Jumat, 12 Mei 2017

JKN Perspective 2017



JKN Perspective 2017
JKN is intended to address these growing disparities in health care in Indonesia. Its main objective is to create a well-integrated, sustainable, accessible, and equitable health system that provides comprehensive, high-quality care to all Indonesians,
This period included the development of a “road map” for continuing expansion of the system from its launch in 2014 to the achievement of UHC by 2019.
Formularium Nasional (FORNAS): The national formulary of medicine containing list of molecules of drugs  aims to support JKN programs
 e catalogue: a tool for e procurement for which prices of products have been negotiated centrally
* Fornas I in 2013       : Totally 538 variety drugs
* Fornas II in 2015      : Totally 562 variety drugs
* Fornas III in 2016     : Totally 927 variety drugs
* Fornas IV in 2017     : Totally 957 variety drugs
Growth  of drugs in ecatalogue 2017 only 3.24% compare last year , whereas count of JKN provider more excessively 

The issue of JKN :

1.It is not clear RKO (Rencana Kebutuhan Obat) as a basic to create ecatalogue , many member      of JKN didn’t forward list of RKO to kemenkes.
Data for RKO 2016 :
- Hospital government 52% 
 - Private hospitas 2%
  - Pharmacy PRB 15%

2. there are two statement from pharmaceutical industries :
a. The price : MOH Ceiling Price (HPS) are Considered Too Low. There are interests from the industry but the proposed prices are above HPS. It seems that the tender will be repeated with in the same HPS again.
There should be an evaluation on the determination of HPS.
Pricing of HPS has to be reconsidered, how prices are being set? Price being the only indicator to win the tender and negotiation
b. Pharmaceuticals company don’t have a guarantee their product can be great demand from JKN member , many provider of JKN will buy products according their expectation.

3.There are  Statement from Distributor ;
a. Distribution Cost Is Included  in the Product Price, Relatively High Distribution Cost .
Distributors found difficulties in sending products to several member of JKN .
the transportation costs were more than higher , distributors are not attracted to serve all the purchase order because the margins given to distributors are not sufficient to send the products, finally, distributor must obey to distribute it because the principals of pharmaceutical has been signed as separate of JKN programs.
b. Payment to distributor
as we know during IJKN implementation, the main problem is JKN provider have many bureaucracy to paid bill to distributor, needed a new policy that make a simple.

4. Need a new role to regulate new method in government Hospital formularium .
It is not linked between Fornas list and Government hospital formularium.
The role of the government in the accountability of hospitals for quality of care involves shaping the community of those interested in quality, developing methods and infrastructure, standardizing information, providing information and technical assistance, and enforcing standard.
We wish all government hospital submissive to implementation “Fornas” in each hospitas

5.Coordination with each institution is powerless
a. LKPP and LPSE Kemenkes
b. Kemenkes and BPOM
to improve healthcare services under the JKN program, the  government should ensure policy certainty related to the future of the SJSN program, including the technical aspects of its implementation, a guarantee that there will be no changes in policy implementation from Sabang to Merauke, and evaluation as well as supply and availability of drugs required for the program.

Donni Noviandi Rafdi
NIDN 0325117404
Lecture Marketing Management