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MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS & SANITARY INSUMES

MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS & SANITARY INSUMES. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS. PERU. Location: South America Extension: 2millions Km 2 Number of Regions: 24 Natural Regions: 3 Coasts: 52.1% (11% Sup)

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MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS & SANITARY INSUMES

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  1. MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS & SANITARY INSUMES

  2. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS PERU Location: South America Extension: 2millions Km2 Number of Regions: 24 Natural Regions: 3 Coasts: 52.1% (11% Sup) Population: 27 millions Poverty Conditions: 54.3% Extreme poverty: 23.4% Esperanza Vida: 68.3 yrs Mother Mortality : 186 /100,000n.v. Children mortality(<5yrs): 60.4 /1000 n.v. Health Expenditure: 2,510 millions US$ Familiar package: rise 35% (last 5yrs.) Health package : risen 65% Excluded population: 30%

  3. PERCAPIT ESTIMATED CONSUMEOF DRUGSACCORDING TO CONSUMER SECTOR - PERU ( 2000) 120 100 110 80 60 70 40 36 20 10 1 7 0 Public Private Excluded Units Value SOURCE: G.Valladares. Rev. de Salud y Medicamentos Nº54; jun 2001

  4. MINISTERIO DE SALUD DIGEMID HEALTH SECTOR PUBLIC PRIVATE Ministry of Health (6806) Sanitary Army Social Security (326) Regulated Private Health Insurance Private Lucrative Pharmacies & Drugs stores No Lucrative Health Regional Administrations (34) Specialized Institutes (7) National Hospitals (5) Hospitals (180) National and local Hospitals Regional Hospitals (72) Health Establishments (6,626) Health Establishments (279) Policlinics

  5. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS HEALTH INSURANCE PUBLIC (57.2%) PRIVATE (5%) Ministry of Health (28%) Sanitary Army (4.1%) Social Security (25.1%) Regulated Private Health Insurance (2%) Private Insurance (3%) Public Health Insurance (28%) National Programs (8%) NO INSURANCE: 37.8% Children and Pregnancy women priorized Source: Cuentas Nacionales de Salud Peru 1995-2000 (2004) Superintendencia de EPS SIS- Boletin Informativo 2003

  6. FINANCING PUBLIC HEALTH INSURANCE PUBLIC HEALTH INSURANCE (US$ 78’774,162) ESSALUD (US$. 398’285,714) FIXED PAYMENT PAYMENT FOR HEALTH CARE (EMPLEADOR + EMPLEADO) DRUGS AND DEVICES (29.9% = US$ 23’553,474) HEALTH SERVICES AND INVESMENTS DRUGS AND DEVICES (21.2 % = ’84’436,571) HEALTH SERVICES, INVESMENTS AND OTHERS SISMED

  7. As a strategy of Public Health applied for the Ministry of Health since January 2003 was implemented the Unitary Managing Drug Supply System. • It’s main goal is: to improve public access to essential drugs with equitity, solidarity, rationality, quality and decentralization

  8. SISMEDhas been implemented in 6806 health establishments from MINSA • Improves national availability of medicines until approximately 85% • Essential medicines are given to every patient from MINSA (Public insurance, National programs and pocket payment). • Improvement of drug supply Process and implemented national indicators in managing drug supply. • Improvement management of Drugs.

  9. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS • Lowered prices in average 75%, and standardized prices of 100 more consumed essential drugsin the country (getting the lowest price in Peruvian market). • National Drug information about stocks and consumes has fulfillment to 85% from health establishments • Improved rational drug use through the control of drugs out from the National List of essential Drugs • Guaranteed drugs stock for a whole year (2004)

  10. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS ESTIMATED SAVING IN DRUG NATIONAL ADQUISITION - 2003 S/.109,233,499 Estimated budget S/. 40’000,000 = US$.11’000,000 (36.00%) Final budget paid S/. 69,233,499 60,000,000 70,000,000 80,000,000 90,000,000 100,000,000 110,000,000 nuevos soles

  11. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS DRUG CONSUME (VALUE) IN THE MINISTRY OF HEALTH PER MONTH (SISMED – 2003) 4.5 4.0 3.5 3.0 Milions 2.5 2.0 1.5 1.0 0.5 0.0 1 2 3 4 5 6 7 8 9 10 11 12 Months SIS IS VENTAS

  12. MINISTERIO DE SALUD DIRECCION GENERAL DEMEDICAMENTOS, INSUMOS Y DROGAS SICK PEOPLE WHO GOT DRUGS AFTER PHISYCIAN CONSULT NO INSURANCE PRIVATE SOCIAL SECURITY AND ARMY PUBLIC HEALTH INSURANCE 0% 20% 40% 60% 80% 100% GETS & PAYS GETS & NOT PAYS NOT GETS Source: ENAHO/Elaboracion OPS

  13. OPPORTUNITIES : PUBLIC HEALTH INSURANCE & SISMED • US$ 11 MILLIONS SAVED TO BE INVESTED IN OTHER HEALTH NEEDINGS • EMPOWER THE RATIONAL USE OF DRUGS • RESEARCH IN DRUG UTILIZATION • AVALILABILITY IMPROVEMENT OF DRUGS

  14. CHALLENGES : PUBLIC HEALTH INSURANCE & SISMED • PROBLEMS TO BE SOLVED: • NO LIST OF ESSENTIALS DRUGS FOR LEVEL COMPLEXITY • NO GUIDELINES • NO CROSSING ANALIZED INFORMATION BETWEEN SIS AND SISMED • DELAY OF REIMBURSEMENT • INSUFFICIENT FINANCING (GOVERNMENT FINANCING)

  15. MINISTERIO DE SALUD DIRECCION GENERAL DE MEDICAMENTOS, INSUMOS Y DROGAS GRACIAS!!!

  16. MINISTERIO DE SALUD DIGEMID COMPRA NACIONAL DE MEDICAMENTOS 2003 ADQUISICION

  17. Logros SISMED 2003 • * Mejoramiento de los niveles de disponibilidad a medicamentos en el MINSA • Estandarización de procesos técnicos y administrativos del sistema de suministro de medicamentos a nivel nacional • * Reorientación del gasto al aspecto asistencial, eliminando duplicidad de funciones y gastos inherentes. • *Capacitación a 1500 trabajadores del MINSA (asistenciales y administrativos) • *Asistencia técnica y supervisión al 60% de DISAs y de sus hospitales regionales • * Información sobre la disponibilidad y consumo de medicamentos en el país al 85% (5800 establecimientos de salud) en forma mensual • * Implementación del sistema informático en 517 puntos de digitación • * Fortalecimiento del sistema informático con un servidor y 29 equipos de computo para las DISAs priorizadas

  18. Logros SISMED 2003 • * Disponibilidad de los 100 medicamentos de mayor uso a los precios mas bajos del mercado farmacéutico en el país • * Ahorro del 36% en la adquisición de medicamentos (Compra Nacional) – 40millones de N.S. • * Control de calidad al 100% de medicamentos adquiridos en la compra nacional para el MINSA • * Reducción del 300%, en promedio, de los precios de venta al público de los medicamentos en el MINSA • * Estandarización del precio de medicamentos a nivel nacional • * Mejoramiento de la calidad del gasto en medicamentos, mediante la reducción de la adquisición de medicamentos fuera del petitorio • * Reducción del precio de medicamentos Antirretrovirales, mediante la negociación conjunta para el mejoramiento al acceso de estos medicamentos • Diagnostico de los almacenes especializados de medicamentos a nivel nacional (87)

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