Lessons from one year experience of pooled procurement of pharmaceuticals: exploration of indicators and assessing pharmacies` performance
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Joint procurement of medicines is a way to improve access and justice in developing countries. The aim of this study is to determine local indicators for assessing the performance of joint procurement agencies and compare the indicators in those pharmacies which use centralized purchasing before and after this change.
This was a mixed method study. In the first qualitative phase, 3 expert panels were held including 20 national experts who were selected through purposeful sampling. Data was analyzed applying a five-stage framework analysis using MAXQDA. In the second quantitative phase, financial, supply and procurement, physical and functional indicators of two hospitals affiliated with joint procurement were assessed and the satisfactions of patients from the pharmacy performance were compared applying a valid questionnaire. Data was analyzed using SPSS through independent test, Paired t-test and ANOVA.
Results show that after settlement of joint procurement, the cost of transportation has increased by 54%, a part of the cost of overhead has increased by 30%, the cost of manpower has increased by 88.9% and cost of insurance of warehouses has increased by 71.85% in 2016 compared to 2015. In addition, the total costs of holding were 89.8% of selling revenue. In other words, the profit was about 10% of revenue in total. Moreover the average score of pharmacies under the Holding has been higher than similar ones in all aspects of satisfaction from the patients` points of view.
The one-year experience of deploying centralized purchasing to supply medicine has led to increased income and patient satisfaction. However, increase in staffing costs, longevity, overhead and warehouse costs have been significant that need appropriate monitoring and interventions.
KeywordsPharmaceutical holding Pooled procurement Joint procurement Centralized purchasing Indicators
This Manuscript is retrieved from MSc thesis that was supported and approved by Shiraz University of Medical Sciences with the ID number of 95-01-07-11582. The research proposal was approved by ethics committee of Shiraz University of Medical Sciences with the ID number of IR.Sums.Rec.1395.s361.
PB: Study concept and design, participated in literature bibliography, Acquisition of data, Analysis and interpretation of data, Drafting of the manuscript, Critical revision of the manuscript for important intellectual content. MHI: Participate in design of study and drafting of the manuscript. HD: Participate in design of study, Drafting of the manuscript and, Acquisition of data. RA: participated in literature bibliography and collecting clinical data, Analysis and interpretation of data. SAD: Acquisition of data, Participate in design of study. KHK: Participate in design of study and drafting of the manuscript, and final revision of the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no competing interests.
Consent for publication
Ethics approval and consent to participate
The study was approved by ethics committee of Shiraz University of Medical Sciences with the ID number of IR.Sums.Rec.1395.s361.
- 1.Gh M, Bastani P. Pharmaceutical strategic purchasing: a key to improve access to medicines. Iran J Pharm Res. 2015;14(2):345–6.Google Scholar
- 3.Koiek S, Gharib A. Iran’s healthcare system challenges at a glance. Chron Dis J. 2013;1(2):96–7.Google Scholar
- 6.Strategy for Pooled Procurement of Essential Medicines and Health Commodities, 2013-2017. available at See http://www.who.int/trade/glossary/story078/en/index.html [accessed 4 April 2013].
- 7.Bagheri LK, GhahramaniS HB. A study on hospitalized patients’ payment in south of Iran after the first round of health sector reform. Iran J Public Health. 2017;46(2):276–7.Google Scholar
- 13.Luborsky MR, Rubinstein RL. Sampling in qualitative research: rationale, issues, and methods. Res Aging. 1995;17(1):89–113.Google Scholar
- 16.Kirytopoulos K, Leopoulos V, Voulgaridou D. Supplier selection in pharmaceutical industry: an analytic network process approach. Benchmarking: An International Journal. 2008;15(4):494–516. https://doi.org/10.1108/14635770810887267.
- 17.National Accounts of the Public Health Sector in Jordan. Amman, Jordan: Health Insurance Directorate; 2006.Google Scholar
- 19.Pooled Procurement of Medicines & Allied Commodities; Joint WHO, WIPO, WTO Technical Symposium Access to Medicines: Pricing and procurement practices -Zafar mirza, secretariat public health, Innovation and Intellectual Property; Geneva 16–20 July 2010.Google Scholar