Managing Drug Suply ISTN

MANAGING
DRUG SUPPLY
Dra. Aziza Nuraini, MM

WASTE IN DRUG MANAGEMENT AND POTENTIAL
FOR IMPROVEMENT
US$ 1,000,000 High prices
Continuing
Poor quality High prices
losses
Losses from
From Theft unaltered US$ 700,000
Problems problems Improved purchasing
With Improper storage
Drug Quality assurance
Expiration of drug
supply Security system
Irrational precribing Better storage
Reduction Careful inventory control
Lack of adherence In losses
Improved prescribing
By patients Through
Improved Public education
US$300,000 Manage-
ment
Original Allocation Therapeutic Benefit Therapeutic Benefit

US$ 1,000,000 With current Problems : With Improved Management :
US$ 300,000 US$ 700,000
NATIONAL DRUG
POLICY – A TREE THAT
BEARS FRUIT
DRUG MANAGEMENT CYCLE
Selection
Management Support
Organization
Use Financing Procurement
Information Management
Human Recources
Distribution
Policy and Legal Framework

THE MANAGEMENT CYCLE
PLANNING IMPLEMENTATION
• Situation analysis • Human recources
• Strategic planning, management
program planning, work • Financial management
planning • Information management
MONITORING & EVALUATION

• Monitoring of programs and
workplans
• Evaluation of organizational
effectiveness
COMMON HEALTH PROBLEMS GUIDE SELECTION,
TRAINING, SUPPLY, AND DRUG USE
List of Common Health Problems
Choice of Standard Drug and

Nondrug Treatment
Drug List
List of Essential Drug Supply
Drugs • Procurement
• Donations
• Distribution Treatment
• Production Guidelines
Rational Drug Use
• Training
Formulary
• Supervision
• Monitoring
Drug Information
Greater Availability andMore Rational Use of Drugs

PROCUREMENT CYCLE
DETERMINE QUANTITES
REVIEW DRUG SELECTION
NEEDED
COLLECT CONSUMPTION RECONCILE NEEDS

INFORMATION & FUNDS
CHOOSE PROCUREMENT
DISTRIBUTE DRUGS
METHOD
LOCATE AND SELECT

MAKE PAYMENT
SUPPLIERS
RECEIVE & CHECK DRUGS SPECIFY CONTRAST TERMS
MONITOR
ORDER STATUS
COMPARISON OF QUANTIFICATION METHODS
Methode Uses Essential Data Limitation

Consumption First choice for Reliable inventory Must have accurate
procurement forecasts, records consumption data
given reliable data Records of supplier Can perpetuate
Most reliable predictor of lead time irrational use
future consumption Projected drug costs
Morbidity Estimating need in new Data on population and Morbidity data not
programs or disaster patient attendances available for all
assistance Actual or prejected diseases
Comparing use with incidence of health Standard
theoritical needs problems treatments may not
Developing and justifying Standard treatments realy be used
budgets (ideal, actual)
Projected drug costs
COMPARISON OF QUANTIFICATION METHODS
Methode Uses Essential Data Limitation

Adjusted Procurement Comparison area or Questionable
consumption forecasting when other system with good per comparability of
methods unreliable capita data on patient populations,
consumption, patient morbidity, and
attendance, service treatment practices
levels, and morbidity
Number of local health
facilities by category
Estimation of local user
population broken down
by age
Service-level Estimating budget Utilization by service Variable facility use,
projection of needs levels and facility type attendance patterns,
budget Average drug costs per supply system
requirments attendance efficiency
SUCCESFUL DRUG QUANTIFICATION REQUIRES A TEAM EFFORT
AND A MIX OF METHODS
MULTIPLE DEPARTMENT PHARMACY SYSTEM
Medical supplies coordinating unit
Issue and Receipt voucher (S 12)
Hospital bulk
Counter requisition and Drug store Counter requisition and
Issue voucher (S 11) Issue voucher (S 11)
Bin card (S 3)
Hospital Pharmacist
Outpatient Pharmacy
Inpatient Pharmacy
Drugs and Revenue Register
Hospital Pharmacy Bin Card
Counter requisition Hospital Pharmacy Bin Card
DDA Register for Pharmacy
and DDA Register for Pharmacy
Issue voucher (S 11)
Oral Antibiotics/
Sulfonamides Register
Flow of
Wards Operating room Special Service OPD Injection Drug
Areas (e.g., X-ray) Room
Flow of
DDA : Dangerous Drugs Act request
INPATIENT DRUG
DISTRIBUTION SYSTEM
 BULK WARD STOCK REPLENISHMENT

 INDIVIDUAL DRUG ORDER SYSTEM
 UNIT-DOSE SYSTEM
OPTION FOR LAYOUT OF STORE AISLES
Very Frequent Access
Assembly Area Arrangement for

Frequent Access
Frequent Acces
Assembly Area Combined Arrangement

Frequent Access for Frequent and
Infrequent Access
Infrequent Access
Assembly Area Arrangement for

Infrequent Access
Infrequent Access Shelves

FACTORS INFLUENCING PRESCRIBING
PRESCRIBING
THE DISPENSING CYCLE
V. COUNSEL I. RECEIVE
& &
SUPPLY CONFIRM
DISPENSING
IV. RECORD CYCLE II. INTERPRET
& &
ENDORSE VERIFY
III. PREPARE
& LABEL

Managing Drug Suply ISTN

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MANAGING

Dra. Aziza Nuraini, MM

Original Allocation Therapeutic Benefit Therapeutic Benefit

Policy and Legal Framework

MONITORING & EVALUATION

List of Common Health Problems

Choice of Standard Drug and

Greater Availability andMore Rational Use of Drugs

COLLECT CONSUMPTION RECONCILE NEEDS

LOCATE AND SELECT

RECEIVE & CHECK DRUGS SPECIFY CONTRAST TERMS

Methode Uses Essential Data Limitation

Methode Uses Essential Data Limitation

Issue and Receipt voucher (S 12)

 BULK WARD STOCK REPLENISHMENT

Assembly Area Arrangement for

Assembly Area Combined Arrangement

Assembly Area Arrangement for

Infrequent Access Shelves

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