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1.
Lima; Perú. Ministerio de Salud; 20210100. 13 p. tab.
Monografía en Español | MINSAPERÚ | ID: biblio-1146075

RESUMEN

El documento contiene el proceso de solicitud de productos farmacéuticos, dispositivos médicos y productos sanitarios por parte de las IPRESS Públicas, y el uso de los recursos para la adquisición y distribución de los mismos a través del Centro Nacional de Abastecimiento de Recursos Estratégicos en Salud (CENARES), a favor de afiliados al Seguro Integral de Salud en el marco del aseguramiento universal en salud.


Asunto(s)
Preparaciones Farmacéuticas , Aparatos Sanitarios , Adquisición en Grupo , Cobertura Universal del Seguro de Salud , Equipos y Suministros , Buenas Prácticas de Distribución
2.
JAMA ; 324(8): 808-809, 2020 08 25.
Artículo en Inglés | MEDLINE | ID: mdl-32840589
4.
Drug Discov Ther ; 14(3): 145-148, 2020 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-32536620

RESUMEN

Healthcare group purchasing organizations (GPOs) are considered to play an integral role in the healthcare supply chain by keeping prices low and helping all members of the healthcare system achieve their objectives. China has been exploring GPOs in the field of drug procurement since 2015, and there are currently three GPO models in Shanghai, Shenzhen, and Guangzhou. Although the three models operate differently and they have each been examined, they have all achieved certain results and demonstrated the ability to control drug expenditures. In 2018, the National Healthcare Security Administration implemented a national centralized drug procurement policy, also known as the 4 + 7 procurement policy ("4+7 Policy"). This policy context has also led to changes in the strategy for development of GPOs in China. GPOs need to explore strategies that do not overlap with the scope of 4 + 7 procurement, and they need to develop dynamic and personalized procurement plans that are more in line with first-line clinical practices to have a synergistic effect in combination with the "4+7 Policy." In the future, GPOs will grow rapidly in China. The number of GPOs need to be increased to prevent monopolies, and GPOs need to expand their diversified value-added services to perform more tasks in terms of supply chain management and data analysis.


Asunto(s)
Costos de los Medicamentos , Adquisición en Grupo/economía , Adquisición en Grupo/métodos , Política de Salud/economía , China/epidemiología , Costos de los Medicamentos/tendencias , Adquisición en Grupo/tendencias , Política de Salud/tendencias , Humanos
5.
Brasília; IPEA; jun. 2020. 20 p. (Nota Técnica / IPEA. Diset, 68).
Monografía en Portugués | LILACS, ECOS | ID: biblio-1102404

RESUMEN

A pandemia da Covid-19 expôs ao mundo a fragilidade dos arranjos institucionais de suprimentos para os sistemas de saúde mundiais. Insumos básicos para o atendimento de saúde, como equipamentos de proteção individuais (EPIs), respiradores artificiais e higienizantes/saneantes, passaram a ser disputados por diversos países e a ensejar comportamentos fraticidas entre sistemas de saúde privado e público de diferentes esferas no Brasil: pelo menos seis estados e diversas prefeituras editaram atos administrativos para requisitar insumos e produtos como respiradores durante a pandemia, levando a União a reagir na Justiça e a defender uma centralização das compras desses produtos. Entes privados como a Associação Nacional de Hospitais Privados (ANAHP), a Confederação das Santas Casas de Misericórdia, Hospitais e Entidades Filantrópicas (CMB) e a Confederação Nacional de Saúde (CNS) questionaram judicialmente o privilégio dos hospitais públicos na distribuição de EPIs. Nesse contexto de ruptura da cadeia de suprimentos e de concorrência predatória entre compradores, a Organização Mundial da Saúde (OMS) recomenda, além da racionalização da demanda e do uso dos insumos hospitalares, a gestão centralizada dessas aquisições e a coordenação do abastecimento das unidades de saúde para evitar excessos e quebras de estoques (WHO, 2020). A transposição dessa reflexão para o cenário brasileiro requer uma apreciação dos desafios e das oportunidades de aperfeiçoar os mecanismos de agregação de demandas e as sistemáticas de compras conjuntas disponíveis para os gestores públicos envolvidos no enfrentamento da emergência de saúde pública da Covid-19, com maior colaboração entre os entes públicos e o possível envolvimento de entes privados que atendam majoritariamente pacientes do Sistema Único de Saúde (SUS), ao mesmo tempo que se preserve a transparência e se facilite a fiscalização. Algumas alterações legais e procedimentais são necessárias, parte delas no nível mais geral das compras e contratações, e sua implementação em caráter experimental, se alcançar resultados satisfatórios, pode se tornar definitiva e inclusive ser expandida para outros contextos (objetos de contratação, modalidades, poderes e entes). A nota tem mais cinco seções além desta introdução. Na próxima, fazemos uma motivação para um arcabouço de compras centralizadas em saúde. Em seguida, varremos algumas experiências internacionais de compras centralizadas e o que tem sido feito no Brasil a respeito. As seções seguintes detalham, então, o arcabouço legal para se implementar um Sistema de Registro de Preços de Emergência, que chamamos de Acordo-Marco, e um leque de propostas de implementação para esse sistema. A última seção consolida as considerações finais.


Asunto(s)
Adaptación Psicológica , Salud Pública , Adquisición en Grupo , Coronavirus , Urgencias Médicas , Pandemias , Equipo de Protección Personal
6.
Brasília; IPEA; abr. 2020. 31 p. ilus.(Nota Técnica / IPEA. Disoc, 63).
Monografía en Portugués | LILACS, ECOS | ID: biblio-1102399

RESUMEN

Esta nota tem por objetivo discutir alguns aspectos relacionados ao fornecimento de equipamentos de proteção individual (EPIs) e outros materiais necessários à minimização do risco de contágio pelo coronavírus por trabalhadores em estabelecimentos de saúde, especialmente o aumento de preços desses produtos em virtude do crescimento da demanda por causa da pandemia de Covid-19.


Asunto(s)
Política Pública , Sistema Único de Salud , Adquisición en Grupo , Infecciones por Coronavirus , Coronavirus , Comercio , Regulación Gubernamental , Pandemias , Equipo de Protección Personal
7.
Brasília; IPEA; 2020. 20 p. (Nota Técnica / IPEA. Diset, 68).
Monografía en Portugués | ECOS, LILACS | ID: biblio-1139905

RESUMEN

A pandemia da Covid-19 expôs ao mundo a fragilidade dos arranjos institucionais de suprimentos para os sistemas de saúde mundiais. Insumos básicos para o atendimento de saúde, como equipamentos de proteção individuais (EPIs), respiradores artificiais e higienizantes/saneantes, passaram a ser disputados por diversos países e a ensejar comportamentos fraticidas entre sistemas de saúde privado e público de diferentes esferas no Brasil: pelo menos seis estados e diversas prefeituras editaram atos administrativos para requisitar insumos e produtos como respiradores durante a pandemia, levando a União a reagir na Justiça e a defender uma centralização das compras desses produtos. Entes privados como a Associação Nacional de Hospitais Privados (ANAHP), a Confederação das Santas Casas de Misericórdia, Hospitais e Entidades Filantrópicas (CMB) e a Confederação Nacional de Saúde (CNS) questionaram judicialmente o privilégio dos hospitais públicos na distribuição de EPIs. Nesse contexto de ruptura da cadeia de suprimentos e de concorrência predatória entre compradores, a Organização Mundial da Saúde (OMS) recomenda, além da racionalização da demanda e do uso dos insumos hospitalares, a gestão centralizada dessas aquisições e a coordenação do abastecimento das unidades de saúde para evitar excessos e quebras de estoques (WHO, 2020). A transposição dessa reflexão para o cenário brasileiro requer uma apreciação dos desafios e das oportunidades de aperfeiçoar os mecanismos de agregação de demandas e as sistemáticas de compras conjuntas disponíveis para os gestores públicos envolvidos no enfrentamento da emergência de saúde pública da Covid-19, com maior colaboração entre os entes públicos e o possível envolvimento de entes privados que atendam majoritariamente pacientes do Sistema Único de Saúde (SUS), ao mesmo tempo que se preserve a transparência e se facilite a fiscalização. Algumas alterações legais e procedimentais são necessárias, parte delas no nível mais geral das compras e contratações, e sua implementação em caráter experimental, se alcançar resultados satisfatórios, pode se tornar definitiva e inclusive ser expandida para outros contextos (objetos de contratação, modalidades, poderes e entes). A nota tem mais cinco seções além desta introdução. Na próxima, fazemos uma motivação para um arcabouço de compras centralizadas em saúde. Em seguida, varremos algumas experiências internacionais de compras centralizadas e o que tem sido feito no Brasil a respeito. As seções seguintes detalham, então, o arcabouço legal para se implementar um Sistema de Registro de Preços de Emergência, que chamamos de Acordo-Marco, e um leque de propostas de implementação para esse sistema. A última seção consolida as considerações finais.


Asunto(s)
Adaptación Psicológica , Adquisición en Grupo , Urgencias Médicas , Equipo de Protección Personal , Pandemias , Salud Pública , Brasil
8.
Brasília; IPEA; 2020. 31 p. ilus.(Nota Técnica / IPEA. Disoc, 63).
Monografía en Portugués | LILACS, ECOS | ID: biblio-1139926

RESUMEN

Esta nota tem por objetivo discutir alguns aspectos relacionados ao fornecimento de equipamentos de proteção individual (EPIs) e outros materiais necessários à minimização do risco de contágio pelo coronavírus por trabalhadores em estabelecimentos de saúde, especialmente o aumento de preços desses produtos em virtude do crescimento da demanda por causa da pandemia de Covid-19.


Asunto(s)
Adquisición en Grupo , Comercio , Coronavirus , Equipo de Protección Personal , Infecciones por Coronavirus , Pandemias , Personal de Salud , Política Pública , Regulación Gubernamental , Sistema Único de Salud , Brasil
9.
Inquiry ; 56: 46958019893857, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31823664

RESUMEN

The exclusion of employment-based health insurance from income and payroll taxes is thought to increase the generosity of insurance coverage and, in turn, increase the overutilization of low-value health care services. We examine this inefficiency of overinsurance by quantifying the change in expected utility across 4 benchmark plans varying in actuarial value (AV) and focus on the distribution of each of these estimates across different groups of people varying in health status. Specifically, we quantify the changes in health care spending due to moral hazard and the changes in uncertainty tied to risk aversion using data from the nationally representative sample of adults with employment-based coverage from the 2007-2016 Medical Expenditure Panel Survey, and produce estimates of expected utility for 24 groups of people based on their age, gender, and preexisting conditions. Our model suggests an average preferred AV of 78% without the tax exclusion, with 29.0% of the population preferring a 60% AV, 6.5% preferring a 70% AV, 18.1% preferring an 80% AV, and 46.4% preferring a 90% AV. When incorporating the distortionary effect of the employment-based tax exclusion, the preferred plan increases to an 83% AV for low-income people (with 71.0% of the population preferring a 90% AV) and an 84% AV for high-income people (with 76.0% of the population preferring a 90% AV). We estimate that policy changes to make subsidies independent of a plan's AV could result in increases in utility equal to about 2.7% of total health care spending, but with those net gains concentrated among the healthy.


Asunto(s)
Empleo/estadística & datos numéricos , Planes de Asistencia Médica para Empleados/economía , Impuesto a la Renta/economía , Cobertura del Seguro/economía , Exención de Impuesto/economía , Adquisición en Grupo , Planes de Asistencia Médica para Empleados/estadística & datos numéricos , Humanos , Impuesto a la Renta/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/economía , Estados Unidos
10.
Pharmacol Res Perspect ; 7(6): e00552, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31857910

RESUMEN

The high cost of drugs for hepatitis C limits access and adherence to treatment. In 2017, the Colombian health care system decided to design a strategy. It consisted of centralized purchasing, regulations, clinical practice guidelines, and direct observation of the treatment and follow-up of patients. The main objective of this study was to assess the centralized purchasing strategy in Colombia. The study design was a policy implementation assessment. We analyzed the change in prices, the clinical outcomes, and the opinions of stakeholders using data from the Ministry of Health. Additional information about effectiveness came from the Colombian Fund for High-Cost Diseases and semi-structured interviews of the stakeholders. The follow-up was from October, 2017 to October, 2018. The total number of patients reported in the cohort period was 1069. The number that finished 12 weeks of treatment, completed the follow-up for the case closure, and were considered cured through the end of October, 2018 was 563 (53%). The remainder, 506 patients (47%), are currently in treatment. A total of 543 of these treated patients (96%) were cured. After implementing this strategy, the drug prices decreased by more than 90% overall. Before implementation, the total direct cost was $100 102 171.75 dollars. Afterward, the cost was $8 378 747 dollars.


Asunto(s)
Antivirales/economía , Prestación de Atención de Salud/organización & administración , Costos de los Medicamentos/legislación & jurisprudencia , Implementación de Plan de Salud , Hepatitis C/tratamiento farmacológico , Antivirales/uso terapéutico , Colombia/epidemiología , Ahorro de Costo/economía , Ahorro de Costo/estadística & datos numéricos , Análisis Costo-Beneficio , Prestación de Atención de Salud/economía , Prestación de Atención de Salud/legislación & jurisprudencia , Prestación de Atención de Salud/normas , Costos de los Medicamentos/estadística & datos numéricos , Industria Farmacéutica/economía , Industria Farmacéutica/estadística & datos numéricos , Femenino , Adquisición en Grupo/economía , Adquisición en Grupo/legislación & jurisprudencia , Adquisición en Grupo/organización & administración , Adquisición en Grupo/normas , Hepacivirus/aislamiento & purificación , Hepatitis C/epidemiología , Hepatitis C/virología , Humanos , Masculino , Persona de Mediana Edad , Negociación , Políticas , Guías de Práctica Clínica como Asunto , Evaluación de Programas y Proyectos de Salud , Participación de los Interesados , Resultado del Tratamiento
11.
Harm Reduct J ; 16(1): 57, 2019 09 18.
Artículo en Inglés | MEDLINE | ID: mdl-31533730

RESUMEN

BACKGROUND: Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is legal in the USA in all but two states. However, people who inject drugs (PWID) face significant barriers accessing sterile syringes, particularly in states without laws allowing syringe services programming. To our knowledge, no recent studies of pharmacy-based syringe purchase experience have been conducted in communities that are both rural and urban, and none in the Southwestern US. This study seeks to understand the experience of retail pharmacy syringe purchase in Arizona by PWID. METHODS: An interview study was conducted between August and December 2018 with 37 people living in 3 rural and 2 urban Arizona counties who identified as current or former users of injection drugs. Coding was both a priori and emergent, focusing on syringe access through pharmacies, pharmacy experiences generally, experiences of stigma, and recommendations for harm reduction services delivered by pharmacies. RESULTS: All participants reported being refused syringe purchase at pharmacies. Six themes emerged about syringe purchase: (1) experience of stigma and judgment by pharmacy staff, (2) feelings of internalized stigma, (3) inconsistent sales outcomes at the same pharmacy or pharmacy chain, (4) pharmacies as last resort for syringes, (5) fear of arrest for syringe possession, and (6) health risks resulting from syringe refusal. CONCLUSIONS: Non-prescription syringe sales in community pharmacies are a missed opportunity to improve the health of PWID by reducing syringe sharing and reuse. Yet, current pharmacy syringe sales refusal and stigmatization by staff suggest that pharmacy-level interventions will be necessary to impact pharmacy practice. Lack of access to sterile syringes reinforces health risk behaviors among PWID. Retail syringe sales at pharmacies remain an important, yet barrier-laden, element of a comprehensive public health response to reduce HIV and hepatitis C among PWID. Future studies should test multilevel evidence-based interventions to decrease staff discrimination and stigma and increase syringe sales.


Asunto(s)
Adquisición en Grupo/legislación & jurisprudencia , Reducción del Daño , Compartición de Agujas/legislación & jurisprudencia , Farmacias/legislación & jurisprudencia , Abuso de Sustancias por Vía Intravenosa/rehabilitación , Jeringas/provisión & distribución , Adulto , Anciano , Arizona , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Hepatitis C/prevención & control , Hepatitis C/transmisión , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Estigma Social , Adulto Joven
13.
JAMA ; 321(17): 1729, 2019 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-31063563
15.
Int J Technol Assess Health Care ; 35(1): 50-55, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30732667

RESUMEN

OBJECTIVES: Procurement's important role in healthcare decision making has encouraged criticism and calls for greater collaboration with health technology assessment (HTA), and necessitates detailed analysis of how procurement approaches the decision task. METHODS: We reviewed tender documents that solicit medical technologies for patient care in Canada, focusing on request for proposal (RFP) tenders that assess quality and cost, supplemented by a census of all tender types. We extracted data to assess (i) use of group purchasing organizations (GPOs) as buyers, (ii) evaluation criteria and rubrics, and (iii) contract terms, as indicators of supplier type and market conditions. RESULTS: GPOs were dominant buyers for RFPs (54/97) and all tender types (120/226), and RFPs were the most common tender (92/226), with few price-only tenders (11/226). Evaluation criteria for quality were technical, including clinical or material specifications, as well as vendor experience and qualifications; "total cost" was frequently referenced (83/97), but inconsistently used. The most common (47/97) evaluative rubric was summed scores, or summed scores after excluding those below a mandatory minimum (22/97), with majority weight (64.1 percent, 62.9 percent) assigned to quality criteria. Where specified, expected contract lengths with successful suppliers were high (mean, 3.93 years; average renewal, 2.14 years), and most buyers (37/42) expected to award to a single supplier. CONCLUSIONS: Procurement's evaluative approach is distinctive. While aiming to go beyond price in the acquisition of most medical technologies, it adopts a narrow approach to assessing quality and costs, but also attends to factors little considered by HTA, suggesting opportunities for mutual lesson learning.


Asunto(s)
Propuestas de Licitación/organización & administración , Costos y Análisis de Costo/normas , Toma de Decisiones , Evaluación de la Tecnología Biomédica/organización & administración , Canadá , Propuestas de Licitación/normas , Control de Costos/organización & administración , Adquisición en Grupo/organización & administración , Humanos , Evaluación de la Tecnología Biomédica/economía , Evaluación de la Tecnología Biomédica/normas
16.
Drug Discov Ther ; 13(6): 365-369, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31956236

RESUMEN

In order to deepen the health system reform and improve the mechanism for the formation of drug prices, in January 2019, the General Office of the State Council of the People's Republic of China issued the "National centralized drug purchasing and using pilot program", selected 11 cities in mainland China to carry out "4+7" city drug volume based purchasing pilot work. This paper introduces the specific implementation plan, organizational structure and drug selection process of China's "4+7" city drug volume-based purchasing pilot work, and expounds the initial effects, existing problems and policy development after the implementation of the policy. After the implementation of the policy, the prices of 25 selected drugs were significantly lower, compared with the minimum purchase price of the same drugs in 11 pilot cities in 2017, the average drop was 52%. After the pilot scope was extended to the nation, compared with the minimum purchase price of the Union in 2018, the proposed price of the 25 drugs have an average price drop of 59%, compared with the selected price of the "4+7" pilot cities, the average price drop was 25%, and the price of drugs dropped further. By the end of August 2019, the implementation progress of 25 selected drugs in the "4+7" city drug volume-based purchasing was better than expected, the burden of patients' drug expenses was reduced, and the pilot work was beginning to bear fruit. The long-term influence and effect of the "4+7" city drug volume-based purchasing and policy implementation after the expansion needs to be further observed.


Asunto(s)
Comportamiento del Consumidor/economía , Adquisición en Grupo/organización & administración , Preparaciones Farmacéuticas/economía , China , Ciudades , Comportamiento del Consumidor/estadística & datos numéricos , Humanos , Proyectos Piloto
18.
Value Health Reg Issues ; 18: 54-58, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30445336

RESUMEN

OBJECTIVE: To understand the stewardship challenges in strategic purchasing of health care in Iran's health system from the viewpoints of experts, policy makers, and decision makers. STUDY DESIGN: This was a qualitative study. METHODS: Researchers used interviews and FGDs for collecting and framework analysis for analyzing data. RESULTS: Stewardship challenges were classified into three themes and nine subthemes. A lack of management information systems, a lack of enforcement for rules and laws, a lack of stewardship units, and the conflict of interest between the Ministry of Health and insurers as care purchasers in the health system are among the main challenges identified in the implementation of the strategic purchasing of health care in Iran. CONCLUSION: A strong stewardship is needed for implementing strategic purchasing of health care, which requires participation of all stakeholders.


Asunto(s)
Prestación de Atención de Salud/economía , Adquisición en Grupo/métodos , Planificación Estratégica , Prestación de Atención de Salud/normas , Prestación de Atención de Salud/tendencias , Grupos Focales/métodos , Adquisición en Grupo/normas , Política de Salud/tendencias , Humanos , Entrevistas como Asunto/métodos , Irán , Investigación Cualitativa
19.
Health Care Manag Sci ; 22(2): 336-349, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29508164

RESUMEN

Most healthcare organizations (HCOs) engage Group Purchasing Organizations (GPOs) as an outsourcing strategy to secure their supplies and materials. When an HCO outsources the procurement function to a GPO, this GPO will directly interact with the HCO's supplier on the HCO's behalf. This study investigates how an HCO's dependence on a GPO affects supply chain relationships and power in the healthcare medical equipment supply chain. Hypotheses are tested through factor analysis and structural equation modeling, using primary survey data from HCO procurement managers. An HCO's dependence on a GPO is found to be positively associated with a GPO's reliance on mediated power, but, surprisingly, negatively associated with a GPO's mediated power. Furthermore, analysis indicates that an HCO's dependence on a GPO is positively associated with an HCO's dependence on a GPO-contracted Original Equipment Manufacturer (OEM). HCO reliance on GPOs may lead to a buyer's dependence trap, where HCOs are increasingly dependent on GPOs and OEMs. Implications for HCO procurement managers and recommended steps for mitigation are offered. Power-dependence relationships in the medical equipment supply chain are not consistent with relationships in other, more traditional, supply chains. While dependence in a supply chain relationship typically leads to an increase in reliance on mediated power, GPO-dependent HCOs instead perceive a decrease in GPO mediated power. Furthermore, HCOs that rely on procurement service from GPOs are increasingly dependent on the OEMs.


Asunto(s)
Equipos y Suministros de Hospitales/provisión & distribución , Adquisición en Grupo/organización & administración , Equipo Médico Durable/economía , Equipo Médico Durable/provisión & distribución , Equipos y Suministros de Hospitales/economía , Adquisición en Grupo/economía , Humanos , Modelos Teóricos , Servicios Externos/economía , Servicios Externos/organización & administración
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