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• W2615185425 abstract "Introduction In developing countries, where budgets for medicines are often tight, the supply cycle needs to be well-managed to prevent all types of wastage, including pilferage, misuse and expiry. This wastage reduces the quantity of medicines available to patients and therefore the quality of healthcare they receive. At least US$550 000 worth of antiretrovirals and 10 million antimalarial doses recently expired in Uganda's National Medical Stores (NMS). (1,2) The Ugandan pharmaceutical supply system comprises three non-profit wholesalers (one government medical store and two private non-profit ventures) and several private for-profit wholesale pharmacies that supply medicines in bulk to retail units (private retail pharmacies, hospital pharmacies and drug shops). Drug shops are the smallest retail medicine outlets, are supervised by non-pharmacist health-care professionals, and are limited to handling small amounts of over-the-counter medicines) The expiry of medicines highlights a problem with the supply chain, which includes medicine selection, quantification, procurement, storage, distribution and use. (4-6) We need to find out the factors contributing to expiry at each stage of the supply cycle in order to design pragmatic strategies to reduce the problem. The main aim of this study was to find out whether medicine expiry extends beyond public medicine outlets to the private for-profit sector, to assess the factors that contribute to or cause expiry and find out which medicines are particularly prone to expiry in the supply chain in Uganda. Local setting and methods A cross-sectional survey of medicine outlets within Kampala city and Entebbe municipality was used to investigate the extent of expiry of medicines and the contributing factors in Uganda. This study area contains about 70% of all pharmaceutical businesses in Uganda including 19 public outlets (three non-profit wholesalers and 16 hospital pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies. (7) We aimed to sample 60 medicine outlets, a figure determined using the Leslie Kish formula based on a margin of error of 10% and expiry rate of 21% of medicines. (8) Non-profit wholesalers were universally sampled, with the remaining complement proportionately stratified into three hospital pharmacies, 22 private wholesales and 32 retail pharmacies. Hospital pharmacies were selected based on acceptance to participate in the study while private pharmacies were randomly chosen. We only investigated large medicine outlets (non-profit wholesalers and private wholesale pharmacies) and medium-sized outlets (retail and hospital pharmacies) and excluded drug shops because of the small range and amounts of medicines they are allowed to stock under Uganda's National Drug Policy. Only 38 outlets including six public outlets (one governmental store, two nongovernmental non-profit wholesalers and three hospital pharmacies) and 32 private pharmacies (nine wholesale, 23 retail) consented, equivalent to a 63.3% response rate. We developed semi-structured questionnaires, which were then administered by an interviewer to a respondent who was familiar with each outlet's medicine supply system (predominantly pharmacists, supplies/ stores officers and managers). Closed questions on expiry-related actions (medicine disposal, return by customers, exchange with supplier and price reduction/donation), and an expansion of the World Health Organization's list of medicines recommended for assessing level II pharmaceutical indicators (antiretrovirals and some slow-moving but vital medicines added) (8,9) were used to assess the incidence of expiry of medicines. We also included closed questions on the characteristics of medicines that commonly expire as this may help to develop solutions for selection and inventory management. These questions included aspects on medicine shelf life, cost, taste, donations, those that treat rare diseases, and medicines affected by changes in treatment policy. …" @default.
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• W2615185425 date "2010-02-01" @default.
• W2615185425 modified "2023-09-23" @default.
• W2615185425 title "Expiry of Medicines in Supply Outlets in Uganda/ Depassement De la Date De Peremption Des Medicaments Au Niveau Des Points D'approvisionnement En Ouganda/ Caducidad De Los Medicamentos En Los Puntos De Distribucion En Uganda" @default.
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