MeTA in Kyrgyzstan MeTA in Kyrgyzstan Mariam Djankorozova, MeTA Co-Director 16/05/2008

Agenda Medicines Issues and Priorities in Kyrgyzstan Past and Current Experience in Addressing Medicines Issues Future Plans to Address Medicines Issues through MeTA Intended outcomes 16/05/2008

Medicines Issues and Priorities in Kyrgyzstan

Past and Current Experience in Addressing Medicines Issues

Future Plans to Address Medicines Issues through MeTA

Intended outcomes

Overview: Medicines Issues and Priorities Limited access to medicines Limited affordability and availability Especially important for chronic diseases highly prevalent in KG Major problem in rural areas (70% population lives in rural areas) 1 pharmacy:1500 people urban; 1 pharmacy:4500 people rural Low Quality of Medicines Counterfeit medicines from abroad; unable to fight against smuggled medicines Limited access to reliable & timely information on medicines Drug info. system under-developed, no info. on price, quality 06/04/09

Limited access to medicines

Limited affordability and availability

Especially important for chronic diseases highly prevalent in KG

Major problem in rural areas (70% population lives in rural areas)

1 pharmacy:1500 people urban; 1 pharmacy:4500 people rural

Low Quality of Medicines

Counterfeit medicines from abroad; unable to fight against smuggled medicines

Limited access to reliable & timely information on medicines

Drug info. system under-developed, no info. on price, quality

Limited access to medicines Case of Hypertension Several important and less expensive medicines (HCTZ) are not prescribed by doctors or recommended by pharmacists in favour of medicines that are highly promoted (enalapril) Written prescription differs from oral directions given by doctor People cannot afford expensive medicines; Insurance system insufficiently funded to adequately cover all beneficiaries Preference for branded generics that are much more expensive No mechanism to control promotion MeTA offers a mechanism to provide information to counteract promotion; engage CSOs to reach public with information 06/04/09

Case of Hypertension

Several important and less expensive medicines (HCTZ) are not prescribed by doctors or recommended by pharmacists in favour of medicines that are highly promoted (enalapril)

Written prescription differs from oral directions given by doctor

People cannot afford expensive medicines; Insurance system insufficiently funded to adequately cover all beneficiaries

Preference for branded generics that are much more expensive

No mechanism to control promotion

MeTA offers a mechanism to provide information to counteract promotion; engage CSOs to reach public with information

Low Quality of Medicines Medicines entering country through official channels 80 medicines per year are withdrawn due to poor quality Currently no link between DRA and customs Medicines entering country through informal channels Major problem; mountainous country difficult to monitor; Impossible to differentiate counterfeit from legitimate medicines Sold to pharmacies at low prices; Some are substandard (lower amount of active ingredient, some have no active ingredient) MeTA offers opportunity to collect information and link activities between customs and DRA; disseminate information on quality of medicines in official and informal channels to consumers; CSOs can assist DRA to monitor and educate 06/04/09

Medicines entering country through official channels

80 medicines per year are withdrawn due to poor quality

Currently no link between DRA and customs

Medicines entering country through informal channels

Major problem; mountainous country difficult to monitor;

Impossible to differentiate counterfeit from legitimate medicines

Sold to pharmacies at low prices;

Some are substandard (lower amount of active ingredient, some have no active ingredient)

MeTA offers opportunity to collect information and link activities between customs and DRA; disseminate information on quality of medicines in official and informal channels to consumers; CSOs can assist DRA to monitor and educate

Limited access to reliable & timely information on medicines Need information on: Import, legislation, licensing, certification, registration, quality, price, procurement MeTA can provide a mechanism for creating a single space on internet where all information can be accessible to all population (consumers and professionals); mobile phones may be an alternative to internet in rural areas; price monitoring will be key Must be two-way communication with feedback from population, utilizing CSOs for outreach 06/04/09

Need information on:

Import, legislation, licensing, certification, registration, quality, price, procurement

MeTA can provide a mechanism for creating a single space on internet where all information can be accessible to all population (consumers and professionals); mobile phones may be an alternative to internet in rural areas; price monitoring will be key

Must be two-way communication with feedback from population, utilizing CSOs for outreach

Summary Kyrgyzstan has been a leader in the region in addressing pharmaceutical issues One of the first countries to implement national drug policy, essential medicines list, standardized national treatment guidelines with training Insurance system for medicines, projects to create networks of pharmacies in rural areas Still, more work is needed; Ultimate goal is to improve access to medicines, especially for the poor MeTA offers opportunity for government, private sector and civil society to work together and disclose information on medicines towards goals of increasing access to medicines 06/04/09

Kyrgyzstan has been a leader in the region in addressing pharmaceutical issues

One of the first countries to implement national drug policy, essential medicines list, standardized national treatment guidelines with training

Insurance system for medicines, projects to create networks of pharmacies in rural areas

Still, more work is needed; Ultimate goal is to improve access to medicines, especially for the poor

MeTA offers opportunity for government, private sector and civil society to work together and disclose information on medicines towards goals of increasing access to medicines

Where to Get More Information Department of Drug Provision and Medical Equipment www.pharm.med.kg Health Insurance Fund www.foms.med.kg Kyrgyz Republic National Health Care Reform Program www.manastaalimi.med.kg/eng/ 06/04/09

Department of Drug Provision and Medical Equipment

www.pharm.med.kg

Health Insurance Fund

www.foms.med.kg

Kyrgyz Republic National Health Care Reform Program

www.manastaalimi.med.kg/eng/

Thank you! Name of presenter: Mariam Djankorozova Email: m_djankorozova@foms.med.kg Mobile number: + 996 555 929412 International Secretariat, info@metasecretariat.org MeTA: www.MedicinesTransparency.org DFID: www.dfid.gov.uk 06/04/09

Name of presenter: Mariam Djankorozova

Email: m_djankorozova@foms.med.kg

Mobile number: + 996 555 929412

International Secretariat, info@metasecretariat.org

MeTA: www.MedicinesTransparency.org

DFID: www.dfid.gov.uk

Kyrgyzstan