OBJECTIVES : Indonesia has had significant drug reforms to guarantee continuous improvement on access to qualified and affordable medicine along with Social Health Insurance mission. This assessment intends to examine the performance of key drug reforms, including the National Drug Formulary, national drug planning, and national procurement and its impact on the provision of qualified health services.

METHODS : This study specifically evaluates the performance and accountability of national drug planning and national procurement for period of 2014–2017. A qualitative approach through in-depth interviews from selected policy makers is gathered, to augment document collection of relevant data.

RESULTS : Under the newly drug reform, the government has developed a national drug item and price list formed from a national bidding system. In its efforts to improve economic relationship between government & health providers, both public and private providers can directly purchase drugs through the national procurement mechanism. This reform has simplified the bureaucracy and shown significant strides in moving towards the practice of rational use of drugs.

Number of drug items in the National Formulary continues to increase. Sales in volume and value have risen substantially to more than three-folds since 2014, indicating that health providers have utilized this improved access to qualified and affordable medicine. The policy has spurred pharmaceutical industries to quickly adapt its marketing approach to align with the national procurement mechanism. Future challenges still exist including limited capacity to estimate national drug volume, limited capacity on IT system at the health facilities to do e-procurement, long lead time for e-procurement, and challenges in timely delivery of drugs

CONCLUSIONS : Although significant drug reform policies have been implemented in Indonesia concurrently with the Universal Health Coverage mission, several improvements are exigent to ensure the momentum of progress can be maintained, most urgently in planning, procurement, and distribution of drugs.