Improving Rational Medicines Use in Rwanda Reduces Procurement Budget by 12% in 6 Months

Nyamata hospital in Rwanda successfully cut down its quarterly medicine procurement budget by 2.7 million Rwandese Francs (12% of the budget) in a period of six months with support from USAID-funded Management Sciences for Health's Strengthening Pharmaceutical Systems (SPS) Program.

SPS worked with the hospital to establish a Drug and Therapeutics Committee (DTC), a multidisciplinary group of health professionals whose objective is to design, implement, and monitor strategies to improve rational medical use. Through rational medical use, patients are given medications that not only meet their own individual requirements for a certain period of time, but that also meets their clinical needs and are at the lowest cost to them and their community.

The Rwandan Health Sector Policy states that to improve the availability of quality medicines, vaccines, and consumables—particularly essential medicines, routine vaccines, and family planning products—the Government of Rwanda will purchase, at every opportunity, generic and essential medicines so that resources are used optimally and rationally. The policy also recommends using only medicines on the essential medicines list to treat the most common diseases in the country.

Before the DTC was established in Nyamata hospital, they faced many challenges such as frequent overstock of unused products, stock-outs of essential products, a high procurement budget, poor quality medicines, patients having adverse effects  associated with medicines, noncompliance to standard treatment guidelines, and different prescriptions given to treat the same illness.

SPS supported the DTC develop a hospital formulary list - a comprehensive list of every drug and therapeutic agent stocked by the hospital - and mechanisms for its regular updates based on product efficacy, cost effectiveness, safety, quality, and its presence in the national essential medicines list.

As a direct result from effectively using the formulary list during prescription and procurement, Nyamata hospital has had some great achievements including decreasing the rate of stock-outs to 3%, ensuring products have not expired within a period of 12 months, making certain products that are prescribed are all from the formulary list, and reducing the quarterly medicine procurement budget by 12% in a period of six months.

The effective use and regular review of the hospital formulary list, through the Drug and Therapeutics Committee, can improve health care service delivery by allowing continuous availability and accessibility of pharmaceutical products while reducing the budget allocated to medicine procurement.

The SPS Program, funded by USAID, is working to build capacity within resource-limited countries to effectively manage pharmaceutical systems, successfully implement priority services, and ultimately save lives and protect the public's health by improving access to and use of medicines of assured quality.