National Formulary Listing Process

i) ii) iii) iv) v) vi) vii) Hospital Meeting State Meeting National Meeting Hospital Drug Utilization meeting First LPO Subsequent LPO Tender

What is Blue Book?

MOH Drug Formulary contains a list of drugs approved for use in all hospitals/institutions in the MOH. The Formulary is to promote rational, cost effective use of drugs whereby newer and effective drugs were introduced in a manner so as to minimize wastages and funds set aside for the purchase of drugs, are optimally used.

Proforma
A - Proposal to delete any of the drug/dosage form/formulation in the MOH drug Formulary B - Proposal to alter/add formulation/dosage form/category of the prescriber/ indication in the MOH Drug Formulary D- Proposal to introduce new drugs into the MOH Drug Formulary ** proforma ( forms )

Category of Prescriber

A* A A/KK B C

Consultants/Specialists for specific indications only Consultant/Specialists Consultant/Specialists/Family Physician Specialists Medical Officers Paramedics

Hospital Drug Committee members

Hospital Director- Chairman Chief Pharmacist- Secretary Senior Consultants from Paeds, O&G, Surgical and Medical Other specialists and DIP

State Drug Committee members

State Health Director - Chairman Deputy State Health Directors (4) ie Medical, Public Health, Dental and Pharmacy Senior Consultants in State ie Medical, Surgical,O&G and Paeds FMS Chief Pharmacist Senior pharmacist ** Quorum for meeting 6 pax

Sub-comm
Anti-infectives Neuro/neurosurgeri ENT Psychiatry Gastro Respiratory Cardiovascular Oncology Rheumatology and Immunology Dermatology Anaesthesiology Paediatric O&G Endocrine Opthamology Urology and Nefrology Transplan ** Quorum for meeting at least 4

Drug Utilization Meeting

Objective: 1) To make new approved drugs available, in the respective hospitals 2) To increase quota for number of patients

First LPO

Follow up closely with the Drug Info Pharmacists on the outcome of the Drug Utilization meeting,or Get meeting outcome from the a) initiator, b) HODs c) purchasing pharmacist Once confirmed, get the pharmacist to put in the 1st LPO If the purchase is less than RM 50K, usually one bumi agent to quote

Subsequent LPOs
Once the drug has reached the RM 50K purchase, pharmacists have to put up the Lampiran Q requests. Lampiran Q is the request form to purchase up to RM 500K Lampiran Q is a form to be filled up by store pharmacists, approved by Chief Pharmacists then passed on to Pengarah Hospital for approval Once Pengarah Hospital approves , it will be passed on to the Store pharmacists for subsequent purchase If the drug reaches RM 500K, then pharmacists can request to Tender Division, Bahagian Farmasi, Petaling Jaya to extend to tender status

Tender

Usually when a drug reaches RM 500K, and it is not the end of the year yet, the pharmacists can write in a request letter to the Bahagian Farmasi, to request to expedite the tender request. Normal way,Bahagian Farmasi will compile the list from all hospitals and then the top 20 drugs will be chosen as tender drugs Specification of these drugs are done by the pharmacists in charge of tender in Bahagian Farmasi, Petaling Jaya After specifications are decided, it will be sent to Bahagian Perolehan dan Penswastaan, MOH in Putrajaya for the calling of tender Tenders are then called for and advertise in papers

Bumi agents interested in participating, will buy the tender documents from Bhg Perolehan dan Penswastaan counter ( RM 50/tender document) Bumi agents will then request from the Principal Pharma company, to participate in the tender, to quote the price through them Pharma company will then submit price through the chosen bumi agents Bumi agents will submit the tender documents to the Bhg Perolehan dan Penswastaan, before the closing date After the closing date, Bhg Perolehan will open the documents and compile according to drugs and number of agents participating for each drug ( pricing revealed) Afterwhich, these drugs go through a technical committee meeting , which comprises of i) the tender division pharmacists from Bahagian Farmasi, ii) Consultants from the respective therapeutics , usually from Klang Valley After the technical committee has decided, the files will be sent to Bahagian Perolehan dan Penswastaan where the division will then go through the files Then it will be sent to the Board of Directors in MOH for approval. Decision is based on both tender specifications and price . Tender value less than RM 50M, Ketua Setiausaha of MOH approves Tender more than RM 50M, goes to MOF to be signed ( tender board A)

If the tender is supplied through CIF then, it has to go through another process of clearance from the Treasury Department, MOF. Then sent to MITI to request for import permit Those supplied through FOB, will then sent to MITI to request for import permit. This is only for drugs that is imported. For drugs manufactured in Malaysia, do not have to go through MITI After receiving the import permit from MITI, Bahagian Perolehan will send letter of award to the respective bumi agents that have succeeded in the tender participation Bumi agents inform the respective Pharma company and also we have to ensure that bumi agents fax a copy of the letter of award to all hospital pharmacists ** Time taken from the technical committee meets to tender awarded differs from CIF to FOB. CIF takes longer as it needs treasury approval, ie 4-5 months FOB takes 2 months

Hospital meeting

State Meeting

BB Meeting

Drug Utilization Meeting

First LPO

Hospital request for tender status

Usage to RM 500K

Lampiran Q