Presentation on theme: "Assessment of the Pharmaceutical Supply Situation in the Republic of Montenegro LCDR Robert Tosatto CAPT (ret.) Terry Green."— Presentation transcript:
Assessment of the Pharmaceutical Supply Situation in the Republic of Montenegro LCDR Robert Tosatto CAPT (ret.) Terry Green
Presentation Objectives To familiarize PHS pharmacists with a type of short-term international assignment To provide details about the assessment of the pharmaceutical supply situation in Montenegro conducted by 2 PHS pharmacists in November 1999
US Involvement in Montenegro Pre-Kosovo Crisis Sanctions Post-Kosovo Crisis Pro-Western, reform-oriented Administration USG pledged support through USAID Economic Support Funds
US Involvement (cont.) MOH provided USAID with unpaid invoices for drugs and medical supplies (totaling over $1.5 million) USAID requested technical assistance from DHHS
Purpose of Assessment (from the Scope of Work) Retrospectively review appropriateness, receipt, issuance and end use of drugs and medical supplies on unpaid invoices Determine if adequate inventory control measures exist to assure transparency Examine the efficiency and effectiveness of the pharmaceutical distribution system Determine the need for essential medicines and make recommendations for action (i.e. optimal medical commodity mixes) based upon perceived needs
Constraints Time frame Security concerns Restricted areas Trade embargo
Information Gathering Interviews Minister of Health key MOH staff members pharmacists and administrators “BusinessMontenegro” NGOs (WHO, UNICEF, PSF) Site visits “MonteFarm” hospitals health centers pharmacies
“MonteFarm” Warehouse Reviewed shelf levels of drugs and supplies Determined supplies of essential medicines Observed inventory control measures Observed distribution system “MonteFarm” Warehouse
Podgorica Clinical-Hospital CenterBar Hospital Reviewed shelf levels of drugs and supplies Determined supplies of essential medicines Reviewed computerized inventory systems Evaluated levels of drugs and supplies on inventory
Podgorica Public Pharmacy Dobrota Psychiatric Hospital Pharmacy “Closet” Reviewed shelf levels of drugs and supplies Determined supplies of essential medicines Observed distribution to end users Reviewed shelf levels of drugs and supplies Determined supplies of essential medicines
Reviewed Unpaid Invoices Analyzed Translated Screened for inappropriate items Finding: The drugs and medical supplies were purchased for appropriate medical uses. Many were not essential, but they were appropriate.
Transparency Analyzed random selection of several drugs and supplies from invoices Tracked ordering, receipt, issuance and end use Finding: Systems are in place to assure that drugs and supplies are procured, stored, and distributed in a manner that assures transparency
Need for Essential Drugs and Medical Supplies Analyzed “needs” list from MOH, information from site visits, and NGO input Finding: There were shortages of many of the drugs that the public health system was obligated to provide, however, many of those drugs were not essential (as defined by WHO).