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Understanding public drug procurement in India: a comparative qualitative study of five Indian states.

Singh PV, Tatambhotla A, Kalvakuntla R, Chokshi M - BMJ Open (2013)

Bottom Line: A total of 30 actors were interviewed in all five states.The analysis indicated that autonomous procurement organisations were more efficient in relation to payments to suppliers, had relatively lower drug procurement prices and managed their inventory more scientifically.The authors highlight critical success factors that significantly influence the outcome of any procurement model.

View Article: PubMed Central - PubMed

Affiliation: ACCESS Health International, Centre for Emerging Markets Solutions, Indian School of Business, Hyderabad, Andhra Pradesh, India.

ABSTRACT

Objective: To perform an initial qualitative comparison of the different procurement models in India to frame questions for future research in this area; to capture the finer differences between the state models through 53 process and price parameters to determine their functional efficiencies.

Design: Qualitative analysis is performed for the study. Five states: Tamil Nadu, Kerala, Odisha, Punjab and Maharashtra were chosen to ensure heterogeneity in a number of factors such as procurement type (centralised, decentralised or mixed); autonomy of the procurement organisation; state of public health infrastructure; geography and availability of data through Right to Information Act (RTI). Data on procurement processes were collected through key informant analysis by way of semistructured interviews with leadership teams of procuring organisations. These process data were validated through interviews with field staff (stakeholders of district hospitals, taluk hospitals, community health centres and primary health centres) in each state. A total of 30 actors were interviewed in all five states. The data collected are analysed against 52 process and price parameters to determine the functional efficiency of the model.

Results: The analysis indicated that autonomous procurement organisations were more efficient in relation to payments to suppliers, had relatively lower drug procurement prices and managed their inventory more scientifically.

Conclusions: The authors highlight critical success factors that significantly influence the outcome of any procurement model. In a way, this study raises more questions and seeks the need for further research in this arena to aid policy makers.

No MeSH data available.


Related in: MedlinePlus

Healthcare spending in India 2004–2005 (figures in USD).
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BMJOPEN2012001987F2: Healthcare spending in India 2004–2005 (figures in USD).

Mentions: Private health expenditure constitutes almost 70% of the total health expenditure of which drugs form a massive component with anywhere between 20% and 65% in India and other transitional economies compared with 18% in Organization for Economic Cooperation and Development (OECD) countries.6 The burden of purchasing medicines is very high in India, accounting for the second largest bulk of expenditure after food. The high cost of medicine purchase in India and relatively low public health investment is exacerbating the lack of access to essential medicines. It is now well known, accepted and documented that out-of-pocket (OOP) payment for healthcare has pushed many people into poverty. Bearing the costs of a single hospitalisation, 35% of people fall below the poverty line and OOP medical costs alone may push 2.2% of the population below the poverty line in 1 year.7Figure 2 below gives a glimpse of the healthcare spending in India for 2004–2005 across various states.8


Understanding public drug procurement in India: a comparative qualitative study of five Indian states.

Singh PV, Tatambhotla A, Kalvakuntla R, Chokshi M - BMJ Open (2013)

Healthcare spending in India 2004–2005 (figures in USD).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3585974&req=5

BMJOPEN2012001987F2: Healthcare spending in India 2004–2005 (figures in USD).
Mentions: Private health expenditure constitutes almost 70% of the total health expenditure of which drugs form a massive component with anywhere between 20% and 65% in India and other transitional economies compared with 18% in Organization for Economic Cooperation and Development (OECD) countries.6 The burden of purchasing medicines is very high in India, accounting for the second largest bulk of expenditure after food. The high cost of medicine purchase in India and relatively low public health investment is exacerbating the lack of access to essential medicines. It is now well known, accepted and documented that out-of-pocket (OOP) payment for healthcare has pushed many people into poverty. Bearing the costs of a single hospitalisation, 35% of people fall below the poverty line and OOP medical costs alone may push 2.2% of the population below the poverty line in 1 year.7Figure 2 below gives a glimpse of the healthcare spending in India for 2004–2005 across various states.8

Bottom Line: A total of 30 actors were interviewed in all five states.The analysis indicated that autonomous procurement organisations were more efficient in relation to payments to suppliers, had relatively lower drug procurement prices and managed their inventory more scientifically.The authors highlight critical success factors that significantly influence the outcome of any procurement model.

View Article: PubMed Central - PubMed

Affiliation: ACCESS Health International, Centre for Emerging Markets Solutions, Indian School of Business, Hyderabad, Andhra Pradesh, India.

ABSTRACT

Objective: To perform an initial qualitative comparison of the different procurement models in India to frame questions for future research in this area; to capture the finer differences between the state models through 53 process and price parameters to determine their functional efficiencies.

Design: Qualitative analysis is performed for the study. Five states: Tamil Nadu, Kerala, Odisha, Punjab and Maharashtra were chosen to ensure heterogeneity in a number of factors such as procurement type (centralised, decentralised or mixed); autonomy of the procurement organisation; state of public health infrastructure; geography and availability of data through Right to Information Act (RTI). Data on procurement processes were collected through key informant analysis by way of semistructured interviews with leadership teams of procuring organisations. These process data were validated through interviews with field staff (stakeholders of district hospitals, taluk hospitals, community health centres and primary health centres) in each state. A total of 30 actors were interviewed in all five states. The data collected are analysed against 52 process and price parameters to determine the functional efficiency of the model.

Results: The analysis indicated that autonomous procurement organisations were more efficient in relation to payments to suppliers, had relatively lower drug procurement prices and managed their inventory more scientifically.

Conclusions: The authors highlight critical success factors that significantly influence the outcome of any procurement model. In a way, this study raises more questions and seeks the need for further research in this arena to aid policy makers.

No MeSH data available.


Related in: MedlinePlus