Summary

The Aklan Consignment System (ACS) was conceptualized in 2014 in response to the growing need of essential, affordable and quality medicines in local hospitals under the jurisdiction of the Provincial Government of Aklan. It was initiated by the Economic Enterprise Development Department (EEDD) to improve on the existing consignment system of the Provincial Government of Negros Occidental. A more decentralized system was installed by organizing the Hospital Consignment Committees (HCCs) in the different government hospitals across the province. Under a decentralized consignment scheme, the old, circuitous bureaucratic processes are eliminated allowing hospital management to readily respond to the needs of clients.

Background and Problem

The inadequate availability of medicines pervaded in the hospitals was caused by the tedious procurement process. In five years, the ACS aims to achieve the following objectives:

  1. Enable easy access to essential, affordable and quality medicine, particularly for indigent patients;
  2. Boost compliance to the No Balance Billing (NBB) policy of Philhealth;
  3. Improve client satisfaction
  4. Reduce appropriations and operational expenses in hospitals
  5. Generate additional revenues for hospitals

Solution and Impact

Government hospitals in Aklan have been beset with logistical and operational problems due to inadequate supplies of essential medicine largely due to budgetary constraints. The ACS was conceptualized in response to the growing need to improve the delivery of health care services. After benchmarking the consignment system of Negros Occidental, a technical working group was organized, comprised of representatives from the EEDD, accounting department, and health department in order to formulate the proposed ordinance, implementing rules and regulations and other documentary requirements. The following activities were undertaken:

  • A series of engagements conducted in hospitals to cascade the operational details of consignment.
  • Pharmacists and other hospital staff dispatched to Negros Occidental to obtain first-hand information on the implementing details.
  • The technical working group constituted to craft the implementing rules and regulations.
  • The Hospital Therapeutics Committee was activated and mobilized to identify medicines to be consigned, preferably those that are fast moving.
  • The Consignment Advisory Committee was constituted and the Hospital Consignment Committee was organized in each hospital.
  • A monitoring scheme was installed through the Consignment Inspection Team/Committee.

Results

  • The availability of essential medicine was sustained
  • The ACS was instrumental for the hospital to comply with the No Balance Billing (NBB) policy of Philhealth
  • Client satisfaction improved
  • Out of pocket expenses have been remarkably reduced
  • Hospital operational expenses and appropriations was reduced

Milestones

  • Increased hospital revenues with a net balance of Php 56.3 M from a seed money of Php 12.5M
  • Improved compliance to NBB from 42% in 2016 to 83% in the first semester of 2019
  • Sustained availability of essential drugs, medicines and supplies in hospital pharmacies
  • Improved client satisfaction

Next steps

  • Consignment of laboratory supplies
  • Consignment of radiology supplies
  • Establishment of satellite pharmacy in Doctor Rafael S. Tumbukon Memorial Hospital dedicated for consigned medicines
  • Consignment of oxygen supply
  • Encourage multinational drug companies as registered consignors under the ACS to further decrease the cost of drugs and medicines in hospitals