both methods – need data on existing stocks, lead times, costs

QUAN8

indicators for m e drug quantification
Indicators for M & E – drug quantification
  • Average percentage of a set of tracer TB commodities available in TB facilities and medical stores
  • Average percentage of time out of stock for a set of TB tracer commodities in TB facilities
  • Presence of 6 months buffer stock at national level and 3 months stock at district level