Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level

Implementation and evaluation of an EHR-integrated perpetual inventory system in a large tertiary hospital oncology pharmacy

PURPOSE

This study aimed to compare the impact of an electronic health record (EHR)-integrated perpetual inventory management system (EIMS) versus a traditional inventory management system (TIMS) on inventory accuracy, visibility, and turnover in a large academic tertiary hospital.

METHODS

The quasi-experimental study was conducted over 12 months (a 6-month preimplementation period and a 6-month postimplementation period, with an 11-month washout period) at Houston Methodist Hospital. The EIMS was implemented following the use of a TIMS. A total of 114 matched inventory items from both systems were identified and compared. The primary outcome was inventory accuracy, calculated as cycle count accuracy. The secondary outcomes were inventory visibility and monthly inventory turnover rate.

RESULTS

Analysis demonstrated a 6.02% absolute increase in inventory accuracy (P < 0.001) with use of the EIMS versus the TIMS. After adjusting for inflation, there was an increase in the captured cost of goods sold from $4.16 million to $5.16 million. The monthly inventory value, adjusted for inflation in the prices of studied inventory items, increased from $2.05 million to $2.33 million. The monthly inventory turnover rate increased from 2.03 to 2.23 turns per month (P = 0.305) when comparing data for the pre- and postimplementation periods. Inventory visibility increased from 133 inventory items to 264 inventory items after EIMS implementation, indicating a 98% visibility increase compared to preimplementation levels.

CONCLUSION

This study found that implementing an EIMS significantly increased pharmacy inventory accuracy and inventory visibility, which are essential for optimizing patient care and pharmacy financial management.

Research on Co-Opetition Mechanism between Pharmaceutical Enterprises and Third-Party Logistics in Drug Distribution of Medical Community

Third-party logistics (3PL) has a relatively perfect distribution system in solving the drug distribution of the medical community and optimizing the distribution efficiency of pharmaceutical enterprises, and it has gradually become an indispensable component of drug distribution. By constructing the co-opetition model of "Pharmaceutical Enterprises-3PL", this paper explores the game strategy choice between pharmaceutical enterprises and 3PL for the solution of drug distribution under the condition of information asymmetry, and it puts forward some suggestions to improve the competition and cooperation mechanism between pharmaceutical enterprises and 3PL in drug distribution in the medical community.

Design and implementation of an online tool for managing the availability of high-cost perishable medicines

Introduction

Due to their impact on healthcare systems, the sustainability and optimization of high-cost drugs is an issue of concern for several countries. Different strategies have been implemented such as centralized purchasing to optimize budgetary resources. However, there is still a need for a mechanism to optimize these drugs further.

Methods

We conducted this prospective multicenter intervention study in five hospitals in the Andalusian Public Health System of Cádiz (Spain) between July 2019 and September 2021. We developed an online website (Farmastock) and implemented it to determine the availability of high-cost, low-use, and near-expiry medicines in each hospital. We used a simple analysis using operational variables to assess the project intervention's savings impact on managing these high-cost drugs.

Results

The implementation of Farmastock in Cádiz resulted in savings of 675,757.52 € for the Andalusian Public Health System, with 238 medicines transferred out of the 373 available. Of these medicines offered, the most considerable percentage were medicines used for pathologies with high clinical instability and accounted for nearly 80% of the medicines optimized by the tool.

Conclusions

Farmastock allowed the Andalusian Public Health System to make substantial financial savings by not making new purchases of high-cost drugs available in other centers of this health network that were not being used. Therefore, this tool is a very efficient measure to contribute to the sustainability of the APHS and could be implemented in more hospitals soon.

Digitalisation in Hospitals in COVID-19 Times—A Case Study of the Czech Republic

In COVID-19 times, the healthcare system needs more financial and other resources for covering all necessary medical products and services. On the other hand, we have observed pressure on the effectiveness and optimisation of resources in hospitals and healthcare facilities. Digitalisation represents an important source of information for various levels of management in hospitals. The main aim of our research is the identification of the benefits of digitalisation of medical devices in hospitals in COVID-19 times, focusing on a case study of the Czech Republic. For our methodological approach, a literature review, data analysis, correlation analysis, and regression analysis were used. The case study presents the changes to the equipment/facilities use in years 2019 and 2020 in a selected hospital in Prague and the impact of COVID-19 on such use of resources. Management and financial issues are discussed, together with recommendations for healthcare sector management. As a result, economic benefits are represented mainly by various kinds of savings and optimisation of both processes and employees. On the other hand, it is not easy to identify all possible savings, as some of them can be in non-financial expression.

Increasing access to quality anticancer medicines in low- and middle-income countries: the experience of Uganda

Cancer is one of the leading causes of death with 9.6 million deaths registered in 2018, of which 70% occur in Africa, Asia and Central and South America, the low-and middle-income countries (LMICs). The global annual expenditure on anticancer medicines increased from $96 billion in 2013 to $133 billion in 2017. This growth rate is several folds that of newly diagnosed cancer cases and therefore estimated to reach up to $200 billion by 2022. The Uganda Cancer Institute, Uganda's national referral cancer center, has increased access to cancer medicines through an efficient and cost-saving procurement system. The system has achieved cost savings of more than USD 2,000,000 on a total of 37 of 42 essential cancer medicines. This has resulted in 85.8% availability superseding the WHO's 80% target. All selected products were procured from manufacturers with stringent regulatory authority approval or a proven track record of quality products.

A collaborative approach to maintaining optimal inventory and mitigating stockout risks during a pandemic: capabilities for enabling health-care supply chain resilience

Purpose

Inventory management systems in health-care supply chains (HCSC) have been pushed to breaking point by the COVID-19 pandemic. Unanticipated demand shocks due to stockpiling of medical supplies caused stockouts, and the stockouts triggered systematic supply chain (SC) disruptions inconceivable for risk managers working individually with limited information about the pandemic. The purpose of this paper is to respond to calls from the United Nations (UN) and World Health Organization (WHO) for coordinated global action by proposing a research agenda based on a review of current knowledge and knowledge gaps on the role of collaboration in HCSCs in maintaining optimal stock levels and reinforcing resilience against stockout disruptions during pandemics.

Design/methodology/approach

A systematic review was conducted, and a total of 752 articles were analyzed.

Findings

Collaborative planning, forecasting and replenishment practices are under-researched in the HCSC literature. Similarly, a fragmented application of extant SC collaborative risk management capabilities undermines efforts to enhance resilience against systematic disruptions from medical stockouts. The paucity of HCSC articles in humanitarian logistics and SC journals indicates a need for more research interlinking two interdependent yet critical fields in responding to pandemics.

Research limitations/implications

Although based on an exhaustive search of academic articles addressing HCSCs, there is a possibility of having overlooked other studies due to search variations in language controls, differences in publication cycle time and database search engines.

Originality/value

The paper relies on COVID-19's uniqueness to highlight the limitations in optimization and individualistic approaches to managing medical inventory and stockout risks in HCSCs. The paper proposes a shift from a fragmented to holistic application of relevant collaboration practices and capabilities to enhance the resilience of HCSCs against stockout ripple effects during future pandemics. The study propositions and suggestion for an SC learning curve provide an interdisciplinary research agenda to trigger early preparation of a coordinated HCSC and humanitarian logistics response to future pandemics.