Organisation of Eastern Caribbean States (OECS) Pharmaceutical Procurement Service (PPS) 22nd - 23rd February 2017 Washington, DC 1

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22nd - 23rd February 2017 Washington, DC 1

Pharmaceutical Procurement Service Meet the PPS Staff

Outline Background Essential features Pricing and supply Tendering/Contracting/Payment Benefits of pooled procurement Challenges Conclusion 22nd - 23rd February 2017 Washington, DC 3

Regional pooled procurement of Pharmaceuticals Anguilla Antigua and Barbuda British Virgin Islands Dominica Grenada Martinique 10 OECS COUNTRIES 1 million people Montserrat St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines 22nd 10th --12th 23rd June February 20142017 Washington, DC 4

Pharmaceutical Procurement Service Inspiring quote Even if you stumble, you re still moving forward Author : unknown 22nd - 23rd February 2017 Washington, DC 5

OECS/PPS MISSION STATEMENT Our mission is to maximize healthcare services of the OECS countries by pooled procurement and management of pharmaceuticals and related medical supplies. 22nd - 23rd February 2017 Washington, DC 6

Background Access to essential medicines is a basic human right. Medicines are a major requirement for foreign exchange. Financial constraints have rendered it difficult for OECS Governments to adequately finance medicines. 22nd - 23rd February 2017 Washington, DC 7

Supply chain management 22nd - 23rd February 2017 Miami, FloridaWashington, DC 8

Pharmaceutical Procurement Service Summary of OECS DURs F. Burnett et al Year # of R Topic 1995 4000 HBP/DM, 4 MSs 1996 1412 Asthma, 3 MSs 1998 354 Epilepsy, 2 MSs 1999 367 Schizophrenia, 2 MSs 2005 3830 HBP/DM, 2 MSs 2010 400 HIV/AIDS, 6 MSs 2012 59 Elderly in LTC in LUC 22nd - 23rd February 2017 Washington, DC 9

Pharmaceutical Procurement Service Courtesy :Asoc. Prof Susan Connell 22nd - 23rd February 2017 Washington, DC 10

Pharmaceutical Procurement Service Features Established in 1986 Permanent Secretariat OECS Economic Union Country-based committees Payments through Central Bank Self-financing in 1989 with 9% surcharge Shared culture, language, ethnicity, currency Restricted International bid for 550 medicines with 30 suppliers Medicines subsidized or free of cost at the point of service 22nd - 23rd February 2017 Washington, DC 1 1

Country receives Goods and inform PPS Supplier ships directly to consignee 22nd - 23rd February 2017 Washington, DC 12

70,000 60,000 [VALUE] vials Consumption 50,000 40,000 30,000 14,600 [VALUE] vials 20,000 10,000 0 2014 2015 2016 Insulin Annual Procurement 22nd - 23rd February 2017 Washington, DC 13

Benefits of pooled procurement Economic Monopsony, bargaining power Economies of scale, prices, 20% Fixed, common price for tender period 22nd - 23rd February 2017 Washington, DC 14

Benefits of Pooled Procurement Non- economic, value-added Enhanced quality assurance Coordinated training, research, M&E Regional cooperation and integration Harmonized formulary manual, STGs Sharing of information and experience Transparent and rational procurement, ICB Confidence-building with clients and suppliers 22nd - 23rd February 2017 Washington, DC 15

Update on hypertension treatment Service Level of medicines 16

Gaps in procuring meds for NCDs Potential for using the PAHO Strategic Fund? DMARDs Orphan medicines Anti-cancer medicines 22nd - 23rd February 2017 Washington, DC 17

OECS/PPS challenges Opposition and influence by suppliers Late payments Poor forecasting Small countries and purchase orders Purchasing outside the cartel Managing donations 22nd - 23rd February 2017 Washington, DC 18

Conclusion OECS/PPS pooled procurement has produced significant benefits for the Organization of Eastern Caribbean States (OECS) Member States. 22nd - 23rd February 2017 Washington, DC 19

22nd - 23rd February 2017 Washington, DC 20