The Administrator met with the Acting Director of Pohnpei Health Services, Mr. Paulino Rosario and his Administrator, Mr. Simao Nanpei, last March 3, 2013, to attain a better grasp of the apparent shortage of medicines at the Pohnpei State Hospital.
MiCare would like to know if in fact a prominent shortage does exists and how could the monthly capitation payment help in improving the situation.
The meeting confirmed that there is a shortage of medicines and pharmaceutical supplies shortages at the Pohnpei State Hospital. The meeting identified the following areas as the root cause of medicine shortages at Pohnpei State Hospital:
- There seem to be no clear inventory/re-order system in place to ensure continued flow and availability of medicines and pharmaceutical supplies;
- Specific functions of medical supply personnel are not clear hence duplication of activities and lack of accountability is prominent.
- The Hospital resorts to emergency order due to purchase contact limitation of only $25,000. No ven- dor seems to be interested in such a small order even if the bid amount goes up to $100,000. The interes begins for bulk purchase when the bid amount goes up to $200,000, however, the quick responses still come from the local vendors.
- Perry Point in Maryland may provide a low cost for medications but the problem with ordering from this US government medical and pharmaceutical provider is the length of time before medicines arrive. It takes about 6 months before it reaches Pohnpei.
- Frequent emergency orders from the local vendors (Genesis, MedPharm, etc.) has raised the cost of medicines which eventually transfers to MiCare, Pohnpei State Hospital and the members.
- When bigger order is bided out, the local vendors usually respond quickly. However, when bid funds are advanced, the local vendors piece meal the delivery of orders.
- MiCare members receive medicine prescription from the private clinic but go to the Pohnpei State Hospital to purchase the medicines. According to the Hospital Administrator, the MiCare members resort to this approach to avoid payment of the 10% of the prescription cost, and such practice has caused speedy depletion of medicines at the State Hospital.
- Funding does not seem to be a problem. Allocation for Pharmaceutical supplies is about $100,000 per quarter. For Medicines, the annual budget is $1.1 million. The MiCare Capitation agreement with the Pohnpei State Hospital has provided additional $420,000.