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ABC analysis in hospitals of NCT of Delhi : Impact of drug policy Khanna N* , Tekur U*, Bhooi N** and Bapna J S** * Deptt. of Pharmacology, UCMS and MAMC , Delhi **IIMHR , Jaipur. Introduction.

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ABC analysis in hospitals of NCT of Delhi :

Impact of drug policy

Khanna N*, Tekur U*, Bhooi N** and Bapna J S*** Deptt. of Pharmacology, UCMS and MAMC , Delhi **IIMHR , Jaipur


Introduction

  • The Delhi Drug Policy was implemented in 1994-95. Before this, essential drugs were not readily available in Delhi hospitals.

  • Drugs available in the hospitals were not cost effective.

  • Unnecessary medicines, including herbal drugs were stocked.

  • EDL was published in 1994. Pooled procurement of drugs in all the Govt. hospitals started from 1995.

  • EDL has been revised every two years. 2002 was the latest one. Work is on for 2004.


Study aims
Study Aims

  • To conduct an ABC analysis of all the drugs procured in three hospitals of Delhi.

    * LNH: Lok Nayak Hospital

    * DDUH: Deen Dayal Upadhyay Hospital

    * LBSH: Lal Bahadur Shastri Hospital


Methods
Methods

  • Prior permission was obtained from Director Health Services, Delhi and MS of all the three Hospitals.

  • Retrospective data was collected for the years 1993-94 and 1994-95 (pre-implementation period) and 2000-01 and 2001-02 (post implementation period). Details of data collected included name of drugs, dosage form, quantity procured and the total cost incurred by the hospital.

  • The drugs were further categorized as those belonging to the EDL of NCT of Delhi or not part of this EDL.

  • Data was subsequently analyzed according to ABC analysis.


Abc analysis
ABC Analysis

  • Examines the annual consumption of drugs & expenditures for procurement

  • Divides the drugs consumed into 3 categories

    • Class A (10 % of items : 75% of exp)

    • Class B (15 % of items : 15% of exp)

    • Class C (75 % of items : 10% of exp)

Uses of ABC

  • Degree to which actual consumption reflects public health needs

  • Reduce inventory levels and costs

  • Seek cost reductions by finding lower prices on class A items

  • Ensure that large orders of class A items are handled expeditiously


Features of abc items
Features of ABC Items

A

B

C

Consumption Value

High

Moderate

Low

Control

High

Moderate

Low

Ordering

Frequent ordering

One in 3 months

Bulk ordering

Purchasing

Central

Combination

Decentralized





Non edl drugs in lnh in class a

Enoxaparin (Clexane)

Surface disinfectant (Baccilocid)

Erythropoeitin

Suface disinfectant (Bcilloid)

Cefotaxime

Crotamiton (Crotorax)

Alcohol based hand disinfectrant (Sterillium)

Pipecuronium

Vancomycin

Alcohol based hand disinfectant (Sterillium)

Ciprofloxacin

Ceftriaxone

Tripolidine Hcl + Phenylpropanolamine Hcl

Chloramphenicol

Ethmoral Forte

Cefotaxime

Sulphasalazine

Codeine phosphate

Ethabutol

Anti D human immuno globulin

Netimycin

Ofloxacin

Natamycin

Haemocoagulase (Botropase)

Chloroquine

Metoclopromide

Hdroxy progesterone caproate

Non EDL drugs in LNH in Class A

Pre drug Policy No of EDLs = 12

Post drug Policy

No of non EDLs = 6

Non EDL drugs in DDU in Class A

Pre drug Policy No of EDLs = 6

Post drug Policy

No of non EDLs = 3


Non essential drugs lnh a class

Name of Drug

Strength

Total Units

Unit Cost

% of Total Value

Enoxaparin (Clexane)

40 mg

237.6

10000

3.41

Surface Disinfectant (Bacillocid)

500 ml bottle

3000

359.84

1.55

Name of Drug

Strength

Total Units

Unit Cost

% of Total Value

Erythropoeitin

2000 l.U

1022

928.7

1.36

Cefotaxime

1gm

24079

25.95

Cefotaxime

1 gm

38011

24.92

2.7

0.90

500 ml bottle

1875

258.96

Alcohol based hand disinfectant (Sterillium)

0.70

Anti D Human immuno globin

300 mcg

250

1609.2

1.15

Vancomycin

500 mg

2918

162.05

0.68

Non – ionic contrast media (Urograffin)

*

250

615.6

0.44

Non Essential drugs (LNH):A Class

Non Essential drug (DDU):A Class




Stocks outs pre post drug policy

1993-94

1994-95

2000-01

2001-02

Total Number of Stock out days

2272

1192

1159

958

Average number of stock out days

56.81

29.8

38.9

23.9

Number of drugs out of stock

28

17

19

16

1993-94

1994-95

2000-01

2001-02

Total Number of Stock out days

2944

1899

918

172

Average number of stock out days

147.2

94.95

41.73

7.82

Number of drugs out of stock

15

13

8

4

Stocks outs : Pre & Post drug policy

LNH

DDU


Summary
Summary

  • ABC analysis was done to determine the impact of Drug Policy in Hospitals of Delhi.

  • There was an increase in the %age procurement of drugs from the EDL after the implementation of drug policy.

  • Number of Non EDL drugs in the Class A category has reduced after the implementation of the drug policy

  • Stock outs have decreased

    • Implies increased availability of drugs

    • Improved service delivery

    • Leading to economic gains for the hospital


Conclusions and policy implications
Conclusions and Policy Implications

  • Drugs which appear very commonly in A Category should be included in the EDL.

    • Large amount of money has been spent on procuring Cefotaxime in all the hospitals. This could be taken into consideration while updating the EDL in future.


Thank

You

We are grateful toProf. R.R. Choudhary, President – DSPRUD &WHO India EDP for providing financial assistance.


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