by Thanh Hai
Viet Duc Hospital recently held its first public drug buying event to stock up with drugs for the next year. It was attended by representatives from 65 pharmaceutical enterprises.
Journalists from the mass media were invited to witness proceedings. The hospital's criteria for the goods were quality and price. Successful tenderers were not necessarily those offering the lowest prices.
However, the hospital's criteria seems to go against the instructions in the Ministry of Health's current circular 01 which insists that only the cheapest drugs be bought.
"The health ministry's circular, in effect, encourages hospitals to buy cheap and poor quality medicine," said Viet Duc Hospital director Nguyen Tien Quyet.
Quyet said that the best drugs were usually more expensive. He added that his hospital had full proof that cheap and low quality drugs had little effect. "Enterprises usually give priority to cheap products because they provide higher profits. However, hospitals have to take responsibility for patients' lives," he said
The director said that a European-made injectable antibiotic, Ciprofloxacin, cost VND80,000 (US$3.80) per ampule while the Asian version cost only VND8,000 ($0.38).
Both antibiotics are licenced in Viet Nam with the same technical ranking. This means the two drugs can be bought by hospitals, but the cheaper drug would probably be selected.
However, Quyet said some medical units had stopped using cheap drugs due to their low quality. He said that medicine was a special product that required special criterion for bidding.
"Drugs for hospitals should be quality goods at a reasonable price instead of a cheap ones with but no efficacy. The hospital would rather pay VND300 billion ($14.3million) to buy good drugs rather than pay half the money for those with little effect.
"The average days of treatment are prolonged if we use these cheap drugs, especially for people with serious infections and resistance to drugs. This would also add to hospital overloading," said Quyet.
A debate has been stirred up among health experts, policy makers and the public. Many said Quyet was courageous to speak out on the issue.
Trinh Minh Lieu, a Ha Noi resident, said that she rarely heard of cheap drugs providing good quality. Doctors usually filled her prescription with expensive medicines for the best results. She said she would rather pay more money for good drugs than buy cheap ones that don't work.
A director of Mekophar Chemical Pharmaceutical, Huynh Thi Lan, backed Quyet's point of view, saying "Good drugs should come at a reasonable price. Patients should not be treated with cheap and poor quality drugs that would result in prolonged treatment and the waste of health insurance."
HCM City Health Department deputy director Pham Khanh Phong Lan said cheap drugs would dominate the tendering process. She said hospitals could be forced to buy drugs made from cheap materials produced in China because European medicines were up to 10 times dearer.
"Materials for drug production should be one of the criteria for drugs used in hospitals because this was a major factor affecting quality," said Lan.
The deputy director of the Drug Administration of Viet Nam (DAVN), Nguyen Viet Hung, has the opposite view on the quality of pharmaceutical products circulated in the country.
He said that all pharmaceutical products licenced in Viet Nam satisfied the health ministry's standards on safety and effectiveness.
"There is no reason to say that the drugs in the winning bids are of poor quality", said Hung.
According to Hung, circular 01 which came into effect in June last year has helped save tens of billion dong in medicine, making up between 20-30 per cent of drug expenses for hospitals nation-wide.
However, the evidence shows that the guidelines on cheap price has created a chance for cheap and nasty imported drugs to flood our hospitals.
Leaders of some hospitals said that many drugs with "strange contents" are being offered at cheap prices to hospitals by successful tenderers from China, Pakistan and India.
Former Deputy Minister of Health Le Van Truyen said that regulations on technical standards in circular 01 were not sufficiently detailed to keep low quality products out of drug bidding. Leaders at some hospitals said that hospitals needed a council made up of drug experts.
Maybe there is some hope. The health ministry is now setting up an interdisciplinary council to revise the contentious circular 01.— VNS