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Introduction: The rapid development of the pharmaceutical industry has increased the need to assess and monitor the use of medicines. Thus, necessitates the importance of monitoring the appropriate use of medicines including antimicrobials. Objective: Pharmacoeconomic analysis of pharmacotherapy in the nephrology department at a multidisciplinary hospital. Methods: The study is a retrospective analysis of medicine use and expenditure. The study utilized the ABC-VEN analysis of medical use and the WHO-AWaRe-2021 analysis of antibiotic use, to determine the prescription and financial trends of the nephrology department (30 beds) of a multidisciplinary regional hospital (total 844 beds) in Turkestan, Kazakhstan 2018-2021. Results: The analyzed costs of drugs included 116 international nonproprietary names prescribed to patients from the nephrology department during the study period. In total, pharmacotherapy costs increased by 52.6% in 2021 compared to 2018. Five INN drugs were purchased without their inclusion in the Kazakhstan National Medicinal Formulary, such as atropine sulfate, sodium bicarbonate, sodium chloride (crystalline salt), nitroxoline, and nitrofural. The pharmacoeconomics analysis of antibiotics usage for 2018-2021 showed a sharp increase in the%age of costs. Conclusion: The study showed an increase in funding for pharmacotherapy in the department of nephrology, which increases the availability of medicines. However, the trend in prescribing drugs with poor evidence base level, and the increase in the proportion of antibiotic prescription, require immediate intervention including the utilization of clinical pharmacy services for regular assessment of the pharmacoeconomic feasibility of antibiotic therapy. This will improve the quality of medical care and reduce the financial costs.

The medical materials, medical supplies, and medicines cover about one-third of the annual health care organization's budget. Effective inventory management is required to balance inventory expenditure against demands for medications. The study aimed to analyze the pharmaceuticals inventory management using ABC-VEN Matrix in selected health facilities of the West Shewa zone. A facility-based cross-sectional study was conducted in health facilities of the West Shewa zone from March 15, 2019, to May 31, 2019, and analyzed by using an MS Excel spreadsheet. At selected public health facilities of West Shewa zone in three years between September 12, 2015, and September 5, 2018, about 539 pharmaceutical items were utilized and consumed 30,837,628.61 ETB. ABC analysis indicated that 64 (11.9%), 68 (13.74%), and 38 (11.14%) of items were classified as the class \"A\" items and consumed around 70% of the total pharmaceutical expenditures (TPE) at selected health facilities (aggregated), hospitals, and health centers (HC), respectively. VEN analysis revealed that 115 (35.94%), 99 (35.61%), and 40 (20.83%) items were categorized as vitals and consumed 53.9%, 51.59%, and 36.93% of TPE at selected health facilities. ABC-VEN matrix analysis indicated that category I items consumed 85% of TPE. ABC-VEN matrix analysis of present study showed that the category I pharmaceuticals consumed a majority of TPE that need great attention for control.

Background: Analyzing purchased health commodities based on their budgetary consumption and importance is crucial for efficient utilization of a hospital’s budget. However, it is rarely seen when hospitals, mostly in developing countries, conduct such kinds of analyses and make an informed decision, including to utilize their limited budget efficiently. Therefore, the purpose of this study was to analyze a 3-year inventory of health commodities (medicines, medical supplies, and laboratory reagents and chemicals) in Saint Paul Hospital Millennium Medical College (SPHMMC). Methodology: The study was conducted in SPHMMC located in Addis Ababa, Ethiopia. It is one of the largest specialized public hospitals in the country. It is a huge teaching hospital in the country where a large amount of budget is utilized. Three years of data were collected and ABC, VEN, and ABC-VEN matrix techniques were applied for the analysis. The data collection period was from March to April 2017. Results: An average of 296 medicines, 194 laboratory commodities, and 105 medical supplies were purchased over 3 years. Class A medicines, which consume 80% of the total annual pharmaceutical expenditures (APE) account, are 17.8%–20% of the total medicines by quantity. Antibiotics (ceftriaxone 1 gm injection and metronidazole), IV fluids (sodium chloride 0.9% injection and dextrose 40% injection), and antidiabetic medication (insulin zin suspension and metformin) are among the top 10 medications by value that consume significant amounts of the budget of the hospital. On VEN analysis, an average of 24% of the items were vital, 67% were essential, and 4–8–8.9% were nonessential. Nonessential items consumed 0.49%, 9.9%, and 1.1% of Annual Expenditures (AEs) in 2013/14, 2014/15 and 2015/16, respectively. On ABC-VEN matrix analysis, a single expensive and nonessential medicine (valganciclovir HCL 450 mg tablet) consumed 9.4% of expenditure in 2014/15. Class A laboratory commodities, which consume 70%–80% of the total laboratory expenditures represented 8.5%–20% of the total laboratory commodities analyzed for the 3 years. From class A items, antimonoclonal antibodies in 2013/14, hemocue glucose 201 4 × 25 tests in 2014/15, and glucose tests in 2015/16 consumed the highest percentages: 9.2%, 8.2%, and 23.7% of the AEs, respectively. There were laboratory commodities procured out of the VEN list, and these accounted for 6.8%–31.2% of the total laboratory expenditures over the 3 years. Class A medical supplies, which consumed 80% of the total medical supply expenditures, represented only 8.2%–15.8% of the total items over the 3 years studied. Surgical gauze 90 cm × 100 m, surgical gloves sterile latex number 7.5, and examination gloves were the top three based on expenditures in all the studied years. In 2015/16, examination gloves alone consumed 71.9% of the total expenditure. Conclusion: SPHMMC manages large numbers of health commodities (more than 500 excluding program commodities) which necessitate efficient inventory management practice in place. However, the purchase of the commodities particularly those products used for laboratory diagnosis is not strictly based on the hospital’s VEN list, indicating the need for better communication of the laboratory unit with the Drug and Therapeutic Committee (DTC) of the hospital. The DTC of the hospital should update the VEN list of the health commodities and strictly enforce the hospital procurement to adhere to the agreed upon list of medicines. In addition, the hospital should prioritize and decide the quantity and frequency of ordering health commodities based on regular ABC-VEN results.

Internal barriers in the procurement process and pharmaceutical supply planning are barriers that can be controlled through interventions. The research focuses on proposing changes to the pharmaceutical supply management system, particularly in the aspects of planning and procurement within the internal team of the RSPG Cisarua Bogor. The intervention in this research applying lean six sigma extends only up to the “improve” phase. Data collection involves in-depth interviews with informants involved in the pharmaceutical supply planning and procurement process, as well as observation and document analysis. The research ends in group discussions to reach an agreement. The research findings reveal that a lack of established procedures in the pharmaceutical supply procurement process contributes to prolonged procedures and the absence of efficiency benchmarks within the system. Moreover, an unavailability of tools to facilitate the pharmaceutical supply procurement process causes low internal team communication. The “improve” phase of lean six sigma leads to proposed changes to the standards of operational procedures for routine pharmaceutical procurement, indicator applications of procurement efficiency and the utilization of the ABC VEN functioning as a tool within the pharmaceutical supply procurement process. The proposed improvement to tackle the matter includes the utilization of ABC VEN and efficiency indicators to overcome waste overproduction identified during the pharmaceutical supply planning process. In addition, it also involves the establishment of a new standard of operating procedure covering timelines, tools for pharmaceutical supply categorization based on ABC VEN and procurement efficiency indicator to handle waste waiting during the pharmaceutical supply procurement process.

To evaluate the prevalence and trend of inventory waste in a tertiary hospital over the last 7 years. This included the type and average monetary value (MV) of inventory waste, as well as the outcome of using the Always-Better-Control (ABC)-Vital-Essential-Non-essential (VEN) matrix as part of a Zero-Waste Strategy. This was a retrospective observational study conducted at King Abdulaziz Medical City (KAMC) over 7 years. The prevalence of waste was 0.21%, which equates to (SAR) 15 million out of SAR 7 billion. The pharmaceutical inventory had significantly higher waste in terms of MV and the number of items (89.8%, and 80.3%, respectively) (P<0.001). The expired pharmaceutical inventory had a significantly higher waste of MV than non-moving and obsolete inventory (79.8%, 14.3%, and 5.9%, respectively) (P<0.001). The ABC-VEN matrix categorized the inventory into Category I, which has the highest MV waste at 82.3%, followed by Category II with 16.8%, and then Category III with 0.9%. However, category II had a significantly higher number of wasted items at (58.2%), followed by Category I (24%) and Category III (17.8%) (P<0.01). The majority of MV waste consisted of a small number of pharmaceutical items that had a high clinical impact, representing 66% and 18%, respectively. After implementing a zero-waste strategy for landfills using the ABC-VEN matrix, the prevalence of waste declined from 0.9% to 0.21%. The waste sent to the landfill was zero from 2018 through 2020, saving 73.64% of the total money. The use of the ABC-VEN matrix positively impacted the reduction of MV waste. The prevalence and trend rate of inventory waste were lower than the benchmarks of global companies, saving more than two-thirds of the inventory value that would have been wasted. The majority of the wasted MV consisted of a small number of pharmaceutical items that had a significant clinical impact.

BackgroundPharmaceuticals account for a large portion of healthcare spending in healthcare organizations. Their effective inventory management is required to match the cost of stocks with the customer demand and avoid shortage of supplies at any health facility level. This study aimed to analyze pharmaceuticals' inventory management using ABC-VEN analysis.MethodsThe study was conducted at Rwanda Medical Supply (RMS) Ltd, Nyamagabe Branch for products distributed to health facilities in Nyamagabe District catchment area from the financial years 2017–2018 to 2019–2020. It consisted of a descriptive retrospective study of 457 items. The latter are generic essential medicines distributed to public health facilities during the study period. Products were arranged according to a descending order of importance, and we performed a breakdown of products according to the Pareto Principle. Following an ABC analysis of distribution data for such drugs billed to healthcare facilities, a VEN analysis was performed to identify high-value vital products that require more attention.ResultsDuring the ABC analysis, 76 products were classified in group A. These accounted for 19.84% and had a value of 74.91% of the total cost of all products. Group B included 116 products, representing 30.29% with a value of 20% of the total cost, while Group C had 191 products, representing 49.87% with a value of only 5.09% of the total cost. During the VEN analysis, 202 products (44.20%) were classified as vital, 231 (50.54%) as essential, and 24 products (75.26%) as non-vital. The analysis with ABC-VEN resulted in Class I representing 55.80% of all medicines that cost 87.88% of all total cost, Class II representing 40.70% with a total cost of 11.82%, and Class III representing 3.50% with a cost of 0.3%.ConclusionsThis study results show that inventory management of vital and expensive products, such as antibiotics, antihypertensive pharmaceuticals, consumables, and massive solutions would be carefully monitored to prevent a shortage of such products at health facility levels. The ABC-VEN analysis is one of the practical and affordable method to achieve their optimized supply chain.

Inventory management is a complex process that accelerates the probability of stock-out and overstocking if not tracked properly. Classification of drugs based on their criticality, cost burden, and in combination is important to make inventory decisions and optimize the quality use of scarce resources. This study analyzed the pharmaceutical inventory management systems of Dessie Referral Hospital using the ABC-VEN matrix for the years 2013 to 2017. Cross-sectional study design was used to review logistic data retrospectively from health commodity management information system and manual records. Data were collected from January 1-20, 2018 in Dessie Referral Hospital. In the five-year ABC-VEN analysis, 310 (17%), 368 (20.18%), and 1146 (62.83%) items were class A, B, and C, while 610 (34.56%), 1125 (63.74%), and 30 (1.7%) of pharmaceuticals were V, E, and N, respectively. Among these, 139 (7.88%) and 339 (19.21%) of AV and CV pharmaceuticals utilized 43.52% and 2.89% of annual drug expenditures, respectively. Category I, II, and III pharmaceuticals also accounted for 43.68%, 54.79%, and 1.53% of items with their respective USD drug expenditure of 2,268,405.64 (84.49%), 411,961.18 (15.34%), and 4483.97 (0.17%). The pharmaceutical inventory cost projected to be 1,619,351.79 USD in 2025 and total cost (β= 10.68, p = 0.001), class A (β= 8.68, p = 0.001), class B (β= 1.27, p = 0.007), class C (β= 0.72, p = 0.03), and E items (β= 6.08, p = 0.01) were statistically significant with inventory cost. A huge amount of budget is invested in class A and category I, which pinpoints the need for strict inventory control to prevent wastage and accumulation of capital in buffer stocks. ABC-VEN analysis should be routinely performed before initiation of any new procurement for efficient use of scarce resources.

Effective inventory management ensures an uninterrupted supply of safe, effective, and affordable pharmaceuticals which could be achieved through developing ABC-VEN (Always, Better, Control-Vital, Essential, Desirable) and FSN-XYZ (Fast, Slow, Non-moving-High, Medium, Low Value) matrix analysis. ABC-VEN matrix analysis is used to control inventory according to their annual consumption and on their functional importance whereas, FSN-XYZ matrix analysis is applied to control inventory by identifying the items to be discarded and the amount saved during the closing of annual accounts. To evaluate inventory management in selected health facilities of West Arsi zone, Oromia regional state for the year 2016-2018. Facility-based cross-sectional descriptive study complemented with a qualitative study was conducted in fourteen health facilities. Data were collected from goods issuing vouchers for the year 2016-2018 to perform ABC-VEN matrix analysis. The frequency of issue was collected to perform FSN analysis and the value of each closing stock was taken to get XYZ analysis. From the ABC-VEN matrix analysis, 26.6% of items were Category I of which the highest proportion were taken by class A and V items consuming 84.7% of annual drug expenditure (ADE). The remaining 49.2% and 24.2% of the drugs accounted for only 13.2% and 2.1% of the ADE being category II and III, respectively. Based on FSN-XYZ matrix analysis findings, category I with 41.% item share account for the highest budget (average 86.5% of values). Of this category, the XN group-non-moving and high-cost drugs had the high value (20%) which need managerial measure. In category III, the ZN group items, being 25% of drugs, only had 2.2% of value-that may increase wastage, inventory holding cost, and shortage of storage space. The matrix analysis for inventory control is a strong tool that enables one to identify items requiring close monitoring. The coupled ABC-VEN matrix analysis, combining their individual advantages - inventory's cost and its functional importance help in achieving a meaningful inventory management. However, to control the stock at an appropriate level with minimum shortage and oversupply, it has to be supported by XYZ-FSN matrix analysis. The XYZ-FSN matrix benefits the health facilities to determine the level of inventory with high value in dead-stock, and to take measures like transferring to others, discarding, or saving.

Medicines can constitute up to 70% of total health care budgets in developing countries as well as considerable expenditure in hospitals. Inventory management techniques can assist with managing resources efficiently. In Kenyatta National Hospital (KNH), a leading hospital in Kenya, over 30% of expenditure is currently allocated to medicines, and this needs to be optimally managed. To investigate drug consumption patterns, their costs and morbidity patterns at KNH in recent years. Cross-sectional retrospective record review. Inventory control techniques, ABC (Always, Better, and Control), VEN (Vital, Essential, and Non-essential) and ABC-VEN matrix analyses were used to study drug expenditure patterns. Morbidity data was extracted from the Medical Records. Out of an average of 811 medicine types procured annually (ATC 5), 80% were formulary drugs and 20% were non-formulary. Class A medicines constituted 13.2-14.2% of different medicines procured each year but accounted for an average of 80% of total annual drug expenditure. Class B medicines constituted 15.9-17% of all the drugs procured yearly but accounted for 15% of the annual expenditure, whilst Class C medicines constituted 70% of total medicines procured but only 5% of the total expenditure. Vital and Essential medicines consumed the highest percentage of drug expenditure. ABC-VEN categorization showed that an average of 31% of medicine types consumed an average of 85% of total drug expenditure. Therapeutic category and Morbidity patterns analysis showed a mismatch between drug expenditure and morbidity patterns in over 85% of the categories. Class A medicines are few but consume the largest proportion of hospital drug expenditure. Vital and essential items account for the highest drug expenditure, and need to be carefully managed. ABC-VEN categorization identified medicines where major savings could potentially be made helped by Therapeutic category and Morbidity pattern analysis. There was a high percentage of non-formulary items, which needs to be addressed. Inventory control techniques should be applied routinely to optimize medicine use within available budgets especially in low and middle income countries.

Inappropriate prescribing decreases the quality of medical care leading to wastage of precious resources especially in developing countries. WHO estimates that more than half of all medicines are prescribed, dispensed, or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse, or misuse of medicines results in wastage of scarce resources and widespread health hazards. Inappropriate or irrational prescribing leads to an increase in the adverse medicine events, antimicrobial resistance, and spread of infections such as HIV, hepatitis, etc., leading to increased pressure on the already burdened resources. In order to address these problems a series of proven interventions need to be conducted to enable the policy makers and health planners and managers to plan and implement reforms.