Kenya Healthcare Federation (KHF) Supply Chain Delegation to COSMOS Pharmaceuticals Limited
KHF supply chain team visited COSMOS Pharmaceuticals Limited on 8th February 2018 towards promoting the newly introduced member integration programme. The high cost of medical care in Kenya is partly due to the high cost of medication which makes up an average of 45% of patients’ hospital bills. COSMOS limited one of the Kenyan local pharmaceutical manufacturers strives to reduce the cost of healthcare and inturn contribute to Universal Healthcare Coverage.
From the presentation by COSMOS limited during the visit indicated that public and private expenditure on imported units once converted to local manufacturing prices, could lead to a potential savings of Ksh. 800 million per year based on the leading molecules, benefiting patients and insurers. Public sector spend 4.5 times more buying expensive medicines, while private sector spend 3.8 times more buying expensive medicines instead of using quality generic brands.
Unregulated trade margins have led to selling of expensive drugs. According to WHO Guideline on country pharmaceutical pricing policies and strategies, countries should consider regulating distribution chain mark-ups for distributors and wholesalers and retail chain mark-ups and fees for pharmacies, dispensing doctors and dispensaries. If mark-ups are regulated, countries should consider using regressive mark-ups (lower mark-up for higher-priced products) rather than fixed percentage markups, given the incentive that the latter provides for higher-priced products to receive a higher net margin.
Remuneration or mark-up regulation if considered can provide incentives for supplying specific medicines (generics, low volume medicines, reimbursable medicines) or to protect specific patients or population groups (e.g., vulnerable groups, remote populations).
One way to improve both availability and accessibility is to produce medicines locally. Which will decrease dependence on foreign suppliers (70% of total consumption) hence provide employment. Local production could also give greater control to Kenyan regulators, which are fighting against low quality drugs, sometimes made in far-off factories that are difficult to monitor.
The delegation witnessed an all-round production facility with five manufacturing blocks with over 180 API and over 6000 SKU’s. The factory which is equipped with marketing & administration offices, also harbor on site finished goods and works in a 24 hour operation. For the tablets manufacturing section, the facility runs 4 Granulation Suites, 6 Compression Rooms, 1 Capsulation Room, 3 Coating Rooms, 6 Blister Packing Lines and 1 Bulk Packing Line. The facility also operates 4 Dry Powder Filling Lines, 2 Ointment & Cream Filling Lines and 2 Liquid Bottle Filling.
With the aims to develop at least 5 highly effective products per year which comply to either British or United States Pharmacopeias, COSMOS practice good manufacturing according to WHO and GMP standards and all formulations are locally developed, following USP and BP. They are accredited manufacturers by USAID and PICS and receive regular PPB inspections leading quality standards roadmap goals. For ARV production COSMOS receive voluntary license from GSK and BI and count with state-of-the-art laboratory with well-trained and qualified staff.
KHF members gracing the delegation included Access Afya, Good Life Pharmacy, Pharm Access Foundation, F&S Scientific, Health Aid Chemist, Karen Hospital and Pharmaceutical Society of Kenya (PSK). A token of appreciation from KHF was presented to COSMOS by Dr. Robert Miano of PSK. Dr. Miano also read a speech from the KHF supply chain leadership team, which reiterated the big 4 agenda laid by President Uhuru Kenyatta. In his speech, Dr Louis Machogu pledges PSK’s total alignment of the sectors aspirations and opportunities into the Pharmacy Priority Agenda (PPA) 2018-2010.
Millions of Kenyan citizens still have limited access to quality-assured and affordable medicines to date. Even today, with increasing expansion of NHIF coverage, many people have to pay for their medicines out-of-pocket but lack the necessary financial resources to do so. With the rising burden of NCD and the reduction of donor funding’s, healthcare expenditures will become more expensive for the population, public and private health insurances and the public budget. KHF strives to promote local manufacturing through creating a better policy environment and strengthening public awareness and in turn reduce the cost of healthcare in Kenya.