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PRICE SURVEY
HIGHLIGHTS FOR STAKEHOLDERS
MEETING
16-December, 2008
Presentation Outline► Background and Problem statement;
► To describe the methodology adopted;
► To share preliminary findings, challenges
► Overall Recommendations;
► Way forward & possible interventions for MCA;
1. Background:
► A survey of medicine conducted by KEMSA in
FY 2005/06 reported that the public
procurement system was achieving very
competitive prices (Source: KEMSA
2005/2006 Price Survey Report)
Problem statement & Rationale of the Survey.
There is a possibility that medicines are accessed at different prices by different segments of the population along the public sector supply chain.
The study therefore seeks to explore trends in price variations for medicines accessed from different sources by various segments/points along the supply chain.
2. Survey Design & Methodology
Design: A non-experimental design was employed Survey methodology was used Cross-sectional approach was adopted because it
allows enormous information to be collected within a short period.
Methodology: Goal
The overall goal of the survey was to document and compare KEMSA’s prices with the International Reference Prices, MEDS, KNH and local manufacturers and distributors to determine whether KEMSA and Ministry of Medical Services are getting value for money in public procurement.
Methodology: Objectives
To undertake a comparison of KEMSA’s prices with
international price reference guide for selected health
commodities used in public health facilities.
To compare KEMSA prices with other procuring agents
To compare KEMSA prices with local manufacturers
and distributors of health commodities
To undertake price documentation for selected
commodities procured locally using Cost sharing
funds available at facility level.
Methodology: Sample & Sampling
Facility type Sampling Frame Sample Size
Provincial General Hospitals 7 7 (Census)
District Hospitals 166 17 (10.2%)
Teaching & Referral Hospitals 2 1 (50%)
Total 175 25
Selection Criteria: Regional representation; Facilities that undertake local procurement (with FIF)
Survey Sample
Variables and Measurements Dependent Variable: Prices of
Indicator items. Independent Variables:
a. Source (IDPIG-International suppliers,
Local suppliers, Local manufacturers,)
b. Supply Chain level (KEMSA, KNH-Referral
hospital, PGH, DH)
c. Region/Province
Measurement
Comparing tender prices of Indicator Items by supplier/source
Comparing prices by ordering point along the supply chain
Comparing KEMSA prices with PPOA prices
Comparing KEMSA prices with those of local manufacturers.
Comparing KEMSA prices with those of local distributors.
Comparing KEMSA price with local procurement at hospitals
( Tender/supplier prices of Indicator Items by source for FY2007/08.)
Tools Development and Pre-testing
TWG: MSH, MOMS, KEMSA
List of Indicator Items defined Multi-source price survey tool developed with
sections for KEMSA, Manufacturers, MEDS/KNH, Wholesalers, Health Facilities
Multi-disciplinary team of 20 data collectors
trained.
Pre-testing done in 6 facilities in Nairobi and
environs.
Data Collection
4 teams of 5 people each
4 supervisors, one per team Covered 24 facilities/ordering points
scattered in all provinces in Kenya
Took 4 weeks
4. Data Analysis
Data captured in Excel Spreadsheets Data analyzed using simple statistical
procedures.
Key Findings: Comparing tender prices of Indicator Items by supplier (source)--- Table1.
Indicator items KEMSA
price ratio
IDPIG
price ratio
Amoxicillin Cap 250mg
1.00 1.13
Amoxicillin Syr 1.00 1.37
Paracetamol Tab 500mg
1.00 1.30
Cotrimoxazole Tab 480mg
1.00 1.37
Key Findings: Comparing tender prices of Indicator Items by supplier (source)--- Table 2.
Indicator items KEMSAprice ratio
MEDSprice ratio
KNH Price Ratio
Amox Cap 250mg 1.00 1.01 1.51
Amoxicillin Syr 1.00 0.89 0.96
Paracetamol Tab 500mg
1.00 1.14 1.03
Cotrimox. Tab 480mg
1.00 1.05 0.99
Key Findings: Comparing Indicator Item prices by ordering point along the supply chain (Table 3)Indicator items KEMSA KNH
Price Ratio
Public Hospitals ( PGH, DH) Price ratio
Amoxicillin Cap 250mg
1.00 1.51 0.96
Amoxicillin Syr 1.00 0.96 0.96
Paracetamol Tab 500mg
1.00 1.03 1.04
Cotrimoxazole Tab 480mg
1.00 0.99 1.10
Key Findings: Comparing KEMSA Prices with PPOA Price Survey Report (Apr 2008)-- Table 4
Indicator items KEMSA KEMSA/ PPOA Price Ratio
Amoxicillin Cap 250mg
1.00 1.45
Amoxicillin Syr 1.00 1.96
Paracetamol Tab 500mg
1.00 1.99
Cotrimoxazole Tab 480mg
1.00 0.88
Key Findings: Comparing KEMSA Prices with those of local manufacturers and distributors (Table 5)Indicator items KEMSA
price ratio
Cosmos price ratio
Regal price ratio
Harley's price ratio
Omaera price ratio
Amoxicillin Cap 250mg
1.00 1.89 1.30 1.07 1.12
Amoxicillin Syr 1.00 2.42 1.62 1.31 1.35
Paracetamol Tab 500mg
1.00 2.40 1.76 1.70 1.31
Cotrimoxazole Tab 480mg
1.00 2.64 1.49 1.21 1.30
5. Summary and Recommendations: Summary of Key Findings
There is marked price variation by source
There exists price variations at different points of the supply chain;
KEMSA’S tender prices for 2007/2008 are more competitive than those obtained by the PPOA Survey;
In most cases, KEMSA prices are better than those of manufacturers and suppliers.
5. Summary and Recommendations
Overall recommendations
KEMSA appears to be a more efficient procurement agency
offering better value for money.
Facilities at different levels of care should procure from KEMSA.
For KEMSA to be the main source, it must improve its efficiency
in its overall service delivery.
This price information should be disseminated through the
MOMS/MOPHS and KEMSA websites to make it available to
sites.
Conclusion
For the most part, KEMSA prices are more competitive than for similar products purchased by health facilities from all the other entities surveyed.
KEMSA is thus achieving value for public funded procurement of medical commodities
Acknowledgements
MoMS/ MoPHS KEMSA USAID MCC MSH/SPS