MeTA and data disclosure

• 1.
  • Samia Saad:MeTA Baseline Assessments Coordinator

• MeTA Country Sharing Meeting

• London, 8 December 2009

MeTA & Data Disclosure 2. OUTLINE

• 1. What does " disclosure " mean within the MeTA hypothesis

• 2. Disclosure as part of the Baseline

• Overview of disclosure Process inMeTA Countries

3. 1. Responsibility for access

• Governments are responsible for providing accessto health care, including access to essential medicines

4. 2. Role of transparency

• Stronger and moretransparentsystemsandimproved supply chain managementwill increase access

5. 3. Equity

• Increasingequitable access to medicines improves healthand enables other human development objectives to be achieved

6. 4. Evidence-based policy

• Improved informationabout medicines can inform public debate, and provide a basis forbetter policy

6 Source WHO 2. Affordable prices ACCESS 1. Rational selection 4. Reliable health and supply systems 3. Sustainable financing 7. 5. Mutual accountability throughmutli-stakeholder action

• Amulti-stakeholderapproachthat involves all sectors private, public and civil society - will lead togreater accountability

7 8. Data DisclosureMETA DisclosureTransparency ImproveAccessto Medicines 9. How MeTA assists disclosure process

• Provides guidelines for a data set

• Baseline studies in pilot countries in collaboration with Harvard Medical School, WHO, and the Institute for Development Studies at Sussex University

• Provide tools, technical assistance, and additional resources to country groups to assist them in assembling existing pharmaceutical sector data, cataloguing key areas of data disclosure, synthesising information for priority setting, and producing concise summary country reports

10. Assisting the data disclosure process -objectives

• To providerobust and validated dataand information for consideration, assessment and evaluation by the 3 stakeholder groups at the Meta Council, the result of which may lead tochanges in government health policy and increases in access to essential medicines

• Thetools and methodologies developed in this process will be made availableby MeTA in the public domain and may be applied by any countries who may wish to implement the MeTA process at a future date

11.

• Commitment by MeTA pilot countries as part of the MeTA core principles todisclose, analyze, and use over time datain the following four core areas:

• • • 1. Medicines registration and quality assurance

• • • Availability of medicines

• • • Price of medicines

• • • 4. Policies and practices concerning the promotion of medicines

Data DisclosureHow does the 'Data Disclosure' fit in with our national MeTA projects? 12. Key data collected/disclosedin MeTA

• Qualityandregistrationstatus

• • Medicines, GMP plants, GDP wholesalers, Licensed outlets

• Pricedata of medicines

• • Procurement prices (~ MSH Intl price indicator)

• • Retail prices private, public sector (~WHO/HAI methodology)

• • Components (tax, VAT, margins, profit etc)

• Availability( for basket of essential medicines)

• Promotion(being developed by MeTA partner- pilot in Jan 2010)

• for each area:

• Policy

• Practices

• Outcomes?

13. Who should disclose what?

• Government : VAT, taxes, budget, selection, quantification,

• Procurement agency : purchase & selling prices

• DRA : quality and registration data, inspection, QC lab results

• Private sector : prices, margins, availability, promotion codes of conduct

• Civil society / academics : Availability (equity), Affordability, Rational use

14.

• • • Objective

• • • Identify, describe and assess the disclosure status of key types of pharmaceutical sector information related to the MeTA transparency agenda

Data Disclosure Survey 15.

• • Part of Component 1 of MeTA baseline data assessment: An inventory of existing pharmaceutical sector data that is then made publicly available

• • Objective - for Essential Medicines List (EML) or basket of 30-50 core medicines:

• • • Assess the current status of data disclosure in the four core MeTA categories

• • • Disclose the currently available data in the four MeTA core categories

• • • Identify where there are gaps in information

• • Many MeTA country workplans include a review of existing data and studies. It is hoped that using the data disclosure tool will facilitate this process

KEY POINTS (I) Data Disclosure Survey 16.

• • Available data for the survey will likely come from one or two sources (often the Govt. drug regulatory authority) and household and healthcare facility surveys (where available)

• • Using the tool is not only about data collection and disclosure!

• • • Discussingdisclosure is a key part of multi-stakeholder work in MeTA. Important that MeTA Secretariat staff and all MeTA Council members be involved in discussion process

• • • Lessons learned from processas important as findings and actual data disclosed

KEY POINTS (II) Data Disclosure Survey 17.

• • PROCESS as important as data

• • WHY?

• • Indicates how well the stakeholder group is working

• • Indicates how willing various stakeholders are to disclose information around medicines

KEY MESSAGE Data Disclosure Survey 18.

• In order that disclosure survey may assist the MeTA Council in setting further national workplan priorities before external evaluation of the global MeTA project takes place [January-March 2010]

• • Aim to complete collection of available data + discussion of findings/analysis by Council30th November 2009

• • Further validation of data could be conducted by31 December 2009,in collaboration with Int. MeTA Sec. + Harvard Pharmaceutical Policy Group

Suggested TIMELINES Data Disclosure Survey 19. MeTA Baseline Assessments 20.

• • All7 countries involved in pilot phase of MeTA initiativenow implementing their country workplans

• • Many country workplans include review of national pharmaceutical sector

• • Int. MeTA Sec. tasked to encourage and support countries to undertake a baseline situation analysis after launch of their workplan activities

• • Baseline Data will help the MeTA country multi-stakeholder groups to set their future priorities

Baseline -Introduction 21.

• • Baseline assessment undertaken in each country may vary to some extent depending on national situation and resources

• • Int. MeTA Sec. & WHO worked with WHO Collaborating Centre in Pharmaceutical Policy atHarvard Universityand theInstitute for Development Studies (IDS)to develop tools, providetechnical assistance and additional resources

Baseline Introductioncont. 22. Objective of Baseline track nationalprogress Long termevaluationof outcomes Level ofengagementofdifferentstakeholders country-specificindicators 23. SuggestedBaseline Assessment Components COMPONENT OBJECTIVE TOOL Component 1. Inventory of existing pharmaceutical sector data - that is then made publicly available

• Pharmaceutical Sector Scan Survey

• Data Disclosure Survey

Component 2. Indication of degree of community access to essential medicines - through healthcare facility and household surveys

• Household Survey

• Health Facility Survey

Component 3. Indication of quality of multi-stakeholder process - includes 360-degree assessment of existing levels of engagement Multi-stakeholder engagement & communication survey 24.

Status of Baseline AssessmentsComponent 1. Component 2. Component 3. Jan. 2010 Disclosure survey complete (7 countries) Pharma sector scan(Gh & Phil.) Jor. Kyrg., Peru,Ug., Za. 1st April 2010 Ug. (2008)Gh. & Phil . Jor. (ongoing) Ug, Ph. Kyrg., Jor.,Peru Phil., Za. 25. OverviewMeTA Countries Data Disclosure Surveys 26.

• Process varied across MeTA countries

• CollectiveMeTA Council Meetings (3) to discuss the keydisclosed data (Jordan)

• Consultant hired with national MeTA funds to collect data(Peru)

• 2. Most countries had some level of engagement from the MSG

• 3. An initial reaction by some MeTA country MSGs: disclosure survey 'imposed' on them by Int. MeTA Sec.some countries needed further justification

• 4. Common theme across countries - national Secretariat coordinators or technical advisors had to do a lot ofchasingfor datathemselves

• 5. Most of data held by public institutions

• 6. Many countries- no 'culture' of transparency (public sector)!

Disclosure Process in MeTA Countries 27.

• MeTA is a Voluntary Project

• Most key stakeholders who hold official resources of data have limited time.

• RED TAPE - laborious and time-consuming process of obtaining data. Data collectors need to know how to navigate the system.

• Data may exist but is not easily available or obtainable.

• Data may exist but it needs piecing together to make sense- lack of capacity within public institutions to analyse and present data on medicines.

• Lack of good information systems.

• Some key Data sources not easily accessible (fee needed to obtain data).

• Official websites sometimes poor or data updated infrequently -hinder accessibility to published data.

• Private sector data often opaque, not 'obliged' to provide data

Key Challenges 28. Samia Saad- International Consultant (Coordinator) Email: [email protected] Bannenberg- Technical Director, Int. MeTA Sec. Email: [email protected] Elodie Brandamir- Operations Director, Int. MeTA Sec. Email: [email protected] Key Contacts -MeTA Baseline Assessments 29. Thank You for your attention!