Medical Care System

at
Institutional
Level
Sri Suryawati
Universitas Gadjah Mada

Obat meningkatkan kepercayaan

dan partisipasi thd pelayanan
kesehatan
Salah satu indikator pemanfaatan pelayanan
kesehatan
Kadang dianggap lebih penting daripada
providernya
Kontinuitas pelayanan sangat tergantung
pada ketersediaan obat
Ketersedia

an obat
sangat
penting
2

Managing Drug Supply 1997

Outline
Medicine supply system in health
facilities
Managing the formulary
Assessing new medicines
Ensuring medicine safety and quality
Tools to investigate the use of
medicines
Promoting rational use of medicines
Essential medicine concept
Standard treatment guidelines
Generic prescribing

Containment of antimicrobial

Siklus manajemen obat

Seleksi
dan
kuantifika
si
Penggunaan

Pengada
an

Pendukung manajemen
Penerimaa
n,
penyimpan
an dan
distribusi

Instalasi Farmasi
Panitia Farmasi Terapi
(PFT)
Komite Medik
UPF/Poli

Seleksi
dan
kuantifika
si
Penggunaan

Instalasi Farmasi
Panitia Farmasi Terapi
(PFT)
Komite Medik
UPF/Poli
Individu provider

Rumah
sakit

Penerimaa
n,
penyimpan
an dan
distribusi

Panitia Pengadaan
Direktur Keuangan
Instalasi Farmasi

Pengada
an

Instalasi Farmasi
Apotek rumahsakit
UPF/Poli

Management & policy

6
support

Instalasi Farmasi
Kab/Kota
Panitia Farmasi Terapi
(PFT)
Puskesmas/BP/Program

Seleksi
dan
kuantifika
si
Penggunaan

Instalasi Farmasi
Kab/Kota
Dinas Kesehatan
Kab/Kota
Puskesmas/BP/Program
Individu provider
7

Dinkes
Kab/Kota

Penerimaa
n,
penyimpan
an dan
distribusi

Panitia Pengadaan
Kab/Kota
Badan
Anggaran/Keuangan
Instalasi Farmasi
Kab/Kota

Pengada
an

Instalasi Farmasi
Kab/Kota
Puskesmas/BP/Program

Management & policy

support

Instalasi Farmasi
Kab/Kota
Panitia Farmasi Terapi
(PFT)
Puskesmas/BP/Program

2
Panitia Pengadaan
Kab/Kota
Badan
Anggaran/Keuangan
Instalasi Farmasi
Kab/Kota

Seleksi
dan
kuantifika
si

8
7

3
Penggunaan

Instalasi Farmasi
Kab/Kota
Dinas Kesehatan
Kab/Kota
Puskesmas/BP/Program
Individu provider

Institusi
pelayana
n
kesehata
n

Pengada
an

Instalasi Farmasi
Kab/Kota
Puskesmas/BP/Program

Penerimaa
n,
penyimpan
an dan
distribusi

5
8

Formulary List and Formulary

Manual
Formulary list:

List of the most cost-effective, safe, locally

available drugs of assured quality that will
satisfy the health care needs of the majority of
the patients

Formulary manual:

Manual containing summary information on

medicines on the Formulary List

The process:

A formulary list and formulary manual should

be developed and maintained based on
recommended treatments from standard
treatment guidelines, using explicit drug
selection criteria, that have been agreed
previously by all departments.

Standard Treatment
Guidelines
Definition (MSH, 1997):
Systematically developed statements to help
pactitioners make decisions about appropriate
treatments for specific clinical conditions
As a minimum, STGs should contain information
on clinical features, diagnostic criteria, nondrug and drug treatments (first-, second-, thirdline), and referral criteria.
Selection criteria for STGs:
Efficacy
Safety
Availability
Cost comparison (cost of treatment)

Pengadaan barang dan jasa

Kepres No. 80 th 2003
Pengguna anggaran
Panitia Pengadaan
Penyedia barang/jasa
Metode pengadaan
Prosedur penawaran s/d
keputusan pemenang
final
LPSE (www.lpse.go.id)

Spesifikasi barang
Ditentukan oleh Pengguna Anggaran
Kesesuaian dengan kebutuhan
(Formulary List)
Penjaminan mutu dan batas
kadaluwarsa
Farmas
is

Good Distribution Practices

Cara Distribusi Obat yang Baik
Pedoman Badan POM
2007
Agar obat terjaga
mutunya pada saat
digunakan untuk
pasien.

Manajemen persediaan
obat
Pedoman pengelolaan Instalasi Farmasi
Kab/Kota
Pengelolaan stok (fisik)
Pengelolaan inventori
Pengelolaan administratif
Sistem informasi manajemen
obat

Ensuring quality use of

medicines
Adherence to Formulary List and STG
Generic prescribing
Drug use evaluation and feedback
Analysis of aggregate medicine use
data
Monitoring and addressing
medication errors
Monitoring and ensuring medicine
quality
Impartial continuing medical

Containing

Anti-Microbial Resistance (AMR)

1. Education for patients and general
community
2. Rational use of AMs by health
providers
3. Infection controls in hospitals
4. Use of antimicrobials in foodproducing animals
5. Supportive national government and
health system
6. Drug and vaccine development
7. Controlling pharmaceutical
promotion
8. International coordination

Onward.. Onward.. No retreat..