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ABC analysis in hospitals of NCT of Delhi : Impact of drug policy

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

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  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Procurement pattern of Drugs in Delhi hospital(1993 to 2002) EDL Procurement

  8. ABC of LNH

  9. ABC of DDU

  10. 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

  11. 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

  12. Budget on EDL for LNH & DDU

  13. Number of Patients Treated in LN & DDU

  14. 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

  15. 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

  16. 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.

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

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