Strategies to implement best practices, innovation in procurement in public health were presented through two cases studies. Dr Suresh Saravdekar, Consultant – Procurement of Medicines & Medical Devices, IMS BHU, presented the first one and elaborated on the use of tools of health technology assessment to prioritise health needs.
He started his presentation by saying that prioritising in public health is essential in these times when new medicines and new medical devices are cropping up, but the sector is facing a scarcity of government funds.
He pointed out that in a market-based economy, prioritisation of healthcare technology is based on market creation and not on actual health needs, thus creating artificial needs. He also opined that in a market-based economy almost all innovations are targeted towards fulfilling the needs of rich countries, which in turn create global concentration and dominance of a few nations and top companies. He added that in the last 50 years, hardly any new drugs have been invented to target diseases like TB, dengue and malaria which are prevalent in poor countries. Elaborating on the new drugs, he said, “According to USFDA, only 14 per cent drugs are innovative and rest are similar to the existing ones.”
Drawing inferences from a Lancet study in 2017, he spoke on the findings of prioritisation of the market based healthcare scenario. The study informs that even though life expectancy has increased substantially, healthy life expectancy has not increased much. He reiterated that there are a few tools which can be put to use to enable appropriate prioritisation of health needs with optimisation of funds. These tools are called Health Technology Assessment tools which aid in prioritising the technological needs of the hospital. He pointed out that they are currently used for only budgetary evaluations, and explained how it is different from economic evaluation. He gave a list of the tools that are available and shared case studies alongwith the procedure of how these tools aid in analysing the different medicines that are available.
He concluded by saying that in healthcare services, allocation of funds, while introducing new technologies should be subjected to not merely budgetary evaluation but also proper economic evaluation. He concluded by saying that the health technology assessment tools, when put to use, will help produce credible and standardised information that is relevant in decision making.