E-DRUG: Demand chain management? (2)
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dear Pascal and E-druggers,
Demand management already is a hot topic in logistics. Pick up any logistics textbook and it will probably have a chapter on demand management in there.
These are issues that are *very* pertinent to health supply chains, and I am happy to see that they are slowly getting some attention.
regards
Michael Keizer
(Student, La Trobe University, Australia)
gnm7-uva6@spamex.com
E-DRUG: Demand chain management? (6)
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Dear E-druggers,
Through my experience in drugs supply chain management in Kenya and Eastern
Africa I note that all the time we have been advocating for demand chain
management since we had the kit system that was a push system introduced in
the 80's in Kenya.
From the kits system it was realised that demands were often forgotten creating shortages and surplus in several facilities.
I believe for this reason, the new KEMSA ie the central coordinating medical supplies body in Kenya has been introducing demand supply operations to avoid these inherent problems of supply or push system.
regards
Dr. Bilha Kiama Murage
Public Health Pharmacist
Kenyatta University
Kenya
bmurage2001@gmail.com
E-DRUG: Demand chain management? (8)
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Dear E-druggers
The discussion on demand chain management is most interesting and timely. Like in other supply chains, many of us are wondering why all these capacity building efforts in supply chain management have not protected us against stock-outs and expired drugs ?
It is surprising that supply chains of health goods have not learnt more from the experiences in other supply chains. Demand chain management is not a new concept; in fact, it is one of a number of strategies can be used to improve efficiency and reliability in supply chains in general.
Already at the end of the 90s, supply gurus such as Marshall Fisher recommended that one defines supply chain requirements according to product type. Fisher argues that products generally fall into two categories, innovative and functional:
Innovative: products with an unpredictable, volatile demand, short shelf life and costly
Functional: products with predictable, not so expensive, usually long shelf lives and probably those goods we have a long history of experience with
Classifying the products that you supply is a critical step, as these two categories of products need different types of supply chains. The functional/predictable supply chains are the ones we are used to in the public sector, supplying a constant supply of essential medicines and medical devices, with long term forecasts. It is in this context where efficiency discussions are relevant, where one would try to save by improving distribution systems or by cutting costs. Lead time is not so much of an issue in this case, as long term planning is possible.
Experts also see a place for technology to improve inventory and automization, among other, as appropriate strategies for these supply chains.
But when new initiatives and/or funds create opportunities to introduce new products for new programmes, we face uncertainty in demand. Supply also becomes complex when products are continuously improved - such as ELISA HIV tests, which are regularly upgraded to improve performance. In these situations we need more responsive supply chains, there is a clear need for buffer stocks in the system, reducing the stock in the pipeline by delivering directly to facilities, etc. It is in this context where the discussions on demand managements and creating transparency in the supply chain as a whole become essential. Personally, I think that because our systems were not flexible enough, we may have supported the proliferation of vertical programmes unintentially.
Unfortunately terminologies used in other supply chains, and in particular retail supply chains, have not emerged in public sector supply chains. Therefore, when we Google for new ideas, we often miss very relevant strategies to improve our own systems. I do hope that future post-graduate students in supply chain management will explore these issues and test the relevance of supply chain experiences in other sectors in the health context, so that we can judge whether the supply chains we use are indeed the best ones.
Helene
Dr Helene Moller, M.Pharm, PhD
WHO Dept. Essential Medicines and Pharmaceutical Policies
20 Ave Appia, Geneva 27, CH1211,
Switzerland
Tel: +41 22 7911493
Fax: +41 22 7914167
E-mail: mollerh@who.int