Pooled procurement of 40 drugs by 23 cancer centres resulted in financial savings of Rs.1,320 crores
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In 1995, Tamil Nadu pioneered the centralised procurement and distribution of drugs and medicines to authorities hospitals throughout the State. This helped in shopping for drugs at a far cheaper charge because of the sheer quantity of drugs procured. Other States have replicated the mannequin with various ranges of success. Like all vaccines equipped to the nationwide immunisation programme at a really low cost, throughout the pandemic, the Central authorities was capable of procure COVID-19 vaccines at about Rs.150 per dose from Bharat Biotech and Serum Institute because of centralised procurement. The COVID-19 vaccines had been priced many instances extra when State governments and personal hospitals had been requested to acquire them immediately from the businesses.
For the primary time, a personal entity — the National Cancer Grid — has been capable of replicate the mannequin and hammer down the cost of high-value, high-volume cancer and supportive care medicines by way of a pilot pooled procurement programme. The pooled procurement of 40 drugs by 23 cancer centres resulted in financial savings of Rs. 13.2 billion (Rs. 1,320 crores), in response to a paper revealed in 2023 in the Bulletin of the World Health Organization. Savings on particular person drugs ranged from 23% to 99% (median financial savings of 82%) from the utmost retail value. Besides anticancer drugs, the record of medicines included antibiotics, antifungals, antiemetics and development components. The drugs included each generic and patented medicines, and the collaborating cancer centres — small, mid-size and large-volume — included each non-public and public cancer hospitals from throughout the nation. There had been eight non-public centres, and the remaining had been public/charitable/belief hospitals. Nine centres had been from main cities/metros and the remaining 14 had been exterior main cities/metros. Cost financial savings had been most for generic drugs and fewer for patented drugs.
Once the record of drugs to be bought by way of pooled procurement was drawn up, the demand for every drug was decided from the collaborating centres. Prior to tendering, the reserve value of every drug was decided by requesting the collaborating centres to share the cost of procurement of every drug for the earlier yr. The lowest value for each listed drug was used because the reserve value for every drug. The reserve value record was shared with all collaborating centres and it served as the utmost value at or beneath which the centres agreed to purchase the drugs. All collaborating centres additionally agreed to a minimal buy dedication based mostly on the reserve value. The minimal buy dedication helped in speaking to the drug firms the seemingly annual volumes required for every drug. This was adopted by on-line tendering. The technical analysis of the drug firms previous to monetary analysis ensures that solely high quality drugs might be equipped.
Once the drug firms had been chosen, an settlement was signed between the businesses and every cancer centre. The settlement ensured that “vendors did not breach the terms and conditions established with the network”. For occasion, the businesses had been required to provide drugs to all cancer centres immaterial of their location.
The whole course of started in 2019 and finalised in 2020. “Rate contracts were valid for two years and then they were extended by another year. They are still valid as supplies began in 2020,” Dr. C. S. Pramesh, Director of the Tata Memorial Hospital, Mumbai says in an electronic mail to The Hindu.
With the success of the pilot programme, extra centres have now evinced curiosity in collaborating in the pooled drug procurement. “We have received requests from more than 40 centres and several state governments for bulk procurement for their state hospitals,” says Dr. Pramesh. “[For the second round of the pooled procurement] the tender has been published and the bids are undergoing prequalification (completed) and technical evaluation (in final stages).”
The pooled procurement programme was performed by way of the National Cancer Grid value discovery cell with a governing physique. The Tata Memorial Hospital was the coordinating centre, and functioned because the Secretariat, explains Dr. Pramesh.
The drastic reduction in drug cost can in flip tremendously lower the out-of-pocket adherence to therapy even in non-public hospitals, and elevated entry and affordability by sufferers at small cancer centres in smaller cities. “[This is] a model that can (and should) be replicated in other disease areas and geographies,” Dr. Pramesh who can also be the corresponding creator of the paper tweeted. “This must rank as one of our most satisfying and fulfilling efforts at democratizing access to cancer medicines.”
