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Generic Medicine Pricing Policies Evaluation in Indonesia and the Impact on Availability and Medicine Price in Private Sectors

Anggriani, Yusi (1); Mohamed Ibrahim, Mohamed Izham (2); Suryawati, Sri (3); S Budiharto, Martuti (4); Akmal Shafie, Asrul (5)

yusi1777@yahoo.com

1: Faculty of Pharmacy Pancasila University, Indonesia, School of Pharmaceutical Science, University Sains Malaysia, Penang, Malaysia; 2: Department of Pharmacy Practice, College of Pharmacy, Qassim University, Al Qassim, Saudi Arabia; 3: Center for Clinical Pharmacology and Medicine Policy Studies,  Gadjah Mada University,  Yogyakarta, Indonesia; 4: National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; 5: School of Pharmaceutical Science, Universiti Sains Malaysia, Penang, Malaysia

Problem statement: The government of Indonesia has given a political commitment to the provision of affordable medicines. Pricing policies on generic medicines that have been implemented by MoH need to be evaluated.

Objectives: To evaluate generic medicines price policies and the impact on the price and availability of selected medicines in private sectors

Design: Policy evaluation, cross-sectional study

Setting: Survey was conducted in 52 private pharmacies from 4 provinces in Indonesia.

Study population: Five generic medicine price policies from the period 2005–10 and 50 medicines (14 global, 15 regional, and 21 supplementary) were evaluated.

Policies: Medicine price policy in Indonesia set maximum prices for generic medicine for procurement and retail. Public sectors procurement price must comply with the policy. Retail price of private sector cannot be more than maximum price.

Outcome measure(s): Number of items in price policy, trend of MoH generic medicine price, comparison of generic medicines price at private pharmacies with MoH maximum price, MPRs of latest MoH procurement price, MPRs and availability of generic medicine in private sectors. The 2009 International Reference Price (IRP) was used to compare MoH procurement price and retail price.

Results: Only 42 generic medicines price were evaluated; 8 global and regional medicines were not on the MoH list. 153 medicines were regulated in 2005 price policy. From 2006 to 2010, items on the policy nearly tripled over the number on the 2005 list. There were 387, 458, 455, and 453 items in 2006, 2006 2008, and 2010, respectively. The trend of generic medicine prices showed that the highest medicine prices were in 2005. After the 2006 policies were enacted, most generic medicine prices decreased significantly from 2005 MoH prices. The changes in prices in 2006 were based on HAI and WHO survey recommendations in Indonesia on 2005. Two years after prices decreased, a new price policy was implemented in 2008. When comparing 2006 and 2008 MoH prices, 32 items did not change, 6 items increased, and 4 items decreased. When comparing current (2010) policy with 2008 price, 33 items did not change, 6 items decreased, 3 items increased. Of 42 items, only 36 items were calculated for MPRs, 6 items were not in IRP 2009. 25 items’ MPRs of MoH procurement price were >IRP, and 9 items MoH procurement price were <IRP. Most of medicine prices in the private sector were more than the MoH maximum price; only 2 items had MPRs <IRP and 34 items had MPRs >IRP. The availability of 42 medicines was very low for 11 items (26.2%), low for 5 items (11,9%), fairly high for 15 items (35,7%), and high for 11 items (26,2%).

Conclusions: MoH generic medicine prices 2005–10 tend to decrease. MPRs of MoH procurement prices were higher than IRP 2009. Most of retail prices in the private sector exceeded MoH maximum price. At private sector facilities, generic medicine prices in Indonesia are still expensive, and availability is still a problem.

Funding source(s): The Ministry of Education of Indonesia

HIPERTENSI RAWAT INAP DI IRNA-B RUMAH SAKIT UMUM PUSAT X PERIODE JULI-DESEMBER 2010 

Yusi Anggriani¹, Agus Purwanggana², Ahmad Subhan³, Ria Puspita Wardhani⁴

^124, Fakultas Farmasi Universitas Pancasila, ³Rumah Sakit Umum Pusat X Jakarta.

Abstrak: Ketepatan penggunaan antihipertensi masih perlu memegang peranan penting dalam keberhasilan pengobatan. Penelitian bertujuan untuk mengetahui kesesuaian penggunaan obat antihipertensi dan mengetahui biaya obat pada pasien Umum, Askes dan Jamkesmas rawat inap di IRNA-B RSUP X. Penelitian bersifat deskriptif analitis dan dilakukan secara retrospektif dengan kriteria inklusi pasien hipertensi primer dan dengan penyakit penyerta (Hypertensive Hearth Disease dengan dan tanpa Congestive Hearth Failure dan Hypertensive Renal Disease dengan Renal Failure) di rawat inap IRNA-B RSUP X. Evaluasi ketepatan dosis antihipertensi sebesar 87,0%.  Obat di luar formularium cukup tinggi yaitu sebesar 39,3%. Biaya obat antihipertensi per item yang paling rendah adalah untuk pasien Askes. Kesimpulan penggunaan obat antihipertensi pada pasien hipertensi rawat inap di IRNA-B RSUP X masih terdapat ketidaksesuaian dengan Standar Formularium RSUP X tahun 2007 untuk penyakit hipertensi. Terdapat perbedaan biaya obat antihipertensi pada pasien Askes dengan Umum maupun Askes dengan Jamkesmas. Tidak terdapat perbedaan biaya obat antihipertensi yang dikeluarkan pada pasien Umum dengan Jamkesmas.

Kata kunci: evaluasi, penggunaan obat, biaya obat, hipertensi, Rumah Sakit Umum Pusat X.

Sistem pengendalian mesin produksi pada tulisan ini, menggunakan sarana komunikasi internet sacara dial-up maupun Local Area Network (LAN). Saluran komunikasinya adalah jaringan terbuka, unutk itu maka  sistem pengedalian dilengkapi dengan pengamanan data menggunkan sistem penyajian sehingga data yang Di komunikasi kan dalam kondisi aman. Hasil pengujian dari rancangan sistem pengandalian Berhasil dengan baik, sehingga system ini dapat digunakan sebagai salah satu alternatif untuk pengendalian  mesin  produksi.

Kata kunci : metode pengendalian, LAN, pengaman data.