With procurement coming under a lot of questions, the health ministry is exploring to reform the medical procurement system, including buying from manufacturers and doing away with middlemen.
Health Minister Dechen Wangmo, at the first high-level committee meeting yesterday, said that quite a significant amount of the health budget is spent on procurement. “About 70 percent of our budget goes into procuring commodities including drugs,” Lyonpo said adding that even health infrastructure is a part of the procurement. “Look at the quality we have. We have some fundamental issues of procurement so we are trying to solve it.”
The minister who had been after quality issues for a while said that she wants to have a good system that is effective, efficient and helps the ministry maximise the utilisation and expenditure.
Citing an example in India, Lyonpo said that while India promotes the private sector in the health sector, they came up with AMRITA, a project by the current government to directly procure from the manufacturers.
The Department of Medical Supplies and Health Infrastructure (DoMSHI) procures a type of malaria drugs through WAMBO, the global fund’s on-line procurement platform and it has a saving of 45 percent.
“We are saving 45 percent so you can only imagine what we can do with that money,” Lyonpo said.
Referring to the data of essential drugs in the last six years, Lyonpo said the cost of more than 70 percent of the drugs has gone up by more than 500 percent. “We are held by our suppliers, we are on the whims and fancies of our suppliers.”
Lyonpo asked DoMSHI officials to take lead, do a thorough study on the new modal of procurement and present it in the next meeting.
The department was asked to provide detailed information on procurement including if the ministry should float international tenders, if the procurement could be done directly, how much the country is spending on medical procurement, where it is going, and how efficiency can be gained.
The department was also asked to study the pros and cons of direct procurement and if the system has to be changed.
On equipment, Lyonpo said there should be detailed information like its brand, if WHO has prequalified it and how much money could be saved if the ministry procured from manufacturers. “The high-level committee will recommend the government and ask the finance ministry for autonomy in procurement,” Lyonpo said.
Bhutan Medical Health Council’s registrar general, Sonam Dorji, said there are many issues in direct procurement like companies not registering because of our limited requirement compared with other countries. DRA’s drug controller, Kinga Jamphel, said when it comes to changing procurement of drugs and medical equipment system, a lot of groundwork has to be done.