Mackey Tim K, Cuomo Raphael E
Global Health Policy Institute, San Diego, CA, USA.
Department of Anesthesiology and Division of Infectious Diseases and Global Public Health, University of California, San Diego - School of Medicine, San Diego, CA, USA.
Glob Health Action. 2020;13(sup1):1695241. doi: 10.1080/16549716.2019.1695241.
: Pharmaceutical corruption is a serious challenge in global health. Digital technologies that can detect and prevent fraud and corruption are particularly important to address barriers to access to medicines, such as medicines availability and affordability, stockouts, shortages, diversion, and infiltration of substandard and falsified medicines.: To better understand how digital technologies are used to combat corruption, increase transparency, and detect fraud in pharmaceutical procurement systems to improve population health outcomes.: We conducted a multidisciplinary review of the health/medicine, engineering, and computer science literature. Our search queries included keywords associated with medicines procurement and digital technology in combination with terms associated with transparency and anti-corruption initiatives. Our definition of 'digital technology' focused on Internet-based communications, including online portals and management systems, supply chain tools, and electronic databases.: We extracted 37 articles for in-depth review based on our inclusion criteria focused on the utilization of digital technology to improve medicines procurement. The vast majority of articles focused on electronic data transfer and/or e-procurement systems with fewer articles discussing emerging technologies such as machine learning and blockchain distributed ledger solutions. In the context of e-procurement, slow adoption, justifying cost-savings, and need for technical standards setting were identified as key challenges for current and future utilization.: Though there is a significant promise for digital technologies, particularly e-procurement, overall adoption of solutions that can enhance transparency, accountability and concomitantly combat corruption, is still underdeveloped. Future efforts should focus on tying cost-saving measurements with anti-corruption indicators, prioritizing centralization of e-procurement systems, establishing regulatory harmonization with standards setting, and incorporating additional anti-corruption technologies into procurement processes for improving access to medicines and to reach the overall goal of Universal Health Coverage.
药品腐败是全球卫生领域面临的一项严峻挑战。能够检测和预防欺诈与腐败行为的数字技术对于消除药品获取障碍尤为重要，这些障碍包括药品的可及性和可负担性、缺货、短缺、药品转移以及不合格和伪造药品的流入。
为了更好地了解数字技术如何用于打击腐败、提高透明度以及在药品采购系统中检测欺诈行为，从而改善人群健康状况。
我们对卫生/医学、工程和计算机科学领域的文献进行了多学科综述。我们的搜索查询词包括与药品采购和数字技术相关的关键词，以及与透明度和反腐败举措相关的术语。我们对“数字技术”的定义侧重于基于互联网的通信，包括在线门户和管理系统、供应链工具以及电子数据库。
我们根据纳入标准提取了37篇文章进行深入综述，这些标准聚焦于利用数字技术改善药品采购。绝大多数文章关注电子数据传输和/或电子采购系统，较少有文章讨论机器学习和区块链分布式账本解决方案等新兴技术。在电子采购方面，采用速度缓慢、证明成本节约的合理性以及制定技术标准的必要性被确定为当前和未来应用的关键挑战。
尽管数字技术，尤其是电子采购，具有巨大潜力，但能够提高透明度、问责制并同时打击腐败的解决方案的总体采用情况仍不发达。未来的努力应集中在将成本节约措施与反腐败指标挂钩、优先实现电子采购系统的集中化、建立与标准制定的监管协调以及将额外的反腐败技术纳入采购流程，以改善药品获取情况并实现全民健康覆盖的总体目标。
