Drug deal

True story accompanying image

With price tags running into millions of dollars, health contracts can mean big money for the winning companies. And where costs are high, so are the risks of corruption – particularly when deals are kept away from public scrutiny.

Still in a transitional phase, these risks are particularly high in Kosovo – and with limited resources to go around it’s important that money is well-spent. Adding one drug to the state shopping list can mean another has to be removed.

Keen to ensure this doesn’t happen, our centre in Kosovo keeps watch over new contracts. Consulting with experts, the team help ensure work goes to the best bidder, at the best price.

In late 2012, one item started to raise alarm bells.

“When we examined the medication on the state’s essential drugs list, we found an anti-nausea drug listed under treatments for cancer,” says Merita, project manager at the centre, who led the monitoring initiative.

And it wasn’t only that it had been misclassified – the drug also seemed to be mispriced.

“Two years earlier the state had purchased two different kinds of anti-vomiting medication at a cost of just €7,920.” Merita explains, “Now, the two previous brands had been cancelled in favour of a new alternative, and the total had skyrocketed to €1.2 million.”

Put another way – there had been a 15,000 per cent increase in the bill. It wasn’t only that this new medication was almost 60 times more expensive per unit, the quantities on order had more than doubled.

We spoke to pharmaceutical experts to find out if there was a reason for the change in supplier. No discernible medicinal benefits could be identified. We also analysed the procurement practices of neighbouring countries in the region, looking to see if any of them chose to rely exclusively on this alternative. No examples were found.  

Releasing our findings at a press conference, the story quickly attracted widespread public attention, prompting swift action from the health minister, who quickly organised a committee to look into the charges. As the final authority for signing high-value contracts, the health minister had the power to refuse the contract.

Following consultation with the committee, the minister publicly accepted our analysis, and refused to sign off on the deal. The medication was removed from the essential drugs list, and reclassified as an anti-nausea treatment.

Taken up by the state prosecutor and the local economic police, an investigation is ongoing into how the case came about. While there have been no official results so far, one message is clear already, says Merita. “Health procurement is too important to be kept in the shadows. For both our budget and our safety, the public has to be able to keep watch.”

This is just one example of our work around the world. Active in more than 100 countries, we’ve already helped thousands of citizens to stand up and challenge corruption.  With your support, we can do even more. 

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