Context
Because Indonesia’s national health insurance program (JKN, or Jaminan Kesehatan Nasional) covers about 94.6 percent of the country’s population, financial resources need to be effectively and efficiently spent on the right services and medical products. To help address this challenge, the United States and Indonesia collaborate to improve decision-making processes for spending on safe, affordable and effective medical products.
JKN offers an extensive benefit package and has vastly improved Indonesians’ healthcare access and overall well-being. By 2024, the Government of Indonesia (GOI) seeks to increase JKN enrollment to 98 percent. However, expenses are outpacing the budget, with pharmaceuticals making up a large portion of the cost. This contributes to more out-of-pocket costs for patients, putting the GOI’s ambitious goal of equitable, affordable, quality, and inclusive healthcare access for all Indonesians at risk.
USAID Medicines, Technologies, and Pharmaceuticals Program (USAID MTaPS)
The objective of the U.S. Agency for International Development’s MTaPS program is to improve the country’s pharmaceutical systems by strengthening their ability to institutionalize transparent and evidence‐based decision making, as well as enhance Indonesia’s capacity to track pharmaceutical expenditures (PE), in order to improve purchasing value and strengthen governance in the pharmaceutical sector.
To do so, USAID MTaPS is enhancing the Ministry of Health (MOH)’s ability to conduct health technology assessments (HTAs). The HTA process informs which medical products and technologies JKN should prioritize for purchase, based on value, quality, and budget. USAID MTaPS also supports MOH to develop a methodology to obtain reliable data on pharmaceutical spending and a comprehensive, transparent tracking system. Together, these will equip the MOH with the data it needs to reduce overspending on pharmaceuticals without compromising the quality of care available through JKN. Finally, USAID MTaPS supports Indonesia to institutionalize these improvements by enhancing collaboration between the MOH and other stakeholders responsible for strengthening the pharmaceutical system in Indonesia, such as other government agencies, medical associations, and pharmaceutical producers.
Results
To date, USAID MTaPS has:
- Assisted the Ministry of Health and the Indonesia Health Technology Assessment Committee (InaHTAC) to develop and publish the 9th HTAsiaLink Conference Digest;
- Assisted the Ministry of Health and InaHTAC to formulate six criteria for the drugs and medical devices selection process, for further assessment and incorporation in JKN’s benefit package;
- Supported the MOH and InaHTAC to select three HTA treatments for 2023, consisting of Bevagen, Abiraterone Acetate, and Pembrolizumab; and
- Supported the MOH to conduct the first nationwide PE tracking and publish the findings in December 2022 to be utilized as evidence in the policy making process.
Contact
Nurul Maretia Rahmayanti, USAID at nrahmayanti@usaid.gov
Arry Lesmana Putra, Country Project Director at aputra@mtapsprogram.org
