Procurement Planning for Medicines and Supplies in the Public Health System of the Dominican Republic

The National Medicine and Supply Management Unit (UNGM) of the National Health Service (SNS) has been using this methodology with the support of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. The planning exercises consist of four steps: preparation, planning exercises, review and consolidation of the planning matrices, and presentation of results to decision makers. The planning exercises have progressively incorporated a greater number of health care units and disease control programs (DCPs). Since 2013, the planning exercise has incorporated five institutions in addition to the Ministry of Public Health (MSP). The planning exercises have also included the joint procurement of medicines and supplies for the public sector, as ordered by Presidential Decree 608-12. The planning exercises have been carried out in a decentralized form within the health care units and Regional Health Services (SRS), with support from specialists from the UNGM, the Essential Medicines Program and Center for Logistical Supplies (PROMESE/CAL), and SIAPS. The preliminary planning results are presented to and discussed with decision makers to be adjusted and validated. The reports are then submitted to the appropriate authorities to include the planned amounts in the MSP budget for the next fiscal year. The planning exercises have resulted in the development of a manual for estimation and planning of purchases (Manual de Estimación y Programación para la Compra) and catalogs of medicines, medical-surgical supplies, and laboratory reagents and equipment. The planning exercises have also led to the creation of a standardized methodology for national planning exercises for purchasing in the public sector. The financial gap in funding for medicines and supplies in the public health system in 2015 was identified as a major challenge. The Ministry of Public Health (MSP) financial gap was estimated to be 1,601 million Dominican pesos (DOP), while the financial gap of other public sector institutions was estimated to be 990 million DOP. The financial gap for joint procurement and disease control programs was estimated to be 660 million DOP. A comparative analysis of the MSP financial gap exercises for procurement in 2014 and 2015 revealed a significant increase in the financial gap in 2015. The results of the MSP procurement planning for 2016 showed a planned amount of 1,601 million DOP, with a total of 990 items planned for purchase. The planning exercise also included the joint procurement of medicines and supplies for the public sector. Recommendations for improving access to medicines and supplies in the public health sector include increasing the financial resources allocated to the Ministry of Public Health (MSP) and other public sector institutions, improving the planning and procurement processes, and strengthening the capacity of the National Medicine and Supply Management Unit (UNGM) and other institutions involved in the planning and procurement of medicines and supplies.