PRICES MONITORING EXPERIENCE OF ARMENIA

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PRICES MONITORING -EXPERIENCE OF ARMENIA
DRUG AND MEDICAL TECHNOLOGIES AGENCY OF MOH OF
THE REPUBLIC OF ARMENIA M.A. ARISTAKESYAN, ,Head
of Pharmaceutical and Economic Researches
Department
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SOME PECULIARITIES OF HEALTH MANAGEMENT

• Health care is one of the most important sectors
  of national security in every country
• Health care is a social merchandise
• Health care is an expensive merchandise
• Health policy must not be implemented under free
  market conditions, but according to the rules of
  a quasi-market, i.e.

Inevitable
solvent
affordable
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SOME OF THE FUNDAMENTAL WHO PRINCIPLES

• Provide universal, equal, equitable and
  accessible health care,
• Provide adequate level and quality of health
  care,
• Provide a client with the right to choose his
  health provider,
• Define a new role of the government and an
  individual in supporting health, and division of
  responsibilities in this aspect,
• Efficient utilization of funds,
• Provide the principles Money follow a patient
  (transparency and targeted use).

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SAMPLING CRITERIA
DRUGS
PHARMACIES

• out of the List of Essential Drugs,
• Registered in the Republic,
• Widely used in clinical practice,
• More often sold at the drugs market,

• Are to be located in the most busy parts of every
  district of the capital (10 in total)
• have broad and qualified experience of dealing
  with the drugs market.

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GOURPS OF OBSERVED DRUGS
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GROUP STRUCTURE OF OBSERVED DRUGS
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DINAMICS OF PRICES AND SALES OF OBSERVED DRUGS
AND MEDICAL SUPPLIES, JULY 1998 DECEMBER 2000
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DINAMICA OF PRICES AND SALES OF OBSERVED DRUGS
AND MEDICAL SUPPLIES, DECEMBER 2000 JULY 2001
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AVAILABILITY OF OBSERVED DRUGS
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STRUCTURE OF OBSERVED DRUGS
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CAUSES OF UNAVAILABILITY OF DRUGS

• At the time being, there is no governmental
  regulation of prices. Drug pricing is regulated
  by the free market laws.
• There is no law or regulating document which
  would limit drug prices, profits of organizations
  engaged in drugs manufacturing and sales, or
  markups on prices.
• There is no governmental registration of drug
  prices.
• There is no insurance mechanism.
• Although there is a centralized supply of drugs
  to health organizations for certain kinds of
  diseases (malignant neoplasm, psychiatric
  disorders, diabetes, TB, periodic peritonitis,
  and etc.) financed at the expense of the state
  budget, those total only to 2-3 of the total
  health financing.
• Although the Governmental Decree of June 6, 1999,
  sets forth lists of some diseases and groups of
  population enjoying free treatment, or
  acquisition of drugs at a discount, these
  measures do not suffice the needs of population,
  and essentially are not fulfilled due to the
  scarce budget.
• Under incomplete budgetary financing conditions
  (actual health financing from the state budget
  has been not more than 46 the last years),
  almost at all health facilities patients were
  neither provided with food (which is also an
  integrate part of the treatment), nor with
  essential drugs.

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MEASURES UNDERTAKEN TO DISSEMIATE RESULTS OF
MONITORING

• Seminars and working conferences to sum up
  results of the monitoring in Erevan (June 1997,
  April 1998, April 1999) and Abovyan (April 2000)
  were held.
• Results of the analysis of the monitoring were
  published in the form of scientific articles in
  the information and scientific magazine of the
  Drugs and Medicine Agency, as well as in national
  newspapers.
• The report The right of access to drugs was
  presented at the meeting of representatives of
  public organizations, MOH of RA, social security
  organizations and scientists dedicated to the
  50th anniversary of the Announcement of the
  Declaration of Human Rights.
• TV and radio broadcasts (interviews for LA TV,
  and Liberty Radio), dedicated to the issues of
  humanitarian aid in terms of drugs, as regards
  the regulation of their prices, economic and
  physical accessibility for the population.

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MEASURES UNDERTAKEN TO DISSEMIATE RESULTS OF
MONITORING

• Article Drugs and poverty after M.
  Aristakesyan was published in the magazine of the
  analytical-statistical center of economic
  transformations under the Government of RA.
• Appropriate materials and recommendations on
  drugs policy designed to improve accessibility of
  drugs for poor and socially vulnerable strata of
  society were included into the Health care and
  physical culture and Social insurance
  components of the State Program of RA Strategic
  Program on eliminating poverty (where M.
  Aristakesyan worked as a national expert).

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MEASURES NECESSARY TO ENSURE ACCESSIBILTY OF DRUGS

• Repeal levying of VAT in the area of drugs
  turnover as of January 2003.
• Provide legal framework for the 10 and 20
  markups on retail and wholesale prices
  respectively, and set forth mechanisms of
  reimbursing expenditures for drugs.
• Introduce efficient mechanisms of restraining and
  regulating drug prices, and provide for free
  provision or discount and reimbursement of cost
  of drugs for low income strata of the
  population..
• Implement state registration of drug prices.
• Introduce mandatory health insurance.
• Introduce utilization of essential drugs at all
  health facilities.
• Reserve about 7 of health financing resources
  for centralized procurement of drugs intended for
  the treatment of certain the most widely spread
  and socially sensitive diseases.

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MEASURES NECESSARY TO ENSURE ACCESSIBILTY OF DRUGS

• Streamline importation of drugs received as
  humanitarian aid based on real needs.
• Adopt new version of the Law on Drugs, and
  provide with appropriate implementing
  regulations.
• Amend and Addend the laws On Licensing, On
  Procurement, On Value Added Tax.
• Promote and control proper and rational
  prescription of effective, safe and quality
  drugs, that have been formally registered.
• Introduce optimal treatment schemes into the
  health practice, and control their
  implementation.

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