Chronic start for drug dispenser

The international company awarded a controversial R500-million, five-year contract to dispense chronic medication to the Western Cape has been penalised R168 000 by the provincial government following a chaotic start after it took over the service in April.

UTi Pharma won the contract to deliver medication to 200 000 patients in the province from Cape Town-based Institutional Pharmacy Management (IPM).

Pharmacists told the Mail & Guardian IPM had run the operation smoothly for more than five years. The pharmacists all spoke on condition of anonymity as they were not allowed to talk to the press.

The Democratic Alliance's health MEC, Theuns Botha, said he had met with representatives of UTi in Washington last month, and they had "acknowledged that they underestimated the complexity of the data transfer and challenges".

It has been widely reported that the new operation caused chaos at most primary healthcare facilities, as medicine was often late in delivery and caused problems for patients. In many cases, when the medicine arrived it was not pre-packaged, and the wrong medicine was sometimes sent and had to be replaced using the pharmacy's own supply, the pharmacists said.

Quick to defend
This week the M&G found the situation at the smaller clinics had improved, as there were fewer complaints and general relief that the chronic medicine was now arriving packaged. However, larger clinics that deal with greater volumes of chronic medication reported that the operation was still fraught with problems.

"The packaging is not clear, like it was before," said a pharmacist from a Cape Flats clinic. "So we have to open it to check the medicine, which takes time. Then when we open it, we often find it contains the wrong medicine, which we have to replace. The old operation ran smoothly, and got the scripts right."

The health department was quick to defend its new contractor. "All medicines are contained in opaque plastic bags for patient confidentiality," said Hélène Rossouw, spokesperson for the MEC. "During the difficult transition phase, where we had inaccurate data from the previous service provider, all parcels were required to be opened to check that all the contents were correct and accurate."

Jürgen Wagenhauser, consultant to IPM, flatly denied that it had supplied inaccurate data to the health department or UTi Pharma. He questioned why UTi was still having problems, because IPM had provided a distributing service of the chronic medication for eight months with UTi before it took over the contact.

"UTi was servicing 40 000 patients, and we were servicing 130000 patients," said Wagenhauser. "UTi struggled with that small distribution to patients during that period."

The health department has put out two tenders for this contract in the past two years. IPM contested the first tender after UTi won the contract. The department cancelled it and gave IPM an interim service delivery contract to work with UTi until April. IPM did not contest the second tender, which UTi won again, because it claimed the health department appeared "determined" to use the international company.

According to plan
IPM said the health department should not link the company to its current problems, but should rather assess whether this could not be attributed to "the inexperience of the new service provider in providing a dispensing service at the required volumes, as well as the unproven processes and technology used".

UTi's divisional director of operation, Stuart Murray, told the M&G the distribution of chronic medicine in the Western Cape was "progressing according to plan" and that the company was confident it was meeting its service level obligations.

Murray dismissed any disparaging comments rival companies had made about it. UTi has been in the "direct to patient" business for 10 years, he confirmed, and is apparently investing more than R530-million in a state-of-the-art distribution facility in Johannesburg.

"Data integrity and missing data challenges" caused delays for some patients at some centres, said Murray. "To put matters into perspective, more than 157000 patients received their chronic medicine from nearly 100 state health facilities in the Western Cape in July."

He added that the much-anticipated home delivery of chronic medicine was not scheduled for "some time".

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