Tuesday, 20 October 2020, 13:35:38
At a government session chaired by the Prime Minister Askar Mamin, Minister of Healthcare Alexey Tsoy reported on the state of medicines supply in the country.
According to the minister, the share of purchases through a single distributor on the country's pharmaceutical market is 42.4% in monetary terms. The share of a domestic manufacturer on the pharmaceutical market of the Republic of Kazakhstan is 17% in monetary terms, in kind, domestic production covers 39% of the market.
In recent years, there has been an increase in domestic exports by 4.3 times, where 57.2% is exported to Russia, 32% to Kyrgyzstan.
“One of the strategic tasks of the state is to support domestic developments and the development of a competitive pharmaceutical industry. The main stimulus for the growth of local production of pharmaceuticals is the program of concluding long-term contracts with domestic manufacturers for up to 10 years. For the period from 2009 to 2020. 88 long-term contracts were concluded for the supply of 5,042 items of medicines and medical devices as part of the purchase of a single distributor. For 10 years, domestic products have been purchased for more than 312.4 billion tenge,’’ said Tsoy.
According to the minister, more than 30% of the purchased volume is domestic products. 48% of COVID-19 medicines are produced domestically.
An accelerated examination of medicinal products at registration has been ensured. The assessment of the quality of medicines and medical devices is carried out according to an accelerated procedure within 3 working days. Access to imported medicines and medical products in case of emergency has been simplified.
For 2019, within the framework of the ALO, the Single Distributor purchased drugs and medical devices for 45 nosologies (within the guaranteed volume of medical care) in the amount of 114.6 billion tenge. Since Jan. 1, 2020, a compulsory health insurance system has been introduced in Kazakhstan, which makes it possible to cover an additional 105 nosologies in the amount of 27.2 billion tenge, within the framework of the guaranteed volume of medical care 32 nosologies in the amount of 130.3 billion tenge. Thus, the coverage of nosologies within the guaranteed volume of medical care and compulsory health insurance was expanded by 3 times from 45 to 137 nosologies.
‘’In order to prepare for a possible new wave of coronavirus infection in the autumn-winter period, a number of measures have been taken,’’ Tsoi noted.
First, this is the formation of an irreducible two-month stock of drugs in the warehouses of the unit. A single distributor purchases 44 items of scarce and demanded drugs for COVID-19 worth 8.2 billion tenge, for the treatment of about 60 thousand patients in hospitals per month.
The volume of the irreducible stock is purchased outside the applications according to the forecast of the Ministry of Health of the Republic of Kazakhstan for the formation of an airbag in the event of the second wave of KVI.
A two-month supply of COVID-19 drugs will be stored at the hubs of the Single Distributor.
“As of Oct. 15, 2020, 37 types of drugs were purchased for 5.92 billion tenge. This measure will make it possible to create a reserve on drugs for the treatment of CVI for a possible second wave and smooth out the problems with planning needs and morbidity,” the minister said.
Second, it is the provision of a stock of medicines in medical organizations.
Since the pandemic, the regions have declared an additional need for drugs for COVID-19 in the amount of 16.6 billion tenge.
From July 22, 2020, the Single Distributor made a decision to form a monthly supply in all medical organizations (infectious and dispensary centers) in the Republic of Kazakhstan, which is promptly replenished due to the additionally purchased additional volume of drugs and medical devices.
To date, the Single Distributor has shipped 91 drugs for the amount of 17.9 billion tenge.
This measure made it possible to cover the urgent additional need of medical organizations, saturate hospitals with drugs for COVID-19, and create reserves in hospitals.
“Third, the list of drugs at the outpatient level for the treatment of COVID-19 has been expanded. That is, patients who have been diagnosed with COVID-19 with a mild course of the disease, regardless of the results of the PCR test, will be able to receive antipyretic drugs and anticoagulants in their clinics at the place of attachment as prescribed by the attending physician. It is planned to cover about 1 million people in the amount of about 1.5 billion tenge. Medicines for the amount of 1.5 billion tenge have already been delivered to the medical organization,” said Tsoy.
This measure will relieve the burden of infectious diseases and provisional centers, treat mild forms of COVID-19 at an outpatient level, reduce the pocket money of the population for the purchase of drugs, and also reduce government spending on inpatient treatment.
Fourth, it is the purchase of medicines for intervention in the retail network. By the decree of the Government of the Republic of Kazakhstan, SK-Pharmacy LLP is empowered to purchase drugs in bulk for subsequent sale in the retail network.
Applications for 3.1 billion tenge were formed — 33 drug types or a two-month need.
The stock will be formed by Oct. 30, 2020.
Fifth, the purchase of medical three-layer masks for intervention in the retail network.
On Sep. 18, 2020, 10 million medical masks were purchased from 8 suppliers. The delivery process is ending.
Sixth, stocks of personal protective equipment.
Medical organizations have formed a three-month supply of personal protective equipment.
Additionally, Chevron will provide humanitarian assistance in the form of 400,000 disposable protective suits. The stock will be formed in the warehouses of the unit until Oct. 25, 2020.
According to the Ministry of Industry, under the order, 1,500 units were shipped to the regions. ventilators in 297 hospitals.
Local executive bodies have signed contracts for the supply of 53 X-ray machines.
Single Distributor within the framework of the guaranteed volume of medical care and compulsory health insurance has purchased 13 million medical masks, 507 thousand PCR tests, 76 million gloves, which are shipped to medical organizations on a monthly basis according to the order.
In all regions, stabilization funds of medicines were organized in the amount of more than 13 billion tenge to allocate funds on a repayable basis to wholesale distributors for the purchase of drugs in demand. On an ongoing basis, we monitor the availability of popular medicines and medical products for 22 names at wholesale distributors in the regions.
According to the minister, the analysis of the monitoring results from July 15 to Oct. 7, 2020, shows an increase in stocks of medicines in wholesale warehouses and pharmacies. For example, antibiotics — 3.8 times, anticoagulants — 33 times, antiviral drugs — 2.9 times, antipyretics — 4.1 times.
“As part of the implementation of the instructions of the Head of State, methodological approaches to determining the minimum standard for stabilization funds in the context of regions were determined. Based on the analysis of drug consumption in the pharmacy network and in hospitals during the peak incidence of the previous wave of COVID-19, drug consumption standards were calculated, which were applied taking into account the predicted morbidity according to a realistic scenario during the expected new wave, taking into account the population in certain regions. In this regard, we ask the regions to ensure the availability of funds according to the minimum standards of stabilization funds,” said Tsoy.
In total, the list of the Single Distributor for 2021 includes 1,521 medicines and medical devices. Medical organizations for 2021, according to the list of the Single Distributor, declared the need for 1440 items of drugs and medical devices in the amount of 343.5 billion tenge.
On Aug. 28, 2020, the purchase of drugs and medical devices for 2021 was announced on the web portal according to the declared needs of medical organizations.
As of Oct. 15, 2020, 502 items of drugs and medical devices were purchased, of which 501 under existing long-term contracts with domestic producers and 1 item through UNDP.
The results of the two-stage tender will be announced by Oct. 23, 2020. Thus, by Jan. 1, 2021, the Single Distributor will purchase more than 95% of drugs and medical devices, and the continuity of drugs and medical devices will be ensured at the beginning of next year.
“The provision of free medicines to Kazakhstanis is under the special control of the Ministry of Health of the Republic of Kazakhstan. Currently, the Single Distributor simultaneously conducts a number of procurement procedures. Direct purchase of drugs and medical products for inpatient and outpatient drug supply is carried out. The implementation of the above measures will allow ensuring drug safety by bringing its own production to 50% by 2025, expanding the coverage of nosologies within the guaranteed volume of medical care and compulsory medical insurance by 3 times from 45 to 137 names of diseases and be ready for a possible new wave of CVI,” Tsoy summed up.
In his speech during the meeting, Erkhat Iskaliev, chair of the Board of SK-Pharmacy LLP, also noted that the purpose of creating a Single Distributor system is to:
- Support domestic pharmaceutical production, which ensured an increase in the share of domestic produccers in the total purchase volume of the Single Distributor for a ten-year period of operation to 30%;
- Ensure uninterrupted provision of the population of Kazakhstan within the framework of state funding and social medical insurance through the advance purchase of drugs and medical devices. Over 10 years, this allowed saving 130 billion tenge of budgetary funds;
- Ensure equal and fair availability of medicines regardless of their delivery distances;
- Provide Kazakhstani patients with original medicines directly from foreign manufacturers without distributors' margin and through international organizations such as UNICEF, UNDP, STOP-TB, etc.
According to Iskaliev, to solve the problems of incorrect planning of pharmaceuticals, medical organizations have proposed a number of systemic measures to revision of planning methodology and full automation of the planning system through the integration of information systems. Currently, work is underway to amend the relevant regulations.
As part of improving the procurement procedures of the Single Distributor, a number of changes were made to the draft Procurement Rules 1729 in terms of optimizing the entire procurement process.
Also, to speed up procurement procedures, ensure its transparency, eliminate the human factor of errors and a possible lobby when considering tender bids, the issue of complete automation of tender procedures is being worked out by integrating at the level of the Center for Electronic Finance of the Ministry of Finance of the Republic of Kazakhstan with
- State Register of Medicines and Medical Products,
- e-Government portal,
- State E-licensing base.
“Today, in order to improve the efficiency of logistics in terms of the uninterrupted operation of each link of supply, the SK-Pharmacy logistics system switched to a new algorithm for the delivery of medicines, which made it possible to increase the number of scheduled flights by 1.7 times, reduce the delivery time (from 2 weeks up to 1 week) and ensure the prompt operation of the entire drug supply chain. Also, in preparation for a possible new wave of coronavirus infection, a complete audit of the logistics processes and the entire Cold Chain — from producer to consumer, was carried out,” Iskaliev noted.
Currently, SK-Pharmacy, in close cooperation with the Ministry of Healthcare and Ministry of Digital Development, is developing an IT strategy that will allow for complete automation of the planning, procurement and logistics of medicines. The use of generally accepted IT solutions from the leaders of the logistics industry and domestic IT developments in the SK-Pharmacy infrastructure will make it possible to track medicines throughout the supply chain, provide operational management of inventory balances and movement of goods, as well as protect medicines from secondary circulation. So, to date, a memorandum has been signed between SK-Pharmacy and Kazakhtelecom on a pilot project for labeling pharmaceutical products. First of all, these are pilot projects with domestic manufacturers, which are already starting to be implemented.
As part of the support of domestic pharmaceutical manufacturers, the volume of purchases through long-term contracts is increasing.
As part of the adoption of support measures for domestic producers, it is planned to revise the criteria for selecting suppliers for concluding long-term contracts, the performance of existing long-term contracts is monitored on a regular basis and the KPI's achievement of the growth in the share of purchases through domestic producers is strictly controlled.
As part of the acceleration of the introduction to the market of medicines of local manufacturers, the examination of registration of domestic pharmaceuticals and the procedure for assessing the safety and quality of Kazakhstani pharmaceutical products were accelerated.
A great stimulus for the development of pharmaceutical clusters, according to Iskaliev, will be the attraction of large players Bigpharm to the industry, the development of domestic R&D centers, as well as the deployment of new industries in free economic and industrial zones.
“To ensure the national drug safety of Kazakhstan, at a government session, a Comprehensive Plan for the Development of the Pharmaceutical Industry until 2025 was adopted, the main task of which is to create a platform for entry into the country of large drug brands and localize the production of original drugs. SK-Pharmacy has a responsible role and we will continue systematic work in this direction,” said Iskaliev.
To implement the assigned tasks, SK-Pharmacy is developing a Restart Program. All proposals and issues are discussed with representatives of the public, the office of "Adaldyq alany", with industry experts, associations and patient organizations, with the scientific community of the Republic of Kazakhstan, as well as at the site under the training program for industry managers of the Elbasy Academy.
"The implementation of the SK-Pharmacy Restart Program will ensure readiness for a possible new wave of coronavirus infection, increase the efficiency and efficiency of the work of a single distributor, transparency and openness of the company's activities,’’ said Iskaliev.