How could the drug procurement procedure be improved to ensure good quality drugs, at the right time, in the required quantities and at an advantageous cost? The Ecuadorian case
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Published:
Jul 20, 2022
Keywords:
drugs, health, acquisitions, cost
Main Article Content
Abstract
The public procurement process is used by countries, especially developing countries, to obtain medicines of good quality, on time, at an affordable price and in the quantities necessary for the benefit of the population. In this way, states safeguard the right to health of their populations. Unfortunately, public procurement is subject to mismanagement and corruption, leading to price inflation, the distribution of poor quality drugs, shortages and waste, with final consequences for the poor and vulnerable. For this reason, this document will analyze how to transform an inefficient public procurement system into one that effectively meets the needs of the population and does not violate citizens' right to health. The analysis will be based on the Ecuadorian case, characterized by serious flaws. To this end, this paper will review the existing literature on the factors influencing the efficiency of public procurement and the characteristics of an efficient public procurement system to determine how our public procurement systems can be improved to ensure timely and cost-effective access. to drugs efficiently.
JEL CODE: D73, K4
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How to Cite
Meythaler Galarza, B. . (2022). How could the drug procurement procedure be improved to ensure good quality drugs, at the right time, in the required quantities and at an advantageous cost? The Ecuadorian case. Revista De La Facultad De Jurisprudencia., 1(12). https://doi.org/10.26807/rfj.vi.398
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Original article (miscellany)
References
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Cameron, A. et al. (2009). Medicine Prices, Availability, and Affordability in 36 Developing and Middle-Income Countries: A Secondary Analysis. The Lancet, 373 (9659), pp. 240-49.
CESCR. (2000). General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12). Adopted at the Twenty-second Session of the Committee on Economic, Social and Cultural Rights, Retrieved from: https://www.refworld.org/pdfid/4538838d0.pdf
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Economic Co-operation and Development (OECD). (n. d.). Retrieved from: http://www.oecdilibrary.org/docserver/download/4215081ec042.pdf?expires=1479378232&id=id&accname=guest&checksum=CC05 0521D00079900C6BE19838339DAA
Ecuadorian Ombudsman (2018). Ombudsman achieves precautionary measures in favour of 80 cancer patients who did not receive their medicines timely. Retrieved from: https://www.dpe.gob.ec/en-azuay-defensoria-del-pueblo-consigue-que-se-otorguen-medidas-cautelares-en-favor-de-80-pacientes-con-cancer-que-no-recibian-sus-medicinas-oportunamente/
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El Comercio. (May 5, 2020) Gobierno crea sistema unificado de compra de medicinas y bienes de salud, tras corrupción en medio del covid-19. El Comercio. Retrieved from: https://www.elcomercio.com/actualidad/gobierno-decreto-transparencia-compra-medicamentos.html
El Diario. (April 14, 2016). Shortage of medicine at the hospital in Manta. El Diario. Retrieved from: http://www.eldiario.ec/noticias-manabi-ecuador/389068-escasea-medicina-en-el-hospital-de-manta/
El Universo. (June 08, 2020). Ministerio de Salud compró paracetamol a un precio 25 % mayor que sus hospitales y distritos. El Universo. Retrieved from: https://www.eluniverso.com/noticias/2020/06/08/nota/7865310/msp-compro-paracetamol-precio-25-mayor-que-sus-hospitales-distritos/
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Expreso. (May 07, 2019). The medical associations unite against the Minister of Health. Expreso. Retrieved from: https://www.expreso.ec/guayaquil/federacion-medico-ecuatoriana-pide-destitucion-ministradesalud-MI2813385
Inter-American Development Bank. (2016). Procurement Policies for Pharmaceuticals: The International Experience. (Based on a webinar presentation at CRITERIA by Panos Kanavos).
International Covenant on Economic, Social and Cultural Rights. (1948). Retrieved from: https://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx
Kanavos, P. (2016). Webinar. Retrieved from: http://www.redcriteria.org/publication2/transcription-procurement-policies-pharmaceuticals/.
Kenny, C. (2007). Construction, Corruption, and Developing Countries, World Bank Policy. Research Working Paper. Retrieved from: http://documents.worldbank.org/curated/en/571281468137721953/Construction-corruption-and-developing-countries
Management Science for Health Inc. (2012). Getting to the heart of the matter, in the procurement field. (18. Managing Procurement by Andrew Barraclough and Malcolm Clark). Retrieved from: https://apps.who.int/medicinedocs/documents/s19577en/s19577en.pdf
Ministry of Health, Document N. MSP-MSP-2018-2406-O. October 17, 2018.
Ministry of Health, Document N. MSP-VGVS-2018-0675-O. October 19, 2018.
Minnesota Department of Health (MDH). (2019). Government's Responsibility for Public Health. Retrieved from: https://www.health.state.mn.us/communities/practice/resources/chsadmin/mnsystem-responsibility.html#a
Mosoti, V. (2004). The WTO Agreement on Government Procurement: A Necessary Evil in The Legal Strategy for Development in The Poor World? Retrieved from: https://www.law.upenn.edu/journals/jil/articles/volume25/issue2/Mosoti25U.Pa.J.Int'lEcon.L.593(2004).pdf
OCP & Development Gateway. (2016). Red Flags for integrity: Giving the green light to open data solutions. Retrieved from: https://www.open-contracting.org/wp-content/uploads/2016/11/Red-flags-for-integrity-Giving-the-green-light-to-open-data-solutions-shared.pdf
Organization for economic co-operation and development – OECD. (2017). A step ahead. Retrieved from: https://www.oecd-ilibrary.org/docserver/978-1-4648-0945-3.pdf?expires=1617787968&id=id&accname=guest&checksum=D8B063FEA0067D6FE56C2C2D511FCE61
Organization for economic co-operation and development – OECD. (2011). Competition and Procurement. Retrieved from: http://www.oecd.org/daf/competition/sectors/48315205.pdf.
Policy Medical. (2015). The Importance of Healthcare Policy and Procedures by Tom Leahy. Retrieved from: https://www.policymedical.com/importance-healthcare-policy-and-procedures/
Red Flag. (April 6, 2021). Red Flag. Retrieved from: https://www.redflags.eu/
Redacción médica. (June 12, 2016). Doctors warn about the poor quality of medicines. Retrieved from: https://www.redaccionmedica.ec/secciones/salud-publica/m-dicos-advierten-mala-calidad-de-medicamentos--88221
SK Perehudoff, RO Laingb & HV Hogerzeilb (2010). Access to essential medicines in national constitutions. Bull World Health Organ, Retrieved from: https://www.who.int/bulletin/volumes/88/11/10-078733.pdf?ua=1
Teleamazonas. (May 29, 2019). Patient reports use of expired medical supplies at Teodoro Maldonado Hospital. Retrieved from: http://www.teleamazonas.com/2019/05/paciente-denuncia-uso-de-insumos-medicos-caducados-en-hospital-teodoro-maldonado/
Teleamazonas. (November 07, 2018). Cancer patient demands IESS to deliver prescribed medicine. Retrieved from: http://www.teleamazonas.com/2018/11/paciente-con-cancer-demanda-al-iess-para-que-entregue-medicina-prescrita
The Universal Declaration of Human Rights. (1948). Retrieved from: https://www.un.org/en/universal-declaration-human-rights/index.html
Transparency International UK. (2017). Making a Case for Open Contracting in Healthcare Procurement. Retrieved from: https://www.transparency.org.uk/publications/making-the-case-for-open-contracting-in-healthcare-procurement
Transparency International. (2014). Integrity Pacts in Public Procurement: An implementation guide. Retrieved from: https://www.transparency.org/whatwedo/publication/integrity_pacts_in_public_procurement_an_implementation_guide
UNCITRAL (2011). Model Law on Public Procurement. Retrieved from: https://uncitral.un.org/sites/uncitral.un.org/files/media-documents/uncitral/en/2011-model-law-on-public-procurement-e.pdf
WHO. (1999). Operational Principles for Good Pharmaceutical Procurement. Retrieved from: https://www.who.int/3by5/en/who-edm-par-99-5.pdf
WHO. (2014). Access to Antiretroviral Drugs In Low- And Middle-income Countries. (Technical Report). Retrieved from: http://apps.who.int/medicinedocs/documents/s21630en/s21630en.pdf
World Bank. (2011). Governance in the Health Sector: A Strategy for Measuring Determinants and Performance. Policy Research Working Paper 5655.
World Bank. (2015). Many developing countries can improve public services through fair and open procurement practices, says WBG report. Retrieved from: https://www.worldbank.org/en/news/press-release/2015/11/18/many-developing-countries-can-improve-public-services-through-fair-and-open-procurement-practices-says-wbg-report.
World Bank. (2016). Data Honduras. Retrieved from: http://data.worldbank.org/country/honduras
World Health Organization -WHO-, World Intellectual Property Organization -WIPO-, World Trade Organization -WTO-. (2013). Promoting Access to Medical Technologies and Innovation - Intersections between Public Health, Intellectual Property and Trade. Retrieved from: https://www.wipo.int/publications/en/details.jsp?id=305&plang=EN
World Health Organization WHO. (2008). Sixty-fourth World Health Assembly A64/7, Provisional agenda item 12.3 - Medium-term strategic plan 2008–2013 and Proposed program budget 2012–2013. Retrieved from: https://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_7-en.pdf
World Health Organization. (2010). The World Health Report - Health systems financing: the path to universal coverage. Retrieved from: http://www.who.int/whr/2010/10_chap04_en.pdf
WTO GPA, (1994). Agreement on Government Procurement), 994, Marrakesh Agreement Establishing the World Trade Organization. Annex 4(b). Retrieved form: http:// www.wto.org/English/docs-e/legal-e/gpr-94_e.pdf