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Will the MH give up the tenders for medicines? |
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 The problems with the provisions of medicines for cancer patients and other diseases included in Regulation 34 are not from yesterday. Thousands of patients are forced to interrupt their treatment due to the irregular supplies from MH. As a result even the few allocated money for medicines go in vain because the broken schemes for treatment make it ineffective and useless. The change of government did not solve these problems and the deficit in the state budget even deepened them. The imposed cutting of expenses of MH forces it to reduce the supplies even further. The situation in the last few months of the year becomes dramatic. Even though the MH hide the data it can be assumed to a large extent that the quantities of medicines under Regulation 34 are about to finish and will not be enough until the new negotiations for 2010. The reasons for that permanent crisis lies in the corrupt way for supply of medicines under Regulation 34. Such a practice of holding tenders is typical to some underdeveloped African and Asian countries but was revoked long ago in the developed European countries.
Besides that in this way prerequisites for corruption are created there can be pointed out many examples in previous years when due to violated procedures and appeals contracts were not signed and there were not supplies for more than half a year and during that time the patients were left in the hands of fate. The current centralized system has another big disadvantage - the medicines are dispensed by strictly defined hospitals and dispensary clinics. That forces most of the patients every month to travel hundreds of kilometres to these hospitals and dispensaries. Besides that the patients have access only to the medicine that has won the tender and all the other medicines can be received only with payment. The built system for prescription, approval and supply is so clumsy that sometimes months pass before the patient receives the medicine and that time can be fatal to the development of the disease. The same system forces the doctors to prescribe not these medicines that they deem most appropriate but those that are in stock in the pharmacy of the relevant dispensary clinic. The pharmaceutical producers have no opportunity to plan their activity for next year because they do not know if they will win the tender.
Is there a way for the patients to receive their medicines on time? There is and it is related to the transition of the medicines in question to NHIF for reimbursement. The health fund does not hold tenders and pays all medicines dispensed to the patients. There we will not hear a sentence like 'depleted quantities'. NHIF has contracts with pharmacies from all over the country and that saves unnecessary travel to the ill persons. NHIF has got a reserve of almost 700 million leva and with a portion of it the needs for the next years can be covered.
Last week Teodora Zaharieva from CPRH announced that she managed to convince the prime minister Borissov of the necessity the NHIF to take the payment of medicines included in Regulation 34. Borissov ordered to the ministers of finance and health and to the Chairman of the health commission in parliament to make the transition within three weeks.
What is necessary to be done? Amendment to the Law on the budget of NHIF for 2009 in order to provide 20 million leva that are needed till the end of the year, amendments to regulation 34 and Regulation 38, changes in the appendixes of the Positive medicine list. The determined by the prime minister deadline of 3 weeks is entirely enough for the work.
Is it possible that despite the orders from Borissov the change will not take place?
It is possible you can bet. Even though from the point of view of patients and doctors the change is for the good and it is completely justified from political, financial and medical point of view, some of the people on whom the technical realisation depends can become an insurmountable obstacle. There are a couple of officials and one advisor at MH for whom the distribution of the scarce quantity of medicines has become the only form of self-expression giving them importance and self-respect and very probably extra income, too, and for whom the change would mean an end to property and non-property benefits. The same will come rushing in to explain how terrible it would be to do the reform, what chaos will come and how it is better to postpone things for at least one year. The same way they convinced the previous ministers. In defence of their interests some formal patients' organisations might be used as well as doctors who are deeply trenched in the sphere of dispensary oncology. Who will overpower - if the interests of the patients or the interests of the a few clerks it remains to be seen. It is going to be e test of the ability o GERB to take and realise good management decisions. From the final decision we will understand if GERB will lead a new transparent policy or will continue in the trodden path of the previous government. |
петък, 03 септември 2010
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