Assessing the procurement of drugs and the results of using drugs for bidding at 105 Military Hospital from 2015 to 2017. Methods: Using retrospective study plan and bidding results for drug purchase.
Trang 1ASSESSMENT OF DRUG BIDDING AND THE RESULTS OF USING
BID-WINNING DRUGS AT 105 MILITARY HOSPITAL
FROM 2015 TO 2017
Ho Canh Hau 1 ; Nguyen Minh Chính 2 ; Hoang Hai 2 Nguyen Thi Lan Huong 1 ; Nguyen Thi Tam 1
SUMMARY
Objectives: Assessing the procurement of drugs and the results of using drugs for bidding at
105 Military Hospital from 2015 to 2017 Methods: Using retrospective study plan and bidding results for drug purchase Results: Having develop a list of hospital drugs in 2015 of 545 items, and 675 items in 2016, and 719 in 2017 Develop a list of bidding drugs: In terms of amounts, in
2015 it was 987 items/226 active ingredients, in 2016 it was 503 amounts/292 active ingredients, in 2017 it was 642 items/386 active ingredients Result of purchase: in 2015, it was
340 items, in 2016 it was 332 and in 2017 was 441 items Results used for health insurance subjects: 2015 was 356 items, 2016 was 354 items and in 2017 was 434 items Conclusion: Develop a list of hospital drugs in 2015 - 2017 from 545 to 719 Developing a list of bidding drugs: not rational for 3 years The result of buying increased from 340 to 441 items in period of
2015 - 2017
* Keywords: Drug bidding; Purchase and use of bid-winning drug; 105 Military Hospital
INTRODUCTION
Article 44 of the Law on Bidding No
43/2013/QH13 states that “Centralized
procurement is a way of organizing
tenders widely to select contractors
through concentrated procurement units
in order to reduce costs, time and
clues organize bidding, enhance the
professionalism in bidding, contribute to
increasing economic efficiency”[1] Guiding
and implementing the Bidding Law No 43
and Decree 63/2014/ND-CP [2] with Circular
No 11/2016/TT-BYT providing regulations
on bidding for drugs at health facilities and the Circular No 09/2016/TT-BYT issues 106 active ingredients required for concentrated local procurement [3], [4] According to the regulations on concentrated drug biddings, there were 59 national-level bids, 106 local-national-level concentrated biddings and 8 negotiated prices Thus, compared to 1,091 western medicines (issued under Circular No 09/2016), medical facilities organize their bidding if required
1 105 Military Hospital
2 Vietnam Military Medical University
Corresponding author: Ho Canh Hau ((dshocanhhau2019@gmail.com)
Date received: 01/10/2019
Date accepted: 27/11/2019
Trang 2From 2015 to 2017, bidding at health
facilities will follow the guidance of
Circular No 01/2012/TT-BYT [5] and
Circular No 11/2016/TT-BYT (from July
1, 2016) During this period, evaluation of
the procurement of drugs and the use of
drugs at 105 Military Hospital which
practical and urgent in conducting the
bidding for the following years at the
research unit Thus, the aims of this study
were: To assess the drug bidding and the
results of using bid-winning drugs at 105
Military Hospital from 2015 to 2017
SUBJECTS AND METHODS
1 Subjects
Legal documents, hospital drug list, drug bidding list and bid-winning drugs list
at 105 Military Hospital from 2015 to 2017
2 Methods
Using retrospective method to evaluate the drug bidding results and the drug procurement through the bidding from the list of hospital drugs, the list of bidding drugs and the list of procurement by bid at
105 Military Hospital from 2015 to 2017
RESULTS
From 2015 to 2017, 105 Military Hospital conducted extensive bidding to purchase drugs Evaluation of bidding and procurement of drugs by bid was shown below
1 Develop a list of hospital drugs
The hospital's drug list serves as a basis for developing a list of bidding and use drugs during the year From 2015 - 2017, the list of hospital drugs was shown in table 1
Year
The analysis results in table 1 showed:
- List of hospital drugs had been built
up year by year: 545 items in 2015, 675
items in 2016 and 719 items in 2017
Thus, compared with 2015, the figure
increased by 130 items in 2016 and 174
items in 2017
- The number of drugs in categories V
and E decreased, while the amount of
drugs in group N increased from 16.33%
in 2015 to 26.56% in 2017
- The list of hospital drugs and the process of increasing the amounts must
be selective, in accordance with the following requirements:
+ Ensuring consistent with disease patterns and costs of drugs used for treatment in hospitals: Focusing on health insurance subjects
+ Appropriate in terms of technical expertise: Grade 1 hospital
Trang 3+ Respond to new methods, new
techniques in treatment
+ Limit the use of some drugs of great
value or drugs with serious adverse
reactions, drugs that are in doubt about
the effectiveness of treatment
- It is necessary to cut down the drugs
in group N and strengthen the drug group
E (the essential medicine group) According
to the proposal of the project, it is necessary to reduce the group of N drugs
to below 10% in order to concentrate funding for group E
2 Developing a list of bidding drugs
* Compare the list of bidding drugs and the list of hospital drugs:
Year
- Develop a list of bidding drugs compared to the list of hospital drugs with a number
of items accounting for 181.10% in 2015; 74.52% in 2016 and 2017 was 89.29%
- The number of active ingredients accounted for 58.33 - 75.39% in 3 years This result showed that there was no link between the bidding list and the list of hospital drugs
* Analysis of the list of bidding drugs according to ABC:
Year
- To achieve about 75% of funding (group A), the number of items in 2015 accounted for 13.58%, 14.91%; 18.69% in 2016 and 2017, respectively
- To achieve about 10% of funding (group C), the number of items in 2015 accounted for 71.02%, 68.59% in 2016 and 65.26% in 2017
The above results were not reasonable, showing that the percentage of group A in the list of drugs for bidding next year was higher than the previous year, while group C gradually decreased
Trang 4* Compare the number of items in the list of budding drugs with the list of hospital drugs by VEN analysis:
The percentage of groups V, E, N in the list of bidding drugs and the list of hospital drugs from 2015 to 2017 was shown in figure 1
hospital drugs
- The percentage of groups V, E, N between bidding drugs and hospital drugs in a year was quite different: Group V in 2015 was about 3% apart, 7% in 2016 and 4% in
2017 Group N in 2015 was about 6% different, about 3% in 2016 and 2% in 2017
- In 3 years, the proportion of groups V, E, N in bidding drugs was not proportional Group V in 2015 was 22.49%, in 2016 it was 17.5% and in 2017 it was 28.35% Group
N in 2015 was 22.90%, in 2016 it was 27.04% and in 2017 it was 22.27%
3 List of purchased and used drugs
* Compare the list of bid-winning drugs with the list of purchased drugs according to ABC analysis:
ABC analysis from 2015 - 2017
Year
Bidding
Purchased
Trang 5- In order to achieve about 75% of the
cost for drugs of group A, the list of drugs
bidding for 3 years accounted for 13.58 -
18.69% of the total items, while the list of
purchased drugs according to bidding
results accounted for 12.06 - 15.42%
- In order to achieve about 10% of the
cost for drugs of group C, the bidding list
from 2015 to 2017 accounted for 65.26 -
71.02% of the items, while the list of
purchased drugs accounted for 69,39 - 73.82%
- There was no positive proportion among drug groups A, B and C between the bidding list and the procurement list from 2015 - 2017
- The use rate of high value drugs (group A) increased year by year (from
12.06% to 15.42% in 2017)
* Compare the list of bid-winning drugs with the list of purchased drugs according to VEN analysis:
to VEN analysis
Year Drug list
Bidding
Purchased
In 2015, the list of bidding drugs and
the list of procured drugs was quite similar
in all 3 groups V, E, N In 2016 and 2017,
the proportion among groups V, E, N was
different:
- In group V: The list of procured drugs
increased by around 5% compared to the
list of bidding drugs
- In group E: In 2016, the list of
purchased medicines decreased by 6%
compared to the list of bidding drugs;
by 2017, on the contrary, the list of
purchased medicines increased by about
6% compared to the list of bidding drugs
This result showed that the construction
of the bidding list of drugs was not close
to the demand for use in 2016 and 2017
* Compare the list of bid-winning drugs with the list of purchased drugs according
to ABC/VEN analysis:
Analysis of groups, of which group I was AV, AE, AN, BV and CV (the most important drug group), group II was BE,
BN and CE (important drug group) and group III was CN (less important drug group) in the ABC/VEN matrix as a percentage of the number of items shown
in table 6
Trang 6Table 6: Comparing list of bid-winning drugs and list of drugs purchased according
to ABC/VEN analysis
Group
Bidding
Purchased
- The percentage of groups I and II of
bid-winning drugs completed quite similar
In group III, the ratio fluctuated quite a lot:
in 2015, it accounted for 15.70%, in 2016
it decreased to 11.13%, in 2017 it
increased to 17.76%
- Percentage of purchased drugs in
groups over 3 years of fluctuating was not
proportional The results in group III (less
important drug group) decreased from
15.88% in 2015 to 12.02% in 2017 This
result showed that the hospital has paid
attention and cut down on less important
drugs in shopping
- Compare the percentage of bid-winning drugs with the percentage of procurement: The proportion in all three groups fluctuated slightly (the highest was
in group III, when the buying ratio was lower than bidding at about 6%)
* Results of procurement and use of drugs for medical insurance subjects:
105 Military Hospital has examination and treatment for 3 main subjects: Army - policy; health insurance and medical services Depth analysis of drug use results for health insurance subjects was shown in table 7, 8
Drugs
Items
Value
(milion)
(DPM: Domestically produced medicine; ID: Imported drugs)
The number of items of domestically procured drugs was equivalent to that of imported drugs for 3 years, but the value of imported drugs always accounted for a large proportion, about 70% in 3 years
Trang 7Table 8: Results of using brand-name drugs for medical insurance subjects
(Unit: Million VND)
Used drugs
The value of imported drugs has focused
mainly on the original brand-name drug
The used items accounted for about 10%
in 3 years, but the used value increased
from 13.33% in 2015 to 29.02% in 2017
From results of tables 7 and 8, it can
be demonstrated that:
- It is necessary to focus on managing
the amount of used drugs for the
brand-name drug group, because this is a
high-cost drug group, increasing the high-cost of
medical examination and treatment by
health insurance subjects
- Priority should be given to the
development of domestically manufactured
drugs to reduce the cost of use of drugs,
and at the same time to meet the Ministry
of Health's "Vietnamese people give priority
to using Vietnamese drugs" project [6]
CONCLUSION
- Building a list of hospital drugs: 545
items in 2015, 673 items in 2016 and 719
items in 2017 In particular, the number of
items in non-essential medicine group (N)
increased from 16.33% in 2015 to 26.56%
in 2017
- Building a list of bidding drugs: 987
items in 2015, 503 items in 2016 and 642
items in 2017 The active ingredient
accounted for 58.33 - 75.39% in 3 years
- Results of the list of drugs used:
545 items in 2015, 673 items in 2016 and
719 items in 2017 In particular, the amount
of non-essential drugs (N) increased from 16.33% in 2015 to 26.56% in 2017
- Implementing the bidding results: In
2015 and 2016, it exceeded 50% of the bidding results, and in 2017 only achieved about 50% of the bidding results
REFERENCES
1 National Assembly Bidding Law No
43/2013/QH13 Entry into force July 1, 2014
2013
2 Government Decree No 63/2014/NĐ-CP
Detailing a number of articles of the Bidding Law regarding contractor selection 2014, June 26
3 Ministry of Health Circular No
11/2016/TT-BYT Regulate the bidding for drugs at public health facilities 2016, May 11
4 Ministry of Health Circular No
09/2016/TT-BYT Promulgate the list of concentrated bidding drugs and the list of drugs subject to price negotiation 2016, May 5
5 Ministry of Health Circular No
01/2012/TTLT-BYT-BTC Guidance on bidding for purchasing drugs in health facilities 2012, January 19
6 Ministry of Health Decision No
4824/QD-BYT dated December 3, 2012 of the Minister of Health, approving the project
"Vietnamese people give priority to using Vietnamese drugs 2012