To what extent has the drug shortage been resolved?

According to some medical facilities, the shortage of basic medicines has now been resolved, creating favorable conditions for improving the quality of medical examination and treatment. However, many difficulties and obstacles remain in this area.

Has the shortage of essential medicines decreased?

Regarding the shortage of gamma globulin for treating hand, foot, and mouth disease that was reported a year ago at Children's Hospital 1 in Ho Chi Minh City, Dr. Nguyen Thi Bich Nhan, Head of the Pharmacy Department, said that the shortage of gamma globulin did not stem from a lack of legal regulations in procurement but was mainly due to disruptions in the supply chain caused by delays in importing the drug into Vietnam.

According to several medical facilities, the shortage of basic medicines has now been resolved, facilitating medical examination and treatment activities.

According to Dr. Nhan, the facility regularly reviews its drug inventory, keeps track of the number of drugs purchased under valid contracts, and monitors supply news and disease forecasts to stockpile drugs.

However, unforeseen situations arose. For example, in 2023, 13 licensed suppliers of Gamma globulin for treating hand, foot, and mouth disease were unable to supply enough, so the hospital proactively sought advice from the Department of Health and the Ministry of Health to secure the necessary supply of the drug to combat the epidemic.

In fact, gamma globulin is a rare drug, and its shortage for many years was due to a lack of suppliers, not because the legal regulations for procurement had not been issued in a timely manner.

Meanwhile, at the University Medical Center of Ho Chi Minh City, the unit receives 7,000-8,000 outpatients and over 1,000 inpatients daily. Currently, this is the medical facility with the highest number of patients in the southern provinces.

Associate Professor Dr. Nguyen Minh Anh, Deputy Director of the hospital, said that after the Government issued Decree 24 on February 27, 2024, only a minimum of one price quote is needed to establish the planned price, instead of requiring three price quotes as before.

If a hospital receives more than one price quote, the highest quote will be used as the planned price, based on the hospital's professional requirements and financial capacity.

Accordingly, the University Medical Center of Ho Chi Minh City no longer has a shortage of medicines, supplies, and equipment because the forecasting process is carried out throughout the year and bidding is conducted continuously. The main bottlenecks are minor issues in the bidding process for medical supplies and equipment due to the grouping of items for bidding.

According to the latest reports, the hospital's procurement and bidding rate has reached 80%. The remaining 10-20% is not due to subjective internal issues but rather objective factors in the supply chain, such as supply chain disruptions caused by contractors; and delays in supply due to waiting for extensions of drug registration licenses.

These are issues outside the purview of the hospital and the Ministry of Health. However, they do not seriously affect the hospital.

Sharing about the difficulties the unit faced in the past, before the Law, Decree, and guiding circulars were in place, Associate Professor Anh said that the most difficult aspect of bidding and procurement was obtaining the planned price of the bidding items, with regulations requiring a minimum of three quotations and the lowest bid price.

Furthermore, if even one item in the bidding catalog cannot be selected for a quotation or has a low price, affecting the entire package, then the bidding package cannot be implemented.

Regarding medical supplies and equipment, many items can only be quoted from the market because the price depends on the supplier; each manufacturer of the equipment must use the same chemicals.

Following numerous legal complications in procurement, many organizations are hesitant because even obtaining price quotes from contractors is not easy.

For example, a CT scanner bulb costs around 2-4 billion VND. On average, the bulb needs replacing every 1-2 years. The requirement to obtain three separate price quotes before purchasing one poses a significant challenge for healthcare facilities.

"No unit dares to purchase because the specifics of this equipment system require that each manufacturer's machine must use a bulb of the same manufacturer, so only one price quote can be produced," an official working at the medical equipment procurement unit of the University Medical Center of Ho Chi Minh City explained.

Thus, this issue has now been resolved. Hospitals have confidently purchased equipment to serve patients' timely medical examinations and treatments, while simultaneously addressing the problem of wasted, unused equipment.

At Cho Ray Hospital, an average of 5,000-6,000 outpatients and over 1,000 inpatients are admitted daily. Dr. Pham Thanh Viet, Deputy Director of Cho Ray Hospital, shared that the current drug shortage is mainly related to disruptions in the global supply chain.

Domestic drug manufacturers are also experiencing delays in supply due to a shortage of imported raw materials. "The drug shortage actually stems from the source, not from a lack of legal regulations or hospitals' inability to purchase enough for patients," said Dr. Viet.

Currently, Cho Ray Hospital still faces a shortage of medicines, but this is mainly due to objective factors, such as the extremely low prices of medicines, which deter any bidders from participating in the tender process.

Either rare drugs have very few suppliers, or some contractors win bids but are unable to import drugs and supplies at the time of delivery due to supply chain disruptions, extending the supply time to 4-5 months.

In these cases, without alternative medications, the hospital would find it very difficult to provide sufficient supplies, and the hospital would not be able to terminate the tender and proceed with a new one.

There are still many difficulties.

Regarding the current drug procurement process, according to opinions from many institutions, the issuance of documents by the National Assembly, the Government, and ministries and agencies has demonstrated an understanding of the practical difficulties and has resolved many obstacles.

However, currently, the procurement and bidding of medicines and medical equipment by some units and localities still do not meet the requirements of practice. The reasons for this are that, in addition to the fact that the legal system still has some points that need further improvement, the most important thing is whether the units and localities dare to undertake and implement the procurement process, and the limited decentralization of procurement authority to units in some localities leads to prolonged procurement processes.

Dr. Nguyen Vu Huu Quang, Director of the Dak Lak Department of Health, said that the shortage of medicines and medical supplies in the locality mainly occurred before the issuance of guiding circulars and decrees. Many medical facilities were hesitant and afraid to bid for supplies due to fear of legal consequences. Therefore, the locality experienced a six-month gap in the supply of medicines, medical supplies, and equipment.

Recently, the Provincial Department of Health has been compiling a framework list for submission to the Provincial People's Committee for approval. By 2024, Dak Lak will essentially have a fairly sufficient supply of medicines for healthcare facilities. The province is currently approving 30 bidding packages for 20 healthcare facilities.

According to Mr. Le Ngoc Danh, Head of the Pharmaceutical Operations Department of the Ho Chi Minh City Department of Health, the drug shortage mentioned in the press recently was mainly not due to procurement issues but rather to supply chain problems.

Accordingly, because Ho Chi Minh City is a unique area with many city hospitals serving the central government, in the event of an epidemic, in addition to preparing for the needs of the city's residents, medical facilities here must also meet the treatment needs of neighboring localities, leading to shortages.

The shortage of hand, foot, and mouth disease medication in Ho Chi Minh City in 2023 was mainly due to the need to allocate supplies to treat patients locally in some areas; if supplies were only for Ho Chi Minh City, they would have been basically sufficient.

In addition, some drugs have been granted registration numbers but are not actually imported by the importers, so Ho Chi Minh City has to issue special import orders.

Previously, regarding the difficulties in bidding for medicines and medical supplies, Mr. Do Trung Hung, Director of the Legal Department (Ministry of Health), stated that, in response to the difficulties and obstacles in procurement and bidding activities in general, and in the procurement and bidding of medicines and medical equipment in particular, the National Assembly, the Government, and the Ministry of Health have issued numerous legal documents on bidding to address these difficulties and obstacles in the process of organizing and bidding for medicines and medical equipment.

After a period of implementation, the Ministry of Health has noted that, at the local and unit levels, most difficulties and obstacles have been resolved. However, some difficulties and obstacles remain in the process of organizing and implementing legal documents. Based on proposals from relevant ministries and sectors, the Government is currently submitting to the National Assembly amendments and additions to several articles of the 2023 Law on Bidding.

Source: https://baodautu.vn/tinh-trang-thieu-thuoc-da-duoc-khac-phuc-den-dau-d228278.html