7 QuantificationTBBKK by q2dPeg6s


									                  Procurement and
                  Supply Management
                  (PSM) Workshop:

                  Understanding basic drug
                  management elements for
                  proposal writing

                  Bangkok, Thailand
                  July 25-30, 2005
Thomas Moore, Management Sciences for Health
Introduction (1)
• Key GFATM documents
  – Guidelines for Proposals
  – Proposal Form
  – M & E Toolkit
  – PSM Assessment Tool
• Workshop handouts
  – “Description of Interventions”
  – “Pharmaceutical Management Guide for Procurement and
    Supply Management plan for GFATM proposals”
  – “Tools for forecasting drug needs”
  – This Power Point presentation
 Introduction (2)
• Describe your drug management system
  – Use the six basic elements in the “framework” slide
  – Describe any gaps within each of the six elements
    in your drug management system
    Examples: (1) no drug policy to govern supply and use;
           (2) no mechanism for good forecasting
  – Describe how you will use the GFATM funds to
    overcome the gaps
  Note: see other suggestions on your handout
    “Pharmaceutical Management Guide for Writing
    Procurement and Supply Management plans for
    GFATM proposals
Introduction (3)

• In GFATM budget proposal must include a
  breakdown of:
   – Functional areas for:
     • Monitoring and Evaluation
     • Procurement and Supply Management
     • Technical Assistance
  – Service delivery areas
  – Partner allocation
Pharmaceutical Management Cycle


  Use         Management       Procurement


        Policy and Legal Framework
Policy, Regulations, and Laws (1)

• Develop or update government TB policy
• Develop policy for health care system
  – Decentralized vs. Centralized
  – Vertical vs. integrated
  – Role of Private sector healthcare providers
Policy, Regulations, and Laws (2)

• Update drug policy for good procurement
  and supply management
  – Reinforce drug regulation capacity
     • National Drug Authority
  – Update Essential drugs list
  – Require use of generic vs. brand names
  – Develop regulations re: Importing, distribution,
  – Promote good manufacturing practices (GMPs)
Suggestions for PSM plan-Policy (1)
  • Personnel needs
    – Regulatory activities
    – Monitoring, inspection, surveillance,
    – Training
  • Infrastructure
    –   Office space
    –   Computers, software, equipment
    –   Access to Quality Control laboratory facilities
    –   Vehicles for distribution, inspection, enforcement
Suggestions for PSM plan-Policy (2)

  • Update drug laws and regulations
    – Publish standard treatment guidelines
    – Update National Essential Medicines List
    – Disseminate information to all organizational
    – Require good procurement practices
    – Require drug registration to promote public safety
    – Require GMP compliance by local drug
Indicators for M & E - Policy
• Average time, in days, required to clear shipments
  of TB drugs from the port of entry*
• Average number of days to register TB drugs
• Percentage of TB treatment facilities that have the
  latest official manual of TB treatment guidelines
• When post-marketing surveillance exists
   – Product quality complaints
   – Adverse drug reaction reporting
   – Inspection of wholesalers and retail pharmacies
   – Testing/sampling
Procurement - quantification/forecasting
• Needed for:
   – Planning, budgeting, and ordering
• Critical issues:
   – Must first have good selection of drugs
   – Decide who will quantify - centralized vs.
     decentralized activity
   – Tools to use - manual vs. computerized
   – Knowledge of lead times, stock-outs, safety
     stock, growth, losses
   – Reconcile quantities needed with budget
Options for Quantification

• Morbidity based: Base estimates on
  expected number of cases
• Consumption based: Estimates based on
  past consumption
• Adjusted-consumption based: Estimates
  based on data from another region or
  health service
        Comparison of Quantification Methods

               Consumption versus Morbidity
        • Consumption – need good inventory
        • Morbidity- need patient attendance data
        • Both methods – need data on existing
          stocks, lead times, costs

Indicators for M & E – drug quantification

• Average percentage of a set of tracer TB
  commodities available in TB facilities and
  medical stores
• Average percentage of time out of stock for
  a set of TB tracer commodities in TB
• Presence of 6 months buffer stock at
  national level and 3 months stock at district

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