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Karaganda Oblast, Kazakhstan, Pharmaceutical Sector Assessment

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Karaganda Oblast, Kazakhstan, Pharmaceutical Sector Assessment KARAGANDA OBLAST, KAZAKHSTAN, PHARMACEUTICAL SECTOR ASSESSMENT Andrei Zagorski Marina Semenchenko Rational Pharmaceutical Management Project C.A. No. HRN-A-00-92-00059-13 Prepared: February–March 2000 Reviewed: April 2000 Published: May 2000 Management Sciences for Health 1515 Wilson Boulevard, Suite 710 Arlington, VA 22209 USA Phone: 703-524-6575 Fax: 703-524-7898 E-mail: [email protected] ii Karaganda Oblast Pharmaceutical Sector Assessment This publication was made possible through support provided by the U.S. Agency for International Development, under the terms of cooperative agreement number HRN-A-00-92- 00059-13. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for International Development. Recommended Citation Zagorski, Andrei, and Marina Semenchenko. 2000. Karaganda Oblast, Kazakhstan, Pharmaceutical Sector Assessment. Published for the U.S. Agency for International Development by the Rational Pharmaceutical Management Project. Arlington, VA: Management Sciences for Health. PREFACE The Rational Pharmaceutical Management (RPM) Project was developed by the U.S. Agency for International Development (USAID) and implemented in more than 20 countries worldwide. The project provided technical assistance and training to public health specialists in improving the pharmaceutical sector. In the Newly Independent States (NIS), RPM has worked, respectively, in Russia, Ukraine, Moldova, and Kazakhstan. The technical areas included rational prescribing and use of drugs, development of regional formulary systems, implementation of competitive drug procurement for the public sector (tendering), and development of drug information services. The RPM workplan in Kazakhstan for 1999–2000 included an indicator-based pharmaceutical sector assessment in the USAID pilot Karaganda Oblast. This report presents assessment findings, identifies gaps in the Karaganda Oblast pharmaceutical system, and suggests possible courses of action to correct problems in each area. The suggested activities are intended to serve as a point of departure for discussion at a RPM-organized policy options workshop, rather than as concrete recommendations. iv Karaganda Oblast Pharmaceutical Sector Assessment ACKNOWLEDGMENTS The authors wish to express their appreciation to all those individuals who helped plan and conduct the assessment, allowed themselves to be interviewed, and supplied the required data. A list of persons who participated in the assessment and provided data appears in Annex 1. In particular, the authors want to thank Kathryn Stratos and Indira Aitmagambetova of USAID and Dr. Kanat Ermekbaev and Dr. Nadezhda Khe from Karaganda Oblast and Professor Alexander Gulyaev from Karaganda State Medical Academy for their considerable support and involvement in planning and conducting the assessment. Special thanks are also extended to the USAID ZdravReform Project staff for providing assistance and, in particular, to Dr. Talgat Nurgozhin for valuable contributions and dedication to pharmaceutical sector reforms in Kazakhstan and the Central Asian Republics. vi Karaganda Oblast Pharmaceutical Sector Assessment CONTENTS PREFACE ......................................................................................................................................iii ACKNOWLEDGMENTS............................................................................................................... v CONTENTS..................................................................................................................................vii EXECUTIVE SUMMARY..........................................................................................................xiii Background ..............................................................................................................................xiii Assessment Objectives.............................................................................................................xiii Key Assessment Findings ........................................................................................................xiii Policy Options and Possible Interventions................................................................................xv Short-Term Activities and Possible Outcomes .....................................................................xv Activities .......................................................................................................................................xv Possible Outcomes .......................................................................................................................xvi Medium-Term Activities and Possible Outcomes ...............................................................xvi Activities ......................................................................................................................................xvi Possible Outcomes ......................................................................................................................xvii Long-Term Activities..........................................................................................................xvii ACRONYMS AND GLOSSARY ...............................................................................................xix CHAPTER 1. RPM ASSESSMENT METHODOLOGY.............................................................. 1 Objectives and Study Team......................................................................................................... 1 Methodology ............................................................................................................................... 1 Tools............................................................................................................................................ 2 Tracer Drugs................................................................................................................................ 2 Selection of Assessment Sites..................................................................................................... 2 Data Collection and Processing................................................................................................... 3 CHAPTER 2. SUMMARY OF INDICATOR FINDINGS ...........................................................5 Pharmaceutical Indicators Data................................................................................................... 5 A. Policy, Legislation, and Regulation ...................................................................................5 B. Formulary/Essential Drugs List and Drug Information...................................................... 6 C. Budget and Finance for the Public Health Sector............................................................... 7 D. Pharmaceutical Procurement in the Public Health Sector.................................................. 8 E. Public Sector Pharmaceutical Logistics.............................................................................. 9 F. Patient Access and Drug Utilization ................................................................................. 10 G. Product Quality Assurance............................................................................................... 11 H. Private Sector Pharmaceutical Activity............................................................................ 11 CHAPTER 3. FINDINGS OF THE KARAGANDA ASSESSMENT......................................... 15 Public Sector Drug Supply System ........................................................................................... 15 Structure and Organization of the Karaganda Drug Supply System..................................... 15 Oblast Administration (Akimat).................................................................................................... 15 viii Karaganda Oblast Pharmaceutical Sector Assessment Oblast Health Administration........................................................................................................ 15 Center for Health Purchasing Densaulyk...................................................................................... 16 State Enterprise Dari-Darmek ....................................................................................................... 16 City Health Administration Departments...................................................................................... 16 Karaganda State Medical Academy .............................................................................................. 16 Hospitals/Health Facilities ............................................................................................................ 17 Table 1. Types and Numbers of Health Facilities.................................................... 17 Legal Framework ...................................................................................................................... 18 Table 2. National Regulations Relating to the Pharmaceutical Sector, by Subject and by Enforcement Agency..................................................................................... 18 Discussion of Legal Framework ........................................................................................... 21 General Laws................................................................................................................................. 21 Drug Manufacturing.....................................................................................................................
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