E-DRUG: drug supply chain performance improving?
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Dear E-druggers,
I am writing with a very general question emerging from a number of discussions we have had in KIT and with partners about the effectiveness of supply chains for "expensive" new drugs - particularly drugs used in the treatment of HIV/AIDs, TB and Malaria.
The question is - do we know how these chains are performing and do we have evidence of current best practice in managing them?
Experience from the management of essential drug programmes demonstrates that up to 70% of "value" is often lost because of sub-optimal management at various phases in the cycle:
- Price variations on the international market that are difficult to predict,
- Increasing operational costs (taxing, waste, transport, personnel, etc)
- Cash flow and monitoring
- Problems in quality (control), regulation and selection of drugs
- Theft and the organisation of control
- Improper storage management
- Improper purchasing: expiration versus "out of stock"
- Irrational prescribing
- Lack of adherence to treatment
The scale of financing for treatment programmes through the Global Fund and other international funds greatly increases the risks of wastage if supply chains are not optimally managed. The sustainability of such programmes will depend substantially on the evidence of success of these programmes. The impact of the programmes will depend on how much they can do with the money they have.
We would be very interested to know if there are reliable country analyses of the performance of the supply chain for these high cost drugs (not only in selection and procurement - but also much closer to the user) and whether major constraints and "wastage" points have been identified and analysed and best practice interventions developed.
Catherine Hodgkin
KIT Development Policy and Practice
KIT ( Royal Tropical Institute)
Amsterdam
The Netherlands
c.hodgkin@kit.nl
Website: www.kit.nl