Drug Management

Drug Management

Introduction

·       Drug management is a critical component of hospital administration and healthcare delivery, ensuring that patients receive safe, effective, and affordable medicines in the right quantity, at the right time, and at the right place.

·       It encompasses the entire cycle of medicine handling—from procurement and storage to distribution and use—while adhering to legal, ethical, and professional standards.

·       Efficient drug management prevents stock-outs, reduces wastage, minimizes medication errors, and supports rational drug use, ultimately improving patient outcomes and the financial sustainability of healthcare institutions.

Site Selection, Space Layout, and Legal Requirements

Site Selection

• The hospital pharmacy or drug store should be located:
• Near outpatient and inpatient services for easy access.
• Away from sources of contamination (e.g., waste disposal, kitchens).
• On the ground floor for convenience of deliveries and movement.
• Accessible to staff and patients but with controlled entry for security.

Space Layout

• Adequate space should be allocated for:
• Drug reception and inspection area
• Storage area (bulk, narcotics, refrigerated drugs, and controlled items)
• Dispensing counters for OPD and inpatient
• Work area for staff
• Record-keeping/documentation zone
• Emergency supply section
• Layout should ensure unidirectional flow of drugs: Procurement → Storage → Dispensing → Distribution.
• Safety measures: fire alarms, ventilation, temperature/humidity control, pest control.

Legal Requirements

• Compliance with:
• Drugs and Cosmetics Act, 1940 and Rules, 1945
• Narcotic Drugs and Psychotropic Substances Act, 1985 (for controlled substances)
• Pharmacy Act, 1948 (qualified pharmacists)
• Drug Price Control Order (DPCO) for pricing
• State licensing authorities’ requirements
• Regular audits and inspections are mandatory.

Purchase of Drugs

Procedure

1. Assessment of needs (based on past consumption, disease patterns, essential drug list).
2. Preparation of purchase indent by the pharmacy or concerned department.
3. Approval by purchase committee (including medical superintendent, accounts officer, pharmacist).
4. Supplier selection through quotation, tender, or rate contract.
5. Purchase order issued to selected vendor.
6. Receipt and inspection of drugs.
7. Payment after verification of supply.

Objectives

• Ensure continuous supply of quality drugs.
• Minimize costs while maintaining quality.
• Prevent shortages and overstocking.
• Promote rational drug use.

Importance

• Directly affects patient safety and treatment outcomes.
• Contributes significantly to hospital expenditure (up to 40% of hospital budget).
• Ensures adherence to standard treatment guidelines.

Supplier Selection, Tender System, and Contracts

Supplier Selection

• Based on:
• Reputation and reliability.
• Quality assurance (Good Manufacturing Practice certification).
• Financial stability.
• Delivery capacity and timelines.
• After-sales service and complaint handling.
• Compliance with regulatory standards.

Tender System

• Commonly used in government and large hospitals.
• Types:
• Open Tender: Invitation to all suppliers.
• Limited Tender: Restricted to registered/approved suppliers.
• Single Tender: Only one supplier (monopoly product).
• Evaluation criteria: lowest price (L1), quality, past performance.

Contracts

• Rate Contract: Agreed price for a period (commonly 1 year).
• Supply Contract: Specific supply with fixed terms.
• Framework Agreement: Long-term arrangement with multiple suppliers.
• Contracts must specify:
• Quantity, quality, price, delivery schedule.
• Penalty for delay/defects.
• Terms of payment.

Drug Storage and Handling

• Storage must follow First Expiry, First Out (FEFO) or First In, First Out (FIFO) principle.
• Conditions:
• Temperature control: Refrigerators for vaccines, insulin, etc.
• Humidity control.
• Separate storage for narcotics, flammable substances, and high-value drugs.
• Secure shelves and racks with labeling.
• Regular stock verification.
• Handling:
• Trained personnel to reduce errors.
• Careful handling of fragile medicines (ampoules, vials).
• Protective gear when handling hazardous drugs (chemotherapy).

Drug Ordering Methods by Hospital Departments

• Requisition-based ordering: Departments submit requests to central pharmacy.
• Stock-level ordering: Orders placed when stock reaches minimum level.
• Schedule-based ordering: Fixed intervals (weekly/monthly).
• Automatic reorder system: Based on consumption and computerized monitoring.
• Emergency ordering: For urgent or life-saving drugs.

Computerized Drug Management

• Use of Hospital Information System (HIS) and Pharmacy Management Software.
• Features:
• Real-time stock monitoring.
• Automatic alerts for expiry and low stock.
• Barcode and RFID for inventory tracking.
• Integration with patient records (prescription → billing → dispensing).
• Data analysis for forecasting and budget planning.
• Benefits:
• Reduces errors.
• Improves efficiency and transparency.
• Enhances accountability.

Drug Dispensing and Distribution System in Hospitals

Dispensing

• Process of providing the prescribed medicine to patients with proper labeling and instructions.
• Principles:
• Right drug, right dose, right patient, right time, right route.
• Patient counseling for proper use.
• Outpatient dispensing: At OPD pharmacy counters.
• Inpatient dispensing: Through unit dose system or ward supply.

Distribution Systems

1. Individual Prescription System
• Drugs supplied against individual prescriptions.
• Advantage: specific to patient needs.
• Disadvantage: costly, time-consuming.
2. Floor Stock System
• Certain commonly used drugs kept in wards.
• Advantage: quick access.
• Disadvantage: risk of misuse, pilferage.
3. Unit Dose System
• Drugs dispensed in ready-to-administer doses for each patient.
• Advantage: minimizes errors, wastage.
• Disadvantage: requires more staff and infrastructure.
4. Centralized vs. Decentralized Pharmacy
• Centralized: One main pharmacy (better control, but slower access).
• Decentralized: Satellite pharmacies in different units (faster access, but higher cost).

Video Description

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