Drug Distribution reference for pharmacy.pdf

Reference material

1. Drug Distribution
By Edao S

2. Learning objectives
At the end of this session students will be able to
Drug distribution
Goals of distribution management
The distribution cycle
Distribution system design

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3. Introduction
•Is a continuous process of receiving drugs from the suppliers
and moving them safely/ securely expeditiously to the many
point in the health care system at which the drugs will be
dispensed to patients.
•Storage and distribution costs are a significant component of
the health budget
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4. •Health programs are frequently managed by well-qualified
personnel who lack logistics experience.
– Logistics is defined as the “science (and art) of getting the
right amounts of the right things to the right places at the
right time”.
•A good distribution system is a cost effective system



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5. Goals of distribution management
A well-run distribution system should:
– Maintain a constant supply of drugs
– Keep drugs in good condition
–Minimize drug losses due to spoilage and expiry
–Rationalize drug storage points
–Use available transport as efficiently as possible
–Reduce theft and fraud
–Provide information for forecasting drugs needs


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6. Distribution cycle
Port
clearing
Receipt &
Inspection
Inventory
control
Storage
Requisition
of supplies
Delivery
Dispensing
to patients
Consumpti
on
reporting
Drug
procureme
nt
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7. •It begins when drugs are dispatched by manufacturer or
supplier.
• It ends when drug consumption information is reported back
to the procurement office.
•The distribution cycle includes the following steps:



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8. 1.Port clearing
Involves: -
•Identifying shipments as soon as they arrive in port,
•Processing all importation documents
•Completing any customs requirements
•Storing drugs properly until they leave the port.
•Surveying the shipment for losses and signs of damage, and
collecting the drugs as soon as they have been cleared.
•It may be managed directly or through a separate contract
with port clearing agent
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9. 2. Receipt and inspection
•When items first delivered from the port or directly from a
supplier to the store room; they must be kept separate from
the other stock until the store staff has performed a complete
formal inspection of the supplies.
•Inspectors should check for damaged and missing items and
for compliance with the contract conditions concerning drug
type, quantity, presentation, packaging labeling and any
special requirements.

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10. 3. Inventory control
•It is the process of maintaining of stock properly at all levels
and at all times.
•It is the process of assuring that the right volume and
movement are secured in order to ensure that drugs have
reached to the final consumer correcting.
•Is used for requisitioning and issuing drugs. For financial
accounting and for preparing the consumption and stock
balance reports necessary procurement.

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11. 4. Storage
•Proper location, construction, organization and
maintenance of storage facilities help:-
–maintain drug quality
–minimize theft, and
–maintain regular supply to health facilities

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12. 5. Requisition of supplies
•The forms and procedures for requisition are a key part of the
inventory control system
• The requisition system may be manual or computerized, but it
should always be designed to simplify distribution by
facilitating inventory control, providing an audit trial for tracing
the flow of drugs, assisting in financial accounting, and listing
drugs issued

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13. 6. Delivery
•Drugs may be delivered by warehouses or collected by health
facilities
•Transportation methods must be carefully selected and
schedule deliveries realistically and systematically to provide
punctual and economic service

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14. 7. Dispensing to patients
•The distribution process achieves its purpose when drugs reach
hospital wards, outpatient clinics, health centers, or
community health workers and are appropriately prescribed
and dispensed to patients

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15. 8. Consumption reporting
•The closing link in the distribution cycle is the flow of
information on consumption and
•Stock balances backs up the distribution system to the
procurement office for use in quantifying procurement needs.

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16. Distribution system design
•Designing distribution system requires
– systematic cost effectiveness analysis and
–operational planning
•Once the system is in place, regular performance monitoring it
needed to ensure that the system functions as intended

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17. Basic design features include : -
•Its degree of centralization
•The number of levels in the system
•The geographic and population coverage
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18. •In a typical central supply system;-
– drug procurement and
–distribution are coordinated at the national level.
• Drugs received at the central medical stores (CMS) are
distributed to lower-level warehouses and onward to the health
facilities.
•In a decentralized system, the districts or regions are
responsible for receiving storing and distributing drugs.
•In some cases, they may also be responsible for procurement.
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19. In designing a distribution system or redesigning an existing
system the following important steps have to be taken: -
A. Determine the member of storage levels in the system.
• Factors to consider in determining the number of storage level
are:
–Geographical factors
–Population, availability of storage space,
–staff, transport facilities, political and other resource
constraints

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20. •Determine the location of storage sites
•Decides at which level of the supply system decisions will be
made concerning orders
•Fix resupply interval or frequency of placing orders
•Select method of distributing drugs to uses units
•Select an appropriate method of transport
•Set delivery routes
•Estimate operating costs

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21. Push and Pull systems
Pull system: -
•Each level of a system determines
–what types and quantities of drugs are needed and places
orders with the supply source.
•It is sometimes known as independent demand or a
requisition system
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22. Conditions favoring a pull system
•Lower-level staff are competent in assessing needs and
managing inventory
•Sufficient supplier are available at supply source to meet all
program needs
•A large range of products is being handled
•Field – Staffs are regularly supervised, and performance is
monitored.

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23. Push system:-
•Supply sources at some level in the systems determine what
types and quantities of drugs will be delivered to lower levels.
• This is also known as an allocation or a ration system.
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24. Conditions favoring push systems
•Lower levels staff are not competent in inventory control
• A limited number of product is being handled
•Disaster relief needed, or the situation calls for short- term
supply through prepacked kits.

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25. Re-supply interval
•Determine whether deliveries are made to user units quarterly,
monthly, weekly or at any other time.
•If deliveries are made weekly, average stock levels will be low
and the likelihood of stock outs will decrease, but transport
costs will be very high.
•If deliveries are made only a year, transport costs will be low,
but the average stocks and storage costs will be high

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26. It is important to consider the following factors before making
in decision:
•Storage capacity at each level of the system
•Availability order size, carrying capacity, & cost of transport
•Seasonal factors that influence transport reliability
•Staffing levels and competence of staff at each level of the
system
•Other factors, such as expiration dates, security

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27. Delivery system versus Collection systems
Basically there are two option to move drugs between
warehouse and receiving facilities:
a. Collection (Pick-up):- the receiving facilities takes on the
responsibility of collecting supply from the warehouse.
b. Delivery:- the warehouse is responsible for delivering supplies
with either in-house transport or a private-sector contract.
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28. Multinational Suppliers Donors
Central PFSA
Health
facilities
PFSA Branches
Health
facilities
Local
Manufacturer
s
Local
Importers/Wholesaler
s Distributors (70)

29. Summary
•Effective drug distribution relies on good system design and
good management
•Designing a distribution system requires systematic cost-
effectiveness analysis and operational planning.
•Operational planning and logistics skills are the key to
developing a cost-effective distribution system.
•It is therefore important to have a logistics team staffed by
qualified people.

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30. Quiz 3
Match from group B to A

1. Cool temperature
2.Room temperature
3.BCG
4.Fentanycl
5.PFSA
6.FMHACA



A. Controlled substance
B. Needs to be stored in
refrigerator.
C. Register and license drug
productr
D. Takes responsibility of
procurement and distribution
of drugs in Ethiopia
E. Temperature ranges of 2-8C0
F. Temperature ranges of 15-25C0
G. Temperature ranges of 8-15C0





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