Apply National Drug Supply

Management
Eshetu Teshome
 Why we do worry about drug?
a) Drugs save lives and improve health
b) Drugs promote trust and participation
c) Drugs are costly
d) Drug are different from other consumer
products
Essential medicines
are medicines that satisfy the priority health
care needs of the population
and therefore should be available at all
times, in adequate amounts in appropriate
dosage forms and at a price the individual
and the community can afford”
The formulary process
• consists of preparing, using and updating a
Formulary list or essential medicines list
(EML)
Formulary manual
Standard treatment guidelines (STGs).
Drug Supply Management cycle
The PURPOSE of a logistics system is to get
the
RIGHT QUANTITIES of the
RIGHT GOODS to the
RIGHT PLACES at the
RIGHT TIME in the
RIGHT CONDITION at the
RIGHT COST.
• Quantification- how much product is required
for purchasing
Estimates the required finance
• There are four basic methods for estimating drug
quantities.
1) Consumption method
based on preveous consumption of products
2) Morbidity method
morbidity method is estimation of required drug
to treat common disease based on standard
treatment protocols and epidemiological data
3) The adjusted consumption method
4) Service – level projection of Budget requirements
Procurement
– is the process of acquiring supplies from
private or public supplier or through
purchasing from manufacturer or agencies
or bilateral aids program.
• Good Procurement Practice
 Generic name
 Limited to EML list or formulary list
 Bulk purchases
 Formal supplier qualification and
monitoring
 Competitive bidding process
 Good Procurement Practice....
– Commitment to a sole source
– Order quantities based on reliable estimate
of actual need
– Reliable payment and good financial
management
– Transparency and written procedures
– Product quality assurance program
– Annual audit with published results
– Regular reporting on performance
 Procurement Methods
Open tender
– is a formal procedure by which quotation
are invited from any manufacturer or its
representative on a local or worldwide basis
– Subject to the term and conditions specified
in tender invitation
Restricted tender (closed bid or selective
tender)
– interested supplier must be approved in
advance
– Prequalification process e.g Adhering to
GMP, past supply performance, financial
viability and related factor
Reverse auction
☞ Variation of restricted tender
☞ Qualified bidders submit an official offer
☞ the lowest offer received is posted publicly
without naming the bidder in the first round
☞ qualified bidders are invited to offer lower
prices than posted low price.
☞ The process continues round by round until no
more prices are submitted.
Competitive negotiation or negotiated
procurement
• buyer approaches a limited number of
selected supplier (at least three) for price
quotation.
• Mainly used in private sector
Direct procurement
• direct purchase from single supplier either at
the quoted or negotiated price
• Simplest, most expensive method of
procurement
• For single source drugs (has 3 options)
negotiated or
direct procurement
selection of alternative drugs
E- procurement
E- procurement is internet based tendering
Inventory management
 Distribution
• Drug Distribution is a continuous process of
receiving drugs from the suppliers and moving
them safely/securely to the many point in the
health care system at which the drugs will be
dispensed to patients.
 Push vs pull system
Pull system
• Each level of the system determines what types
and quantities of medicines are needed and
places orders with the supply source
Push system
• Supply source at some level of the system
determine what types and quantities of
medicines will be delivered to lower levels
 Good storage practices
• Storage condition based on temperature
– information directly from the
manufacturer.
– In a deep freeze (-15°C)
– In a refrigerator/cold 2°C -8°C
– Cool temperature 8°C-15°C
– Room temperature 15°C - 25°C
• Clean and disinfect storeroom regularly
– Rodents and insects
– Avoid food and drink
• Store supplies in a dry, well-lit, well-
ventilated storeroom out of direct sunlight.
– extreme heat and exposure
– E.g Latex condom (> 40 oC )
– air conditioning
– ceiling fans and forced ventilation.
– Avoid direct sunlight( dark colored or opaque
bottle
Secure storeroom from water penetration.
– Destroy supplies and packaging
– Repair leaky roofs and windows
– Use dehumidifiers
– Stack supplies off the floor on pallets
• 10 cm high and 30 cm away from walls
• Store condoms and other latex products away
from electric motors and fluorescent lights.
– Emit ozone → rapidly deteriorate condoms
– proper packaging (i.e., boxes and cartons)
– Keep away from light and motors
• Ensure that fire safety equipment is available
and accessible and personnel are trained to use
it.
– Strictly prohibit smoking in the store.
– Place smoke detectors
– Check smoke detectors every 2–3 months to
ensure that they are working properly.
• Stopping the fire
fire extinguishers
use buckets of sand
Train staff in the use of the available fire
safety equipment
Flammables
Must be stored in special buildings or
rooms.
well ventilated and fireproof.
• Maintain cold storage, including a cold chain,
for commodities that require it.
– Ex. Insulin, Oxytocin, vaccines
– Damage if the cold chain is broken
• Keep narcotics and other controlled
substances in a locked place.
– Dangerous when misused
– Stolen for sale on the black market
Limit access to the storeroom
Track the movement of products.
Physical inventories
• Stack cartons at least 10 cm off the floor, 30
cm away from the walls and other stacks, and
not more than 2.5 m high.
– promote air circulation
– facilitate the movement of stock
– cleaning and inspection
– Stocked pallet, Pallet racking, Shelves
 Shelves: Basic Rules
Shelves and cupboards, are used to
store smaller products; if possible
Batch No: Batch No: Batch No:
shelves must be adjustable to allow Expiry: Expiry: Expiry:

• Heavy and for packages of different sizes Batch No:

Description
Batch No:
Description
Batch No:
Description
Expiry: Expiry: Expiry:
fragile items on Batch No: Description
Description
Expiry:
Batch No: Description
Expiry:
Batch No:
Expiry:
the lower Batch No:
Description
Batch No:
Description
Batch No:
Description

shelves Expiry:
Description
Expiry:
Description
Expiry:
Description

• Frequently Reserve Stock Reserve Stock

picked items at
waist height Batch No: Batch No: Batch No:
Expiry: Expiry: Expiry:
• Extra stock on Description Description Description
Batch No: Batch No:
Expiry: Expiry:
the upper Batch No: Batch No: Batch No:
Expiry: Expiry: Expiry: Description Description
shelves (if it is Description Description Description

not too heavy)

• Boxes tidy and Batch No:
Batch No: Expiry:
closed as much Expiry:

as possible Description
Description

Fragile Items Fragile Items Heavy Items Heavy Items

 Pallets: Basic Rules
Stack cartons on pallets
m At least 10 cm off the floor
c
30 At least 30 cm away from the walls and other stacks
No more than 2.5 m high (general rule)

• Pallets are used to

Description: Description: Description: Batch No:
Expiry: store bulk items and
Description larger cartons
Description: Description: Description:
Batch No:

Batch No:
Expiry:
Description
• They keep things off
Description: Description: Description: Expiry: the floor and can be
Description
used with forklifts to
Batch No: Batch No:
move around groups
Description:
Batch No: Batch No: Batch No:
Expiry:
Expiry: Expiry:
Expiry: Expiry:
Description: Description: Description: Description:
Description: Description:
Description: Description: of larger items
Batch No:
Batch No: Batch No: Batch No: • arrows point up and
Expiry:
Expiry: Expiry: Expiry:
Description: Description: Description: Description:
Description: Description: Description: identification labels,
Description:
Batch No: Batch No:
Batch No: Batch No:
Batch No:
expiry dates, and
Description: Description: Description:
Expiry:
Description:
Expiry:
Expiry:
Description:
Expiry:
Expiry:
Description: Description:
Description:
manufacturing dates
30 cm are visible
• Light goods
Block-stacked pallets • Items without expiry dates
• Items with very high turnover