Minister of Health Dr. Bheri Ramsaran yesterday denied recent reports in the Kaieteur News about inflated prices for certain drugs under a billion-dollar contract and he also pointed to international concerns about counterfeit items and said his ministry is seeking to avoid this.
Pointing to his recent attendance at a World Health Organisation (WHO) Conference where the issue was one of the major concerns raised, Dr. Ramsaran noted that while there have been many interventions by the WHO on this issue, it was noted that these kinds of drugs are moving towards emerging economies where there may be a lack of monitoring functions, the Government Information Agency (GINA) reported him as saying yesterday.
The Health Minister, reporting to the media during the weekly post-Cabinet media briefing, said that Guyana is looking at this and the standards for pre-qualification by the WHO, which includes that the product must be able to stand up to scrutiny in the country where it is produced, and be part of the WHO certification scheme for commerce.
Regarding the tender process, Minister Ramsaran said he is satisfied that the process for the $1.3B contract to the New GPC as defined by the laws of Guyana has been followed. The National Procurement and Tender Administration Board (NPTAB) approved two companies as pre-qualified to supply the Ministry of Health with medical supplies. The International Pharmaceutical Agency was not one of the companies pre-qualified and with respect to the firm seeking answers on disqualification; all questions related to contract tenders should be addressed to NPTAB, he advised.
The Minister of Health also addressed what he called “the mischief of the myth of the pathological, spurious counterfeit claims of these inflated prices (of) $8,000 vs a few hundred dollars” made by the Kaieteur News.
Dr. Ramsaran focused on the probe into the alleged claims of pricing irregularities in the procurement for the purchase of medications for the health sector.
Stating that information regarding specific products was examined, the minister shared the following:
* Depo Provera, a contraceptive injection for females, was purchased for $1,561 in 2011 and not $8,000. This price for this pre-syringed 150mg – 3ml product has had a slight increase in 2012 to $1,957.
* Asprin: a package size of 1,000 aspirin tablets with a dosage of 300 mg costs $485 and dropped in 2012 to $468. The fictitious price claimed was $2,700.
* Atenonol, a frequently used drug -the claim was that the ministry was expending $18,000 on a 1,000 package size of this product. In 2011 the price paid was $1,165 and in 2012 $1,461, for the 50 mg tablets, 1,000 package in size. For 100 mg, the ministry paid in 2011, $1,693 and this year $1,985.
Regarding the issue of the skin creams, Dr. Ramsaran noted that while the prices were $1,990 for ketoconazole and miconozole at $2,578, there is need to be on guard, GINA said.
There was no further explanation but it appears that the higher price is being explained on the grounds of avoiding counterfeit items. Observers have questioned whether on large contracts such as this there is a risk of the majority of items being priced within range but others being assigned exorbitant prices.
New GPC has since called for a Value For Money audit of the contract.
Observers have also suggested that the Public Accounts Committee of Parliament and the Economic Services Committee of Parliament may be appropriate fora for a fine-tooth comb examination of this particular contract.
Inventory management
On the issue of inventory management to deal with expired drugs, Dr. Ramsaran stated that systems are being improved at the Materials Management Unit.
He explained too that a Change Management Scheme consultancy has over the past few years been installing software and other systems and training staff in the central bond and other major locations. However, this only accounts for about 80 to 85% of distributed quantities of pharmaceuticals.
Dr. Ramsaran expressed the hope of achieving comprehensive monitoring but noted that there are challenges with training and retaining staff.
Meanwhile, even as the ministry is aiming for a ‘first in, first out system’ drugs are still expiring. However, there are plans to start from scratch with a new bond in Diamond, GINA reported.
He noted that stored material from the old bond at Farm, East Bank Demerara will not be decanted into the new facility.
The issue of requisition for drugs, the forms and their preparation in a timely fashion will be addressed, focusing on human errors and disciplinary methods.
The ministry will also be preparing standard treatment guidelines to deal with doctors’ use of medication. This will ensure that drugs don’t pile up while doctors seek new ones. “In this way we will be able to identify drugs that may pile up and those that would be withdrawn,” the minister stated.
The new bond will be managed in a military-like fashion, involving the Auditor General, he said. This will ensure no slippage or disappearance of drugs and the management for the transition has been ceded to a foreign consultancy.
