PROCUREMENT

BY : RINI NOVIYANI

AN EFFECTIVE PROCUREMENT PROCESS

Procure the right drugs in the right

quantities
Obtain the lowest possible purchase
price
Ensure that all drugs procured meet
standards of quality

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Arrange timely delivery to avoid shortages and
stockouts
Ensure supplier reliability with respect to
service and quality
Set the purchasing schedule, formulas for order
quantities and safety stock levels to achieve
the lowest total cost at each level of the system
Achieve these objectives in the most efficient
manner

THE PROCUREMENT CYCLE

The cycle includes most of decisions and
actions that determine the specific drug
quantities obtained, prices paid and quality
of drugs received
Definition : the process of acquiring supplies
from private or public suppliers or through
purchases from manufacturers, distributors,
or agencies such as UNICEF, WHO

Review drug
sections
Collect
consumption
information

Determine
quantities
needed

Reconcile
needs and
funds

Distribute
drugs

Choose
procurement
method

Make payment

Receive and
check drugs

Locate and
select suppliers

Monitor order
status

Specify
contract terms

Review drug sections

Determine quantities needed
Reconcile needs and funds
Choose procurement method
Locate and select suppliers
Specify contract terms
Monitor order status
Receive and check drugs
Make payment
Distribute drugs
Collect consumption information

Procurement methods

Open Tender
Restricted Tender
Competitive negotiation

Direct procurement

Good pharmaceutical procurement practices

Procurement by Generic Name (INN)
Use generic names (international non
proprietary names) for fair competition
Specify quality standards, not specific
brands for drugs with bioavailability
problems
Procurement Limited to Essential Drugs List or
Formulary List
Select safe, effective, cost-effective drugs
Use formal approval procedures for
procurement of non listed drugs

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Procurement in BULK
Concentrate purchases on limited list to increase
quantities, reduce price
Specify divided deliveries
Formal supplier qualification and monitoring
Use formal supplier qualification based on drug
quality, service reliability and financial viability
Approve suppliers before tendering or after
tendering
Use a formal monitoring system to ensure continued
supplier qualification

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Competitive procurement
Use competitive bidding on all but very
small or emergency purchases to obtain
the best prices
In restrictive tenders only prequalified
suppliers compete
In open tenders, suppliers must be
evaluated after submission of bids

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Sale source commitment
All contracted drugs are procured
from winning supplier
Enter into no separate deals with
noncontracted suppliers

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Order quantities based on reliable
estimate of actual need
Develop reliable consumption records
and morbidity data
Systematically adjust for past
surpluses, shortages and stockouts
Adjust for expected program growth
and changing disease patterns

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Reliable payment and Good financial
management
Develop mechanisms for prompt,
reliable payment
Prompt payment may bring down
drug prices as much as bulk
discounts

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Transparency and written procedures
Develop and written procedures for
all procurement actions
To the maximum extent possible
make information on the tender
process and results public

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Separate of key functions
Separate key functions that require
different expertise
Functions that involve different
committees, units or individuals may
include selection, quantification,
approval of suppliers and award of
contracts

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Product Quality Assurance Program
Establish and maintain a formal
system for product quality
assurance
Include quality assurance product
certification, inspection of
shipments, targeted laboratory
testing and reporting of suspect
products

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Annual audit with published results
Conduct annual audit to assess
compliance with procurement
procedures, promptness of
payment and related factors
Present results to the appropriate
public supervising body

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Regular reporting on procurement
performance
Report key performance indicators
against targets at least annualy
Use key indicators such as ratio of prices
to world marketprices, supplier lead
times, percent of purchases made
through competitive tendering and
planned versus actual purchases

Prioritization based on WHO

1993
PUT

MetodeABC
VEN
Analisa

VEN

ABC
VITAL

ALWAYS

ESSENSI
AL

BETTER

NON
ESSENTI
AL

CONTRO
L

VEN
V= VITAL
Obat termasuk potentially life saving artinya jika
pasien tidak mendapatkan obat tersebut,
kemungkinan meninggal sangat besar atau
menimbulkan kecacatan, memiliki efek withdrawal
yang signifikan atau sangat krusial dalam
menyediakan pelayanan dasar
kesehatan.Biasanya digunakan lebih dari 5%
populasi pasien
Contoh antidotum

Lanjutan..
E = ESSENTIAL
Effective against less severe but nevertheless
significant forms of illness, tapi tidak terlalu krusial
dalam hal pelayanan dasar kesehatan.
Contoh : analgesik

N = NON ESSENTIAL
Untuk pengobatan penyakit minor dan yang
terbatas jumlahnya, efikasinya masih belum jelas.
Contoh ; vitamin C

Langkah Penggunaan VEN

Klasifikasikan setiap obat menjadi V,E,N
Lakukan analisa pada kategori N, jika
memungkinkan kurangi jumlah pengadaannya
dan batasi
Identifikasikan dan kurangi duplikasi jenis obat
Kurangi kuantitas setiap item obat, jika dana
terbatas
Tambahkan dana jika memang memungkinkan
untuk memenuhi kebutuhan obat

ABC Analysis
NO

KLPK OBAT

DANA YG
DIBUTUHKAN

ITEM OBAT

70-80 %

20

10-15 %

20-40

5-10 %

60

80
D
A
N
A
%

15

5
20

40

60

80

% ITEM OBAT

Cara menggolongkan ABC

Kalikan jumlah permintaan dengan harga satua
untuk mendapatkan Total harga
Jenis obat diurutkan kembali berdasar total nilai
uang per jenis barang mulai dari yang tertinggi
hingga terendah
Berikan nomor urut baru
Hitung jumlah kumulatif dan % kumulatif dari
item barang dan nilainya
Kemudaian dikelompokkan berdasrakan
klasifikasi ABC

ABC
A = ALWAYS
10-20% item obat saja yang disediakan, tetapi
dana yang dikeluarkan untuk pengadaan obat
obat ini sangat besar yaitu mencapai 70-80% dasri
keseluruhan pengeluaran

B = BETTER
20-40% item obat yang disediakan, dana yang
dikeluaran untuk pengadaan obat-obat ini cukup
besar yakni mencapai 10-15% dari keseluruhan
pengeluaran

C = CONTROL
Ketersediaannya sangat banyak yakni mencapai
60% dari keseluruhan item obat, namun
kebutuhan dana yang dikeluarkan dalam
pengadaannya rendah yaitu hanya 5-10% dari
keseluruhan pengeluaran

Lanjutan..
Metode ABC cenderung bersifat profit oriented
product karena berdasar pada dana yang
dibutuhkan pada masing masing obat
Metoda ini bermanfaat untuk mengetahui %
penggunaan obat pada periode tertentu sehingga
berguna untuk merencanakan pengadaan obat
pada periode berikutnya
Untuk mendapatkan profiit yang besar, prioritas
utama adalah pengadaan obat kategori A
Kontrol untuk barang dengan jenis A harus lebih
ketat dan teliti dpd B dan C
Persediaan safety stock untuk jenis A harus
seminimal mungkin, jika memungkinkan dibuat
sistem Just In Time

prio
rita
uta
s
ma
tam
bah
an

PUT method

PRIO
RITAS

VITAL
ABC

UTA
MA ESSE

NTIAL
ABC

TAMB
AHAN

NON
ESSE
NTIAL
ABC

PUT
Obat dikategorikan menjadi tiga yaitu
P = PRIORITAS
Termasuk didalamnya kategori V, ABC
U = UTAMA
Termasuk didalamnya kategori E, ABC
T = TAMBAHAN
Termasuk didalamnya kategori N,ABC

Lanjutan..
Metode PUT tidak hanya berorientasi pada profit
tetapi juga berorientasi pada pasien
Merupakan idealisme farmasis dalam melakukan
pelayanan kefarmasian
Metode PUT, VEN, ABC dapat diguanakan untuk
Perencanaan obat
Pembuatan formularium
Pengendalian : memprediksi jumlah obat yang akan
dipilih berdasarkan jumlah yang dipakai tahun
sebelumnya
Melihat trend obat yang sedang IN di masyarakat

PROCUREMENT MANAGERS
Acquiring quality supplies at the best
possible price
Ensuring prompt and dependable
delivery
Following procedures that are
transparent and not influenced by
special intersets

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Maintaining a procurement pattern that
produces an even workload and
constant supply to clients
Limiting total procurement operating
costs
Ensuring that revenue is adequate to
support the office

Methods of quantification
Consumption method
Uses records of past consumption of
individual drugs to project future need
Morbidity method
Estimates the need for specific drugs based
on the expected number of attendances, the
incidence of common diseases and standard
treatment patterns for the diseases
considered

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Adjusted consumption method
Used data on incidence drug consumption
or utilization and or drug expenditures
from a standard supply system and
extrapolates the consumption or
utilization rates to the target supply
system based on population coverage or
service level to be provided

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Service-level projection of budget
requirements
Uses the average drug procurement
cost per attendance or bed-day in
different types of health facilities in a
standard system to project drug costs
in similar types facilities in the target
systems

Consumption Method
USES
First choice for procurement forecasts, given reliable data
Most reliable predictor or future consumption
ESSENTIAL DATA
Reliable inventory records
Records of supplier lead time
Projected drug costs
LIMITATIONS
Must have accurate consumption data
Can perpetuate irrational use

Morbidity Method
USES
Estimating need in new programs or disaster assistance
Comparing use with theoretical needs
Developing and justifying budgets
ESSENTIAL DATA
Data on population and patient attendances
Actual or projected incidence of health problems
Standard treatments )ideal, actual)
Projected drug costs
LIMITATIONS
Morbidity data not available for all diseases
Standard treatments may not really be used

Adjusted Consumption
Method
USES
Procurement forecasting when other methods unreliable
Comparing use with other supply systems
ESSENTIAL DATA
Comparison area or system qith good per capita data on
consumption, patient attendance, servicel levels and
morbidity
Number of local health facilities by category
Estimation of local user population broken down by age
LIMITATIONS
Questionable comparability of patient populations,
morbidity and treatment practices

Service-level-projection of
budget requirements Method
USES
Estimating budget needs
Essential data
Utilization by service levels and facility type
Average drug cost per attendance
LIMITATIONS
Variable facility use, attendance, treatment
patterns, supply system efficiency