MeTA Baseline Assessments


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Overview of Medicines Transparency Alliance (MeTA) baseline Assessments of pilot phase.

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  • Enable country-specific indicators to be identified by the national MeTA multi-stakeholder groups Track own national progress and demonstrate level of engagement of different stakeholders to MeTA process Provide foundation for longer term evaluation of outcomes and impact beyond pilot phase
  • MeTA Baseline Assessments

    1. 1. <ul><li>Samia Saad </li></ul><ul><li>International MeTA Consultant for Baseline Studies </li></ul><ul><li>Second Jordan MeTA Forum </li></ul><ul><li>Dead Sea, Jordan </li></ul><ul><li>23 September 2010 </li></ul>MeTA Baseline Pharmaceutical Situation Assessments
    2. 2. <ul><ul><li>Introduction </li></ul></ul><ul><ul><li>Objective of Baseline </li></ul></ul><ul><ul><li>MeTA Baseline Components </li></ul></ul><ul><ul><li>Status of Baseline Assessments In Countries </li></ul></ul><ul><ul><li>Introducing Pharmaceutical Sector Scan </li></ul></ul><ul><ul><li>Overview of Preliminary Pharmaceutical Sector Scan Findings in Jordan </li></ul></ul>OUTLINE
    3. 3. <ul><ul><li>Many MeTA country workplans included review of national pharmaceutical sector </li></ul></ul><ul><ul><li>Int. MeTA Sec. tasked to encourage and support countries to undertake a baseline situation analysis after launch of their workplan activities </li></ul></ul><ul><ul><li>Baseline assessments undertaken in each country varied to some extent depending on national situation and resources </li></ul></ul><ul><ul><li>Int. MeTA Sec. & WHO worked with WHO Collaborating Centre in Pharmaceutical Policy at Harvard University and the Institute for Development Studies (IDS) to develop tools, provide technical assistance and additional resources </li></ul></ul>INTRODUCTION
    4. 4. OBJECTIVE track national progress Long term evaluation of outcomes Level of engagement of different stakeholders country-specific indicators
    5. 5. MeTA Baseline Components COMPONENT OBJECTIVE TOOL Component 1. Inventory of existing pharmaceutical sector data - that is then made publicly available <ul><li>Pharmaceutical Sector Scan Survey </li></ul><ul><li>Data Disclosure Survey </li></ul>Component 2. Indication of degree of community access to essential medicines - through healthcare facility and household surveys <ul><li>Household Survey </li></ul><ul><li>Health Facility Survey </li></ul><ul><li>Price, availability and affordability survey </li></ul>Component 3. Indication of quality of multi-stakeholder process - includes 360-degree assessment of existing levels of engagement Multi-stakeholder engagement & communication survey
    6. 6. <ul><li>Conducted in staggered sequence Aug. 2009- Aug. 2010 </li></ul><ul><li>Component 1. </li></ul><ul><ul><li>Pharmaceutical Sector scans conducted in all 7 MeTA countries </li></ul></ul><ul><ul><li>Data Disclosure Surveys conducted in all 7 MeTA countries </li></ul></ul><ul><ul><li>Component 2. </li></ul></ul><ul><ul><li>Level II Healthcare facility and Household Surveys conducted in Ghana, Jordan & Philippines (Uganda prior to MeTA launch) </li></ul></ul><ul><ul><li>Component 3. </li></ul></ul><ul><ul><li>Assessment of level of Multi-stakeholder engagement conducted in 5 MeTA countries ( Jordan, Peru, Philippines, Uganda and Zambia) </li></ul></ul>Status of Baseline Assessments in MeTA Countries
    7. 7. <ul><li>MeTA </li></ul><ul><li>Pharmaceutical Sector Scan </li></ul>
    8. 8. OVERVIEW <ul><li>The Pharmaceutical Sector Scan intends to: </li></ul><ul><li>Collect, organize, and synthesize existing data on the Pharmaceutical Sector with sources </li></ul><ul><li>Assess how medicines for primary care are supplied and used </li></ul><ul><li>User friendly data collection tables which allow for systematic analysis </li></ul><ul><li>Highlights availability and gaps in key information </li></ul><ul><li>Helps MeTA stakeholder groups improve transparency in the pharmaceutical sector and set priorities for future activities </li></ul>
    9. 9. METHODOLOGY Data Collection Background Scan ( National + International Sources) Key Informants for National Data Collate, synthesize and validate data and sources Review Data with Key Informants and Council Discussion & Formulation of Recommendations Validation of Data Collection by Harvard Team
    10. 10. Pharmaceutical Sector Scan DOMAINS <ul><li>27 data collection forms classified according to: </li></ul><ul><ul><li>Country Profile </li></ul></ul><ul><ul><li>Medicines Policy and Regulatory Framework </li></ul></ul><ul><ul><li>Medicines Market </li></ul></ul><ul><ul><li>Medicines Financing </li></ul></ul><ul><ul><li>Medicines Trade </li></ul></ul><ul><ul><li>Medicines Supply System </li></ul></ul><ul><ul><li>Medicines Access </li></ul></ul><ul><ul><li>Medicines Use </li></ul></ul>
    11. 11. Key Issues JORDAN Sector Scan Data <ul><li>Public Expenditure on Pharmaceuticals 33.3% of total Pharmaceuticals Expenditure </li></ul><ul><li>Solid legal and regulatory framework underpins the pharmaceutical sector - NDP of 2002 now being reviewed and action plan will be developed (MeTA as facilitator) </li></ul><ul><li>General lack of information available on the market- difficult for a government agency to make appropriate policy decisions in the absence of high quality information </li></ul><ul><li>No publicly available list of registered drugs (originator, branded generics and generics) </li></ul>
    12. 12. Key Issues JORDAN Sector Scan Data <ul><li>Lack of Standard Treatment Guidelines (STGs) for common illnesses </li></ul><ul><li>Promotion Guidelines have been developed by JFDA but </li></ul><ul><ul><li>no regulatory committee for controlling medicines advertising & promotion; </li></ul></ul><ul><ul><li>no formal process for complaints and sanctions within manufacturers’ national code of conduct; </li></ul></ul><ul><ul><li>no routine publicly available reports on complaints handling of promotional practices </li></ul></ul><ul><li>no national strategy to manage antimicrobial resistance & no national reference laboratory to coordinate epidemiological surveillance on antimicrobial resistance </li></ul>
    13. 13. Key System Weaknesses Apparent in Sector Scan Data <ul><li>Supply Chain </li></ul><ul><ul><li>~60% availability in public health facilities </li></ul></ul><ul><ul><li>High expenditure on medicines (~ 30% of total health expenditure) </li></ul></ul><ul><ul><li>High private sector prices (originator & generic) </li></ul></ul><ul><ul><li>Difficult to monitor or enforce standards and guidelines </li></ul></ul><ul><li>Demand- Rational Use </li></ul><ul><ul><li>Poor public sector prescribing and dispensing indicators </li></ul></ul><ul><ul><li>Overuse of antibiotics </li></ul></ul><ul><ul><li>No monitoring or data on private sector prescribing </li></ul></ul><ul><ul><li>Dispensing without prescription </li></ul></ul><ul><ul><li>Lack of patient knowledge and information on medicines </li></ul></ul>
    14. 14. CONCLUSIONS (I) Baseline Assessments <ul><li>Took longer than anticipated to conduct - MeTA Jordan busy implementing an ambitious pilot phase workplan </li></ul><ul><li>Not all 3 sectors were able to supply data- but important for all sectors to engage in validating and cross examining the data </li></ul><ul><li>Transparent, systematically collected data within multi-stakeholder setting - will lead to more accountability </li></ul><ul><li>Gaps in disclosure or availability of data were identified and discussed by MeTA stakholders (Data Disclosure Survey) </li></ul>
    15. 15. CONCLUSIONS (II) Baseline Assessments <ul><li>Wealth of primary data collected (WHO Level II Surveys) to measure outcomes on: </li></ul><ul><ul><li>access (affordability and availability of key medicines and geographical accessibility of dispensing facilities) </li></ul></ul><ul><ul><li>rational use of quality medicines, including some indication of the quality of medicines at health facilities and pharmacies </li></ul></ul><ul><li>MeTA stakeholders are now able to make recommendations to decision makers based on solid evidence on pharmaceutical situation in Jordan </li></ul>
    16. 16. Baseline Assessments <ul><li>Baseline data enables decision makers to have evidence to review & reform pharmaceutical policies to improve access to good quality medicines for ALL Jordanian citizens </li></ul>
    17. 17. Jordan Abeer Rabaya - MeTA Secretariat Pharmacist Email: Rania Bader - Country Consultant Email: Salah Gammouh- WHO Technical Officer for MeTA (Level II surveys) Email: [email_address] International Samia Saad - International Consultant (Baseline Coordinator) Email: Wilbert Bannenberg - Technical Director, Int. MeTA Sec. Email: Key Contacts MeTA Baseline Assessments
    18. 18. Thank You for your attention!