In the era of National Health Insurance (JKN), the government compiled and established the National Formulary (Fornas) as a quality and cost control instrument, to ensure the achievement of optimal health services through the rational use of drugs so that patients get safe, quality, efficacious, and cost-effective drugs.

The implementation of Fornas needs to be monitored and evaluated continuously to assess compliance and the impact of Fornas implementation in JKN implementation.

The Directorate General of Pharmaceuticals and Medical Devices through the Directorate of Pharmaceutical Management and Services held a Workshop on the Evaluation of Fornas Implementation in Hospitals and Puskesmas on October 6-7 in Jakarta.

The purpose of this meeting was to analyze and evaluate the impact of the use of drugs outside the Fornas on the cost and quality of health services for JKN participants, identify challenges and opportunities for the implementation of Fornas in health facilities, and increase the understanding of health workers (prescription writers and pharmacists) on the importance of Fornas implementation as quality control and cost control in the JKN program, as well as to obtain recommendations and action plans to improve the implementation of Fornas in health facilities.

The meeting was attended by representatives from the Ministry of Health, WHO Indonesia, Provincial Health Office, District Health Office, Puskesmas and hospitals, as well as the Fornas Team.

"In accordance with the mandate of Law Number 17 of 2023 concerning Health, in article 317 that the Central Government compiles a list and types of essential drugs that must be available for the benefit of the community. The list of drugs is reviewed and refined at most every two years in accordance with the development of needs and technology, evenly available and affordable by the community," said Plh. Director General of Pharmaceuticals and Medical Devices, Dita Novianti S.A. when opening the event.

Until now, the reporting of the implementation of Fornas in hospitals has not been implemented optimally. This condition is indicated by the achievement of the RPJMN indicator in 2022, namely the percentage of hospitals that use drugs according to Fornas at 80.09 percent of the 80 percent target, where there are 358 hospitals that use drugs according to Fornas more than 80 percent of the 447 hospitals that report.

"Although the achievement of these indicators has exceeded the target, we hope that hospitals will intensify the reporting and use of drugs according to Fornas so that we get a complete picture of the achievement of indicators of Fornas implementation in hospitals," added Dita.

On the same occasion, Director of Pharmaceutical Management and Services, Agusdini Banun Saptaningsih said, "Fornas is an integrated part of the drug governance system, where the process of drug selection and procurement refers to Fornas, especially Fasyankes, as well as an instrument for quality and cost control in the implementation of JKN through measuring the suitability of drug use in pharmaceutical services". "Fornas was first established in 2013 and has undergone several changes (addendum). Until February 28, 2023, Fornas 2021 is still in effect, which includes 630 active substance items in 1,074 preparations including referral drugs. The Fornas 2021 addendum was established in December 2022, and came into effect on March 1, 2023, so that the Fornas contained 623 active substance items in 1,059 preparations. Fornas 2023 will be published at the end of October or early November 2023," said Agusdini.

Agusdini further explained that even though Fornas has been prepared, there are still challenges in the application of Fornas, namely the use of drugs outside Fornas and the application of the use of Fornas drugs that are not in accordance with the provisions of restriction and maximum prescribing.

"For this reason, the government in collaboration with all levels of stakeholders always evaluates the implementation of JKN as an effort to improve the implementation of the JKN program and continues to encourage the optimization and improvement of pharmacist competence as part of the health care team," Agusdini concluded.