MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS

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MINISTRY OF HEALTH NATIONAL DIRECTION OF DRUGS
SANITARY INSUMES
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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS
Location South America Extension 2millions Km2
Number of Regions 24 Natural Regions 3
Coasts 52.1 (11 Sup) Population 27
millions Poverty Conditions 54.3 Extreme
poverty 23.4 Esperanza Vida 68.3 yrs Mother
Mortality 186 /100,000n.v. Children
mortality(lt5yrs) 60.4 /1000 n.v. Health
Expenditure 2,510 millions US Familiar package
rise 35 (last 5yrs.) Health package risen
65 Excluded population 30
PERU
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PERCAPIT ESTIMATED CONSUME OF DRUGS ACCORDING TO
CONSUMER SECTOR - PERU ( 2000)
120
100
110
80
60
70
40
36
20
10
1
7
0
Public
Private
Excluded
Units
Value
SOURCE G.Valladares. Rev. de Salud y
Medicamentos Nº54 jun 2001
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MINISTERIO DE SALUD DIGEMID
HEALTH SECTOR
PUBLIC
PRIVATE
Ministry of Health (6806)
Social Security (326)
Sanitary Army
Private Lucrative
Regulated Private Health Insurance
Pharmacies Drugs stores
No Lucrative
Specialized Institutes (7)
Health Regional Administrations (34)
National Hospitals (5)
Hospitals (180)
Regional Hospitals (72)
National and local Hospitals
Health Establishments (6,626)
Health Establishments (279)
Policlinics
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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS
HEALTH INSURANCE
PUBLIC (57.2)
PRIVATE (5)
Private Insurance (3)
Ministry of Health (28)
Social Security (25.1)
Sanitary Army (4.1)
Regulated Private Health Insurance (2)
Public Health Insurance (28)
National Programs (8)
NO INSURANCE 37.8
Children and Pregnancy women priorized
Source Cuentas Nacionales de Salud Peru
1995-2000 (2004) Superintendencia
de EPS SIS- Boletin Informativo
2003
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FINANCING
PUBLIC HEALTH INSURANCE
PUBLIC HEALTH INSURANCE (US 78774,162)
ESSALUD (US. 398285,714)
FIXED PAYMENT
PAYMENT FOR HEALTH CARE (EMPLEADOR EMPLEADO)
DRUGS AND DEVICES (29.9 US 23553,474)
HEALTH SERVICES AND INVESMENTS
DRUGS AND DEVICES (21.2 84436,571)
HEALTH SERVICES, INVESMENTS AND OTHERS
SISMED
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• As a strategy of Public Health applied for the
  Ministry of Health since January 2003 was
  implemented the Unitary Managing Drug Supply
  System.
• Its main goal is to improve public access to
  essential drugs with equitity, solidarity,
  rationality, quality and decentralization

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• SISMED has been implemented in 6806 health
  establishments from MINSA
• Improves national availability of medicines until
  approximately 85
• Essential medicines are given to every patient
  from MINSA (Public insurance, National programs
  and pocket payment).
• Improvement of drug supply Process and
  implemented national indicators in managing drug
  supply.
• Improvement management of Drugs.

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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS

• Lowered prices in average 75, and standardized
  prices of 100 more consumed essential drugs in
  the country (getting the lowest price in Peruvian
  market).
• National Drug information about stocks and
  consumes has fulfillment to 85 from health
  establishments
• Improved rational drug use through the control of
  drugs out from the National List of essential
  Drugs
• Guaranteed drugs stock for a whole year (2004)

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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS
ESTIMATED SAVING IN DRUG NATIONAL ADQUISITION
- 2003
S/.109,233,499
Estimated budget
S/. 40000,000 US.11000,000 (36.00)
S/. 69,233,499
Final budget paid
60,000,000
70,000,000
80,000,000
90,000,000
100,000,000
110,000,000
nuevos soles
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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS
DRUG CONSUME (VALUE) IN THE MINISTRY OF HEALTH
PER MONTH (SISMED 2003)
4.5
4.0
3.5
3.0
Milions
2.5
2.0
1.5
1.0
0.5
0.0
1
2
3
4
5
6
7
8
9
10
11
12
Months
SIS
IS
VENTAS
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MINISTERIO DE SALUD DIRECCION GENERAL
DEMEDICAMENTOS, INSUMOS Y DROGAS

• SICK PEOPLE WHO GOT DRUGS AFTER
• PHISYCIAN CONSULT

NO INSURANCE
PRIVATE
SOCIAL SECURITY AND ARMY
PUBLIC HEALTH INSURANCE
0
20
40
60
80
100
GETS PAYS
GETS NOT PAYS
NOT GETS
Source ENAHO/Elaboracion OPS
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OPPORTUNITIES PUBLIC HEALTH INSURANCE SISMED

• US 11 MILLIONS SAVED TO BE INVESTED IN OTHER
  HEALTH NEEDINGS
• EMPOWER THE RATIONAL USE OF DRUGS
• RESEARCH IN DRUG UTILIZATION
• AVALILABILITY IMPROVEMENT OF DRUGS

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CHALLENGES PUBLIC HEALTH INSURANCE SISMED

• PROBLEMS TO BE SOLVED
• NO LIST OF ESSENTIALS DRUGS FOR LEVEL COMPLEXITY
• NO GUIDELINES
• NO CROSSING ANALIZED INFORMATION BETWEEN SIS AND
  SISMED
• DELAY OF REIMBURSEMENT
• INSUFFICIENT FINANCING (GOVERNMENT FINANCING)

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MINISTERIO DE SALUD DIRECCION GENERAL DE
MEDICAMENTOS, INSUMOS Y DROGAS
GRACIAS!!!
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MINISTERIO DE SALUD DIGEMID

• ADQUISICION

COMPRA NACIONAL DE MEDICAMENTOS 2003
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Logros SISMED 2003

• Mejoramiento de los niveles de disponibilidad a
  medicamentos en el MINSA
• Estandarización de procesos técnicos y
  administrativos del sistema de suministro de
  medicamentos a nivel nacional
• Reorientación del gasto al aspecto asistencial,
  eliminando duplicidad de funciones y gastos
  inherentes.
• Capacitación a 1500 trabajadores del MINSA
  (asistenciales y administrativos)
• Asistencia técnica y supervisión al 60 de DISAs
  y de sus hospitales regionales
• Información sobre la disponibilidad y consumo
  de medicamentos en el país al 85 (5800
  establecimientos de salud) en forma mensual
• Implementación del sistema informático en 517
  puntos de digitación
• Fortalecimiento del sistema informático con un
  servidor y 29 equipos de computo para las DISAs
  priorizadas

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Logros SISMED 2003

• Disponibilidad de los 100 medicamentos de mayor
  uso a los precios mas bajos del mercado
  farmacéutico en el país
• Ahorro del 36 en la adquisición de
  medicamentos (Compra Nacional) 40millones de
  N.S.
• Control de calidad al 100 de medicamentos
  adquiridos en la compra nacional para el MINSA
• Reducción del 300, en promedio, de los
  precios de venta al público de los medicamentos
  en el MINSA
• Estandarización del precio de medicamentos a
  nivel nacional
• Mejoramiento de la calidad del gasto en
  medicamentos, mediante la reducción de la
  adquisición de medicamentos fuera del petitorio
• Reducción del precio de medicamentos
  Antirretrovirales, mediante la negociación
  conjunta para el mejoramiento al acceso de estos
  medicamentos
• Diagnostico de los almacenes especializados de
  medicamentos a nivel nacional (87)