Clarity needed over vital drugs, says Aids group

THE “PEOPLE’S Health Systems Movement” group has expressed concerns over the vacuum in group purchasing for expensive overseas drugs, as there is still no clarity over which state agency will continue the work formerly undertaken by the National Health Security Office (NHSO). 
Nimit Thien-Udom, director of the Aids Access Foundation, warned yesterday that with only two months left of the current financial year, stocks of vital products such as anti-retroviral drugs, kidney wash liquids and vaccines were getting low and in need of replenishing. He said the lack of clarity would affect patients in need of constant medication.
The NHSO has acted as group purchaser of high-cost drugs for more than a decade and managed to negotiate the best prices, saving the country Bt5 billion a year while ensuring patients received vital medications, Nimit said. 

The Office of the Auditor-General recently ruled, however, that the NHSO had no authority to do the task and Nimit lamented the void.
He also revealed that the government had reportedly prepared a model in which seven major public hospitals would arrange the group purchasing for seven groups of high-cost drugs so any medical facility in need of such medicines could buy directly from them. 
The NHSO also recommended that the government fund the group purchasing of drugs in a form of a fixed budget sent directly to the seven hospitals. 
The NHSO has issued a directive to its board and a submission for the Cabinet’s approval, while the Finance Ministry vowed to issue a special regulation to authorise the seven hospitals to buy drugs directly from the Government Pharmaceutical Organisation provided that the purchase received the Cabinet’s nod.
“So if the drugs cost Bt10 billion, is such a budget allocation directive to the seven hospitals doable in the eyes of the Auditor-General? ” asked Nimit. “This doesn’t make sense, as there will be no regulation in place to ensure people’s access to the medicines. Hospital directors also are not authorised to spend this much money hence the requirement for the Cabinet’s nod. Why don’t you just let the NHSO do the task as the Council of State suggested – a law amendment to authorise the NHSO to do this job? Is this because the NHSO is ex-PM Thaksin Shinawatra’s legacy? Is this a political matter to justify the undermining of the universal healthcare system principle?”
Nimit urged the committee amending the National Health Security bill to consider the Council of State’s idea to authorise the NHSO for group drug purchasing or to set forth clarity over which state agency can do the job. He said his group considers the NHSO a suitable option.
In a related development, a source at the Public Health Ministry revealed that Dr Varakorn Samakoses – who chairs the committee drafting the National Health Security Bill – would today sit down with Public Health Minister Piyasakol Sakolsatayadorn to discuss two key issues in the bill. 
“One is about the central procurement system for some types of drugs. The other is about the separation of an extra personnel budget from the flat-rate per-head subsidy for the universal healthcare scheme,” the source said. 
According to the source, the People’s Health Systems Movement” group is upset that the bill does not authorise the NHSO to handle the procurement. 
“The group is also dismayed that the bill will separate the extra personnel budget from the subsidy. That’s why the discussions between the two key men have to take place,” the source added.