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[e-drug] RFI: 10 best case studies in procurement?

E-DRUG: RFI: 10 best case studies in procurement?

Dear E-Drug members,

I am just finishing a comprehensive review of best methods in
pharmaceutical procurement.  I have found surprisingly few case studies
that provide evidence that can guide the implementation of procurement
systems.  There are so few, in fact, that I thought it would be interesting
to put together a "10 best" list.

I can suggest 7 to get the discussion started.  Are E-Druggers aware of
others?  Language does not matter; we can always have reports
translated.  My only preferences are that the papers contain evidence
(whether of an implementation or a field study), and that the report is
less than 10 years old.

If you send me suggestions I will collate and report back to the list.  A
short explanation of why you like the article, and hints on how to obtain
copies will be appreciated!  Also feel free to comment on the papers that I
list below.

Thank you in advance,

Libby Levison
Independent pharmaceutical management consultant

Case studies

1) Organization of Eastern Caribbean States
1a) Burnett, F. 2003, "Reducing costs through regional pooled procurement",
Essential Drugs Monitor, vol. 2003, no. 32, pp. 7-8.
1b) Huff-Rousselle, M. & Burnett, F. 1996, "Cost containment through
pharmaceutical procurement: a Caribbean case study", International Journal
of Health Planning and Management, vol. 11, no. 2, pp. 135-157.

Describes the pooled procurement system put in place across the
Organization of Eastern Caribbean States.  By pooling orders across island
nations, adopting a system of restricted tendering, guaranteeing payment to
suppliers within 30 days, participating countries saved 70% in the first
two years.

2) The Delhi Society for Promotion of Rational Use of Drugs
Chaudhury, R. R. 1999, "Rational use of drugs: Change in policy changes
lives", WHO Essential Drugs Monitor no. 27, pp. 2-4.

Describes The Delhi Society for Promotion of Rational Use of Drugs, DPSRUD,
which re-organized their procurement system by creating an Essential Drug
List, installing Standard Treatment Guidelines, centralizing procurement,
adjudicating tenders of only pre-qualified suppliers, and promoting
rational use, and has, as a result, seen price reductions of 30-35%.

3) Van der Veen, F. & Fransen, L. 1998, "Drugs for STD management in
developing countries: choice, procurement, cost, and financing", Sex
Transm.Infect., vol. 74 Suppl 1, p. S166-S174.

This study by Van der Veen and Fransen showed that the purchase of STD
drugs is reliably less expensive when done through an international
procurement agent than when procured by the national procurement office

4) Kawasaki, E. & Patton, J. 2002, Drug Supply Systems of Missionary
Organizations: Identifying Factors Affecting Expansion and Efficiency: Case
Studies from Uganda and Kenya, WHO Department of Essential Drugs and
Medicines Policy, Geneva, WHO #HQ/01191467.

A WHO report on two mission-run drug supply systems in east Africa (MEDS in
Kenya and JMS in Uganda) that shows that efficiency and high-quality
service are both possible and sustainable.  By focusing on good inventory
management, strong logistics support, good financial management, and the
efficient use of resources, MEDS and JMS have both increased access to
safe, essential drugs.

5) Bhutan Essential Drugs Programme
Stapleton, M. 2000, Bhutan Essential Drugs Programme: A Case History, WHO
Department of Essential Drugs and Medicines Policy, Geneva,

Stapleton reports on the procurement system implemented in Bhutan.  This
case history focuses on issues of supplier performance and quality
control.  Of particular interest is Stapleton's report that Bhutan spent
0.39% of the procurement value on quality control of the procured medicines.

6) The Medicine Prices project
See articles in Essential Drugs Monitor, vol. 32 by:
6a) Kishuna, A. 2003, "Drug pricing survey in KwaZulu-Natal",
6b) Wickremasinghe, R., Balasubramanium, K., Jayarathna, U., Abeywardena,
C., Ranwella, S., De Silva, A., & Hettiarachchi, B. 2003, "Measuring drug
prices in Sri Lanka",
6c) Aristakesyan, M. 2003, "Some results from Armenia",
6d) Nurghozin, T. 2003, "The survey in Kazakhstan".

The WHO and Health Action International have launched a new project to
collect data on the prices patients pay for medicines in different
countries, as well as investigating the cost components, and the
affordability and availability of key medicines.  Early data is reported in
the above studies.

7)      Bala, K. & Sagoo, K. 2002, Patents and Prices, Health Action
International, HAInews.
Available at:

Research by Bala and Sagoo show the effect of patent policies and product
competition on pharmaceutical prices.  They found that product competition
results in lower prices for generics than for brand name equivalents as
well as smaller variations in cost between similar products.  Specifically
they report that "differences in the retail prices of brand name drugs are
much wider (range 1:16  1:59) than those for prices of generic equivalents
(range 1:7  1:18)".

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