Towards A Medicines Transparency Alliance

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Towards A Medicines Transparency Alliance

• Stakeholder Meeting of the Medicines Transparency
  Alliance (MeTA)
• 17 April
• London United Kingdom
• Ph. Adi Nuseirat
• Head of Rational Drug Use Unit
• Jordan Food and Drug Administration

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Jordans Background

• Population in millions 5,906,760
• of rural population 17.7
• Total adult literacy rate 91.1
• Two major public institutions MOH and RMS
• In addition two smaller public institution JUH
  and KAUH and the (UNRWA).
• Health Insurance 68 insured, 32 not
  insuredInsured NHI (55), Refugees Mission
  (18), Private Insurance (8) Some of the
  population has multiple insurance coverage
• One of the signatory countries in the WTO and
  also signed the Jordan United State FTA.

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Jordan Delegation

• Dr. Mohammed Obeidat President of the National
  Society of Consumer Protection
• Dr. Lama AL Hmoud Director of Supply/ MOH
• Dr. ADI Nuseirat Head of Rational Drug Use/ JFDA
• Dr. Hanan Sboul Secretary General/ The Jordanian
  Association of Pharmaceutical Manufacturers

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Medicines Expenditures

• Jordan is a lowmiddle income country.
• GDP per capita 4,700 US
• 9,4 of the Jordanian GDP is spent on health
  with one third of this spent on medicinal drugs.
• One quarter of the drug expenditure is spent in
  the public sector with the remaining three
  quarters spent in the private sector.
• Number of local drug manufacturers 17
• Drug expenditure is growing at 17 per annum
  compared to GDP growth of 3.3.

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Jordan Food Drug Administration (JFDA)

• JFDA have been created in 2003 as the sole
  national competent authority for drug safety,
  efficacy and pricing and food safety and quality.
• It contains Drug Directorate which deals with the
  drug from its early stages as a raw material
  and ending with a finished product ready to be
  used by the patient.

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JFDA interaction with Public, Private Academic
Sector

• There are many working committees in the drug
  directorate involve all the sectors
• Their main responsibility is to take the right
  decision concerning different issues like
  
• - Registration of new/generic drugs, medical
  plants herbs, and medical devices.
• - Re-registration of registered products.
• - Pricing re-pricing of the drugs.
• - Accreditation of pharmaceutical sites.
• - Clinical studies.

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JFDA website

• JFDA website contains the following clear
  information, available in the public domain
• 1. Pricing and registration criteria and
  policies.
• 2. List of the registered medicines and
  their prices as
• determined by JFDA.
• 3. List of drugs submitted for
  registration.
• 4. Jordan Rational Drug List.
• 5. Jordan National Drug Formulary.
• 6. The Bar Code Project (Drug Information
  Prices).
• 7. Latest JFDA safety drug information
  received by
• Jordan pharmacovigilance center in the
  JFDA.

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Counterfeit Medicines

• Less than 5
• It could be a growing problem
• No accurate statistics about it
• Penalty for this crime does exist but its
  implementation lacks strong commitment
• Joint efforts are needed at country levels (MOH,
  JFDA, JPA, law enforcement agencies) in
  collaboration with local police, Customs and
  health agencies to fight this phenomenon.

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Rational Drug Use (RDU)

• Jordan has the challenge of balancing its scarce
  resources on one hand and providing equitable
  quality healthcare to its growing population on
  the other. JFDA recognized the importance of RDU
  concept implementation and accordingly RDU
  department was established in August 2005.
• The main objective is to ensure that the patients
  receive medications appropriate to their clinical
  needs, in doses that meet their own individual
  requirements, for an adequate period of time, and
  at the lowest cost to them and their community.

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Issues and Challenges (1)

• In Jordan
• Lack of
• - National drug classification system Standard
  Treatment Guidelines (STG).
• - Supervision on prescribing practice and
  pharmaceutical promotion .
• - Studies concerning drug utilization
• Over prescribing of anti-microbial NSAID.
• Prescribing by brand name rather than generic
  name in private sector.

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Issues and Challenges (2)

• Lack of patient education about illness and
  drugs.
• High medicine prices especially in the private
  sector
• Low availability of medicines in the public
  sector.
• Counterfeit medicines.

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Issues for discussion under MeTA

• Studies and research to highlight irrational drug
  use practices
• Need for more accurate statistics on drug
  expenditures
• 3. Developing Standard Treatment Guidelines
  (STG)
• 4. Working together with the professional
  associations to promote rational prescribing,
  dispensing use of drugs by health professionals
  using evidence-based approaches and to encourage
  the community for appropriate use of drugs.

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Issues for discussion under MeTA

• 5. Monitoring gathering evidence on unethical
  promotion of medicines
• 6. Fight the production, distribution and sales
  of counterfeit medicines.
• 7. Engaging consumer organizations civil
  society institutions in policy formulation for
  medicines transparency issues.
• Action plans should be designed implemented by
  relevant stakeholders

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THANK YOU