expenditures on the top 20 drugs in the various ABC analyses are likely to be appropriate or not, bearing in mind the morbidity and mortality patterns. Table(s) 4.3.1, 4.3.2 and 4.3.2 show the top 20 items consumed by value at national, district and hospital level respectively. Table 4.3.1: ABC analysis of top 20 items – national level Source of data (government department/organization): Year: Rank Item Name (including strength & formulation) Unit costs Monetary Value EML Yes/No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 % budget on top 20 medicines: % budget spent on antibiotics: % budget spent on vitamins:
Average % difference [(NUP-MSHUP)/NUP] x 100% Allocation of budget for medicines in the public sector Please describe allocation of budget from review of reports and interview with government staff at the centre and periphery, remembering to include the following points: How is the budget allocated - on the of population? Number of beds in hospitals? What is the formula for allocating resources to provinces? Districts? Health facilities? Drug quantification in the public sector Please describe drug quantification from review of reports and interview with government staff at the centre and periphery, remembering to include the following points: How are quantities needed estimated? Past consumption? Morbidity? What is the formula (if any) for estimating quantities and is buffer stock included? Is actual estimation done according to the chosen method/formula (if any)? Drug Management and Distribution in the public sector
facility types*** Insert type Insert Name Insert Name Insert Name Insert Name Average % key EML items available* % on supply list that are non-EML % prescribed drugs belonging to the EML** EML available in pharmacy? Yes/No * Belonging to the national EML or the provincial / hospital formulary in decentralized systems – please see the same indicator recorded in table 4.2.1. ** From prescription audit done during the health facility surveys – please see the same indicator recorded in table 6.3.1. *** e.g. private hospital, private clinic, public pharmacy, outreach clinic. Summary status including progress, changes and problems in drug selection since last situational analysis Have the recommendations from the last situational analysis been acted upon and, if not, why not? Drug Selection: Recommendations
Cadre of prescriber in OPD* No. patients/ day seen of CME in last year Subjects covered in CME Used DIC in last year? Y/N Seen Med Rep in last Y/N 1. 2. 3. * doctor, nurse, paramedical worker, other. DIC = Drug Information Centre Review the documentation in the consultation rooms of a few prescribers, discuss with them, and fill in the table below. Cadre of prescriber in OPD* OPD register (drugs recorded in >80% cases) OPD register (diagnosis recorded in >80% STG /EML available in consulting room? documentation? e.g. separate drug slips No. patients/day given prescriptions to buy drugs in outside pharmacies 1. 2. 3. * doctor, nurse, paramedical worker, other. STG = Standard Treatment Guidelines 13.4.2. Inpatients 2-3 general wards and answer the questions below. Ward name Ward type No. beds No. today No. nurses in the ward now No. patients/day buying drugs from outside pharmacies Sink with running water and soap present in the ward Clean Yes/No? Ward name Ward type List drugs out of stock Describe the inpatient records: e.g. forms, numbered tags, dispensing records: Describe the dispensing process to inpatients:
# Diagnosis Age* (yrs) No. items No. generics TRM (Y/N) AB (Y/N) Inj (Y/N) Vit (Y/N) No. on No. items dispensed Drug names (preferably generic names but brand names if generic names unknown) Cost per prescription 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Totals Average % % of total items % of items % of total cases % of total cases % of cases % of total items % of total items *If <1 year indicate as follows: 3 months = 3/12, 5 months = 5/12, etc.; TRM=Traditional Medicine; AB=Antibiotic; INJ=Injection; VIT=Vitamin; Px=Prescription
Please tick relevant box Number of emergency orders in last one weekly monthly 3-monthly 6-monthly annual Ordering from suppliers Distribution to health facilities Describe the store conditions Stock availability of essential items: Warehouse name_______________ Fill in the drug names that have been selected from the EML & mark whether they are available or not. Even if one bottle / vial or a few tablets are present, the drug should be marked available. # Drug Name Formulation Strength Available? Y/N Unit Price 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
15.3.5. Pharmacy Client Data Collection Form Retail Pharmacy name: ___________________________ Date: ____________ Data collected from: prescriptions / dispensing register / computer registry / bills Please circle # Diagnosis Age (yrs) Px Y/N No. No. generics No. TRM AB (Y/N) INJ (Y/N) VIT (Y/N) No. items on No. dispensed Drug names (preferably generic names but brand names if generic names unknown) Cost per Px 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
# Diagnosis Age* (yrs) Px Y/N No. items No. generics No. TRM A/b (1/0) Inj (1/0) Vit (1/0) No. items on No. dispensed Drug names (preferably generic names but brand names if generic names unknown) Cost per Px 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Totals Average % % of total cases % of items % of total items % of total cases % of total cases % of total cases % of total items % of total items *If <1 year indicate as follows: 3 months = 3/12, 5 months = 5/12, etc.; TRM=Traditional Medicine; AB=Antibiotic; INJ=Injection; VIT=Vitamin; Px=Prescription