Access to Essential Medicines in Selected Municipalities in Philippines

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Drug Management System: Access to Essential Medicines

Abstract
Most leading causes of death and disability in developing countries can be prevented, treated or at least alleviated with cost-effective essential drugs1. These are essential medicines that save lives and improve health if they are available, of assured quality and properly used. Despite this fact hundreds of millions of people do not have access to essential drugs. Inadequate provision of good quality essential drugs often results to the inaccessibility of these drugs to the general population, particularly the poor. This situation remains one of the most serious public health problems. As a response, the government crafted the Philippine National Drug Policy. The policy aims to guarantee that the drugs in the market are affordable, accessible, safe and effective. However, years after it was first implemented, the drug management system in the country is far behind the goal. Similarly, the government passed the Generics Act of 1998 to increase the population’s access to essential drugs. Yet, it has not been successful because of the perception and reality of poor quality generic drug products. Multinational drug companies segment the market resulting to the perception that branded, expensive drugs are of high quality while generic while affordable drugs are perceived to be inferior quality. This is the reality even down to local level2. This paper summarizes the results of the descriptive study documenting the drug management system and the availability of essential medicines in the Zuellig Family Foundation’s (ZFF) Cohort 2 partner-municipalities. Given the situation in the national level, this paper illustrates the current system of drug management in the local level. This is part of the situational analysis for an intervention that intends to recommend possible strategies and interventions to address the identified problems of local government units.

DRUG MANAGEMENT SYSTEM
Every cause of public health problems particularly in medicines can directly or indirectly affect the communities. Today, despite the potential health impact of essential medicines borne either by government or by the patient, lack of access to essential medicines, irrational use of medicines and poor product quality remains serious public health problems3. Purchasing of Drugs All municipalities in cohort 2 follow the usual process of purchasing medicines. The MHO decides on the medicines that must be included in the Purchase Request (PR) form. Ideally, medicines should be based from the Philippine Drug Formulary List but more often than not, the choice of medicines is dependent on the causes of morbidity cases of each municipality, previous medicines procured and its medicine price as well. Hereafter, prepared PR is submitted to the Bidding Awards Committee (BAC). The BAC consolidates the PR and prepares a purchase order. Prior to drug placement to the supplier, BAC will look for a lowest bidder of medicines listed in the PR. Upon the receipt, the BAC inspects the drugs and documents. The MHO is notified of the receipts of drugs. The supplier confirms the receipt of payment and issues the official receipt. The process involves the checking up of medicines in terms of quantity and quality. As per role, it is with the MHO’s choice which drugs will be purchased not from the BAC. Are these drugs being used rationally? Since drugs being purchased are based from the usual cases of morbidity and mortality per municipality, it was guaranteed that drugs purchased complement the health needs of the community, most especially of the underprivileged. However, there were instances that most available drugs in the RHU are those that were given by other benefactors. From the MOHs perspective, as a recipient from other donors, this was highly appreciated and recognized though it must not be considered as a reason of not utilizing the budget allocated for drugs efficiently. Management Support In...
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