abc ven analysis 2009

Analyzing and Controlling Drug Expenditure

BENGKEL ANALISIS ABC/VEN

PEJABAT TIMBALAN PENGARAH KESIHATAN NEGERI (FARMASI)NEGERI KELANTAN

8 JULAI 2009

ASMA BT MURSHIDHOSPITAL SULTAN ABDUL HALIM

SUNGAI PETANI

KEDAH DARUL AMAN

FIVE

RIGH

TSFIVE

RIGH

TSFIVE

RIGH

TS

DRUGTIMETIME

PATIENT

PATIENT

DOSEDOSE

ROUTE

ROUTE

.

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IntroductionIntroductionAggregate dataAggregate dataTools for analyzing costTools for analyzing costConducting ABC \ VEN AnalysisConducting ABC \ VEN AnalysisApplications of the ABC \ VEN AnalysisApplications of the ABC \ VEN AnalysisSteps in performing the ABC \ VEN AnalysisSteps in performing the ABC \ VEN AnalysisSummarySummary

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Irrational drug use is widespread and results Irrational drug use is widespread and results in:in:Poor patient outcomePoor patient outcomeHigh cost of inappropriate drug useHigh cost of inappropriate drug use Increased risk of adverse drug reactionsIncreased risk of adverse drug reactionsEmergence of antimicrobial resistanceEmergence of antimicrobial resistance

Measuring drug use problems is the first step Measuring drug use problems is the first step to improving useto improving use

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Indicator study methodsIndicator study methods Use data collected at the individual level - patient, health facilityUse data collected at the individual level - patient, health facility Data insufficient to make judgements about appropriateness of a Data insufficient to make judgements about appropriateness of a

drug for a specific diagnosisdrug for a specific diagnosis

Aggregate data methodsAggregate data methods Use routine data (e.g. stock records) not collected at the Use routine data (e.g. stock records) not collected at the

individual patient levelindividual patient level Gives an overview of drug use and can highlight problem Gives an overview of drug use and can highlight problem

areasareas

In-depth investigation of drug useIn-depth investigation of drug use Prescription audit, patient record reviewPrescription audit, patient record review Drug use evaluation (review) (DUE)Drug use evaluation (review) (DUE) Qualitative methods to understand causes of a drug use problemQualitative methods to understand causes of a drug use problem

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Drug use aggregate Drug use aggregate data sourcesdata sources

Procurement recordsProcurement records

Warehouse drug recordsWarehouse drug records

Pharmacy stock and dispensing recordsPharmacy stock and dispensing records

ADR and medication error reportsADR and medication error reports

Patient medical recordsPatient medical records

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Data Data that can be retrievedthat can be retrieved

Drug ConsumptionDrug Consumption

Drug availability Drug availability

Frequency of use Frequency of use

Per capita use of specific productPer capita use of specific product

Prevalence of adverse drug reactionsPrevalence of adverse drug reactions

Prevalence of medication errorsPrevalence of medication errors

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2 major areas 2 major areas

• Personnel expensesPersonnel expenses- reducing staff- reducing staff- reform policies- reform policies

• Drug purchasesDrug purchases- identify major cost, lossess - identify major cost, lossess

andand opportinities for savingsopportinities for savings

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• VEN analysis VEN analysis √√

• ABC analysis ABC analysis √√

• Therapeutic category analysisTherapeutic category analysis

• Price comparison analysisPrice comparison analysis

• Total variable cost analysisTotal variable cost analysis

• Lead-time and payment-time analysisLead-time and payment-time analysis

• Expiry date analysisExpiry date analysis

• Hidden cost analysisHidden cost analysis

What is the VEN Analysis?

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Method to prioritise for drug selection, purchase Method to prioritise for drug selection, purchase & stock in which drugs are classified according & stock in which drugs are classified according to their health impactto their health impact

VV–Vital–VitalPotentially lifesavingPotentially lifesavingCrucial to providing basic health servicesCrucial to providing basic health services

E–E–EssentialEssentialEffective against less severe but significant illness, but Effective against less severe but significant illness, but

not absolutely vital to providing basic health servicesnot absolutely vital to providing basic health services

N–N–Non-EssentialNon-EssentialFor minor illnessesFor minor illnessesHigh cost and low therapeutic advantageHigh cost and low therapeutic advantage

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Characteristic of Drug or Target Condition

Vital Essential Nonessential

Occurrence of target condition

Persons affected (% of population)

Persons treated (number/ day at average health centre)

Over 5%

Over 5

1-5%

1-5

Less than 1%

Less than 1

Severity of target condition

Life-threatening

DisablingYes

Yes

Occasionally

Occasionally

Rarely

Rarely

Therapeutic effect of drug

Prevents serious disease

Cures serious disease

Treats minor, self-limited symptoms and conditions

Has proven efficacy

Has unproven efficacy

Yes

Yes

No

Always

Never

No

Yes

Possibly

Usually

Rarely

No

No

Yes

May or may not

May or may not

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The World Health Organization’s (WHO)

Essential Drugs List

According to the WHO’s definition, essential drugs are those that meet the healthcare needs of the majority of the population; thus should be easily available in adequate quantities and in suitable dosage forms.

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The National Essential Drugs List

The National Essential Drugs List was formulated by using the Ministry of Health’s (MOH) Drugs List as a basis. The MOH Drugs List which was introduced in 1983 serves as the essential drugs list for the public healthcare sector.

Latest Edition – SENARAI UBAT PENTING KEBANGSAAN (NEDL) EDISI 2 Bil (17) dlm BF/PP/2/9 Bhg 12 BERTARIKH 21 JANUARI 2009

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NEDL /1

16

NEDL / 13

U - universal

S- secondary

T-tertiary

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Consensus by a committee in the institution

Eg. DRUG COMMITTEE

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Identifies Identifies high-priority drugs high-priority drugs for selection, procurement for selection, procurement and use in a supply systemand use in a supply system

- - SelectionSelection - V & E drugs given priority - V & E drugs given priority esp.esp.

when funds are shortwhen funds are short

- - ProcurementProcurement - - Order monitoring Order monitoring

- Safety stock- Safety stock

- Order quantities- Order quantities

- Supplier selection- Supplier selection

- - UseUse - Review- Review

- - DistributionDistribution - Stock control- Stock control

- Assignment of staff - Assignment of staff

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Identifies Identifies low-priority drugs low-priority drugs to be analyze carefully to be analyze carefully for deletion from the formularyfor deletion from the formulary

Compared with ABC analysis to monitor how well Compared with ABC analysis to monitor how well actual use compares with prioritiesactual use compares with priorities

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Step 1:Step 1: Classify all drugs on the list as V, E, or N Classify all drugs on the list as V, E, or N

Step 2:Step 2: Reconsider proposed purchase quantities Reconsider proposed purchase quantities

Step 3: Step 3: Find additional funds if needed or possibleFind additional funds if needed or possible

Step 4Step 4: Analyze “N” items. Where possible, eliminate them: Analyze “N” items. Where possible, eliminate them

Step 5Step 5: Analyze “N” items. Where possible, reduce quantities: Analyze “N” items. Where possible, reduce quantities to purchase to purchase

Step 6Step 6: Identify and limit therapeutic duplications: Identify and limit therapeutic duplications

Step 7Step 7: Reduce quantities of drugs purchased by using the : Reduce quantities of drugs purchased by using the preferential weighting or equal misery preferential weighting or equal misery

FUNDING GAP

What is the ABC Analysis?

ABC analysis is a business term used to define an inventory categorization technique often used in materials management.

ABC analysis provides a mechanism for identifying items which will have a significant impact on overall inventory cost whilst also providing a mechanism for identifying different categories of stock that will require different management and controls

When carrying out an ABC analysis, inventory items are valued (item cost multiplied by quantity issued/consumed in period) with the results then ranked. The results are then grouped typically into three bands. These bands are called ABC codes."A class" inventory will typically contain items that account for 60% of total value "B class" inventory will have around 20% of total value "C class" inventory will account for the remaining 20%

ABC Analysis is similar to Pareto in that the "A class" group will typically account for a large proportion of the overall value but a small percentage the overall volume of inventory. - WIPEDIA

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Method for determining and comparing drug Method for determining and comparing drug costs within the formulary systemcosts within the formulary system

Tool for identifying many drug use problemsTool for identifying many drug use problems

Utilizes computer and appropriate software to Utilizes computer and appropriate software to run analysisrun analysis

““Separating the vital few from the trivial many”– Separating the vital few from the trivial many”– Pareto PrinciplePareto Principle

What is the Pareto Principle?

In 1906, Italian economist Vilfredo Pareto created a mathematical formula to describe the unequal distribution of wealth in his country, observing that twenty percent of the people owned eighty percent of the wealth.

Definition: The Pareto Principle, also known as the 80-20 Rule, states that a small number of causes (20%) is responsible for a large percentage (80%) of the effect.

Also Known As: 80-20 Rule, Pareto's Law, Pareto's Principle

General Use: The Pareto Principle is generally applied to vendors or customers in a retail setting. This rule assumes that 20% of the customers generate 80% of the sales, or that 80% of merchandise comes from 20% of the vendors.

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Category Percentage ofbudget

Percentage ofdrugs ordered

“A” drugs 70-80% 10-20%

“B” drugs 15-20% 10-20%

“C” drugs 5-10% 60-80%

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““A” drugsA” drugs–High percentage of funds spent on –High percentage of funds spent on large volume or high-cost itemslarge volume or high-cost items

Greatest potential for savingsGreatest potential for savingsGreatest potential for identifying expensive drugs that Greatest potential for identifying expensive drugs that

are overusedare overused

““B” drugsB” drugs–Moderate cost and moderate number of –Moderate cost and moderate number of items; important itemsitems; important items

““C” drugsC” drugs–Small amount of funds spent on the –Small amount of funds spent on the majority of the inventorymajority of the inventory

Links consumption to public health needs & Links consumption to public health needs & morbiditymorbidity

Reducing inventory levels & costsReducing inventory levels & costsmore frequent purchases or deliveries of A itemsmore frequent purchases or deliveries of A items

Cost reduction Cost reduction seek lower prices for class A itemsseek lower prices for class A items

Assign import and inventory staff Assign import and inventory staff Provide information for:Provide information for:

Choosing most cost-effective alternativesChoosing most cost-effective alternativesTherapeutic substitutionsTherapeutic substitutionsPharmacoeconomic analysisPharmacoeconomic analysis

Used in combination with VEN analysisUsed in combination with VEN analysisUsed as a guide in Drug Committee MeetingUsed as a guide in Drug Committee Meeting

Performing an ABC analysis is facilitated by a computer and software that will perform the necessary calculations. A computer is not absolutely necessary, but it becomes more important as the number of line items increases and the complexity of the analysis widens. Management Sciences for Health provides this software free of charge on its web site at

www.msh.org It is easy to download and has instructions on use of

the software in the “help” section of the main menu.

Generate Data

HIS Pharmaniaga / LP

CPS Pharmaniaga / LP

Can retrive from computer or Pharmaniaga Bukit Raja

Transaction Enquiry Fast Moving / Expensive Volume - type 2000 Search Print Report Click Briefcase Choose format – CSV / Destination – desk file –ok Coose format – Same Number – ok Choose Desktop - Save

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Step 1Step 1 -List all items purchased and enter the unit -List all items purchased and enter the unit costcost

Step 2Step 2 -Enter consumption quantities for each item -Enter consumption quantities for each item Step 3Step 3 -Calculate the value of consumption for each -Calculate the value of consumption for each itemitem Step 4Step 4 -Sort the list in descending order by total value -Sort the list in descending order by total value Step 5 Step 5 -Calculate the percentage of total value -Calculate the percentage of total value represented by each itemrepresented by each item Step 6Step 6 -Calculate the cumulative % of total value for -Calculate the cumulative % of total value for each itemeach item Step 7Step 7 -Choose cut-off points for A, B, and C -Choose cut-off points for A, B, and C

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Description Price1 AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S R 2.682 AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG R 115.273 BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES R 36.314 CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S R 19.735 CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML R 10.756 CLOXACILLIN SODIUM FOR INJECTION500MG R 2.817 CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S R 1.918 DIAZEPAM TABLETS 5MG ;1000'S R 9.909 ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S R 83.56

10 GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML R 1.9711 IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML R 11.1812 INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML R 33.7413 ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S R 61.6514 LITHIUM CARBONATE TABLETS 250MG; 1000'S R 224.6415 LOPERAMIDE 2MG TABLETS;6'S R 1.2216 MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML R 0.6817 NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML R 5.6618 PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S R 2.3819 PARACETAMOL TABLETS 500MG;500'S R 16.6120 PERINDOPRIL TABLET 4MG;28'S R 20.0821 RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S R 7.2422 TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S R 42.4623 THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML R 10.1824 VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE R 5.3125 VITAMIN B6 TABLETS 25MG;500'S R 11.3026 WATER FOR INJECTION PLASTIC;10ML R 0.53

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TOTAL = 666,643 NO.ITEMS = 26Pack Qty

Description Price Issued Value20 PERINDOPRIL TABLET 4MG;28'S R 20.08 3000 60,22613 ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S R 61.65 800 49,32018 PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S R 2.38 20000 47,5202 AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG R 115.27 400 46,109

25 VITAMIN B6 TABLETS 25MG;500'S R 11.30 4000 45,2003 BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES R 36.31 1200 43,572

23 THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML R 10.18 4000 40,70515 LOPERAMIDE 2MG TABLETS;6'S R 1.22 30000 36,46210 GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML R 1.97 18000 35,38112 INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML R 33.74 1000 33,7396 CLOXACILLIN SODIUM FOR INJECTION500MG R 2.81 12000 33,696

22 TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S R 42.46 700 29,7244 CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S R 19.73 1500 29,5965 CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML R 10.75 2500 26,865

26 WATER FOR INJECTION PLASTIC;10ML R 0.53 50000 26,72914 LITHIUM CARBONATE TABLETS 250MG; 1000'S R 224.64 65 14,6021 AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S R 2.68 5000 13,3889 ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S R 83.56 160 13,370

21 RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S R 7.24 1400 10,13019 PARACETAMOL TABLETS 500MG;500'S R 16.61 600 9,9687 CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S R 1.91 3000 5,724

17 NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML R 5.66 1000 5,65911 IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML R 11.18 500 5,58924 VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE R 5.31 600 3,1888 DIAZEPAM TABLETS 5MG ;1000'S R 9.90 15 148

16 MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML R 0.68 50 34

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TOTAL = 666,643 NO.ITEMS = 26Pack Qty % of

Description Price Issued Value Value20 PERINDOPRIL TABLET 4MG;28'S R 20.08 3000 60,226 9.03%13 ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S R 61.65 800 49,320 7.40%18 PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S R 2.38 20000 47,520 7.13%2 AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG R 115.27 400 46,109 6.92%

25 VITAMIN B6 TABLETS 25MG;500'S R 11.30 4000 45,200 6.78%3 BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES R 36.31 1200 43,572 6.54%

23 THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML R 10.18 4000 40,705 6.11%15 LOPERAMIDE 2MG TABLETS;6'S R 1.22 30000 36,462 5.47%10 GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML R 1.97 18000 35,381 5.31%12 INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML R 33.74 1000 33,739 5.06%6 CLOXACILLIN SODIUM FOR INJECTION500MG R 2.81 12000 33,696 5.05%

22 TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S R 42.46 700 29,724 4.46%4 CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S R 19.73 1500 29,596 4.44%5 CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML R 10.75 2500 26,865 4.03%

26 WATER FOR INJECTION PLASTIC;10ML R 0.53 50000 26,729 4.01%14 LITHIUM CARBONATE TABLETS 250MG; 1000'S R 224.64 65 14,602 2.19%1 AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S R 2.68 5000 13,388 2.01%9 ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S R 83.56 160 13,370 2.01%

21 RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S R 7.24 1400 10,130 1.52%19 PARACETAMOL TABLETS 500MG;500'S R 16.61 600 9,968 1.50%7 CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S R 1.91 3000 5,724 0.86%

17 NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML R 5.66 1000 5,659 0.85%11 IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML R 11.18 500 5,589 0.84%24 VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE R 5.31 600 3,188 0.48%8 DIAZEPAM TABLETS 5MG ;1000'S R 9.90 15 148 0.02%

16 MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML R 0.68 50 34 0.01%

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TOTAL = 666,643 NO.ITEMS = 26Pack Qty % of Value

Description Price Issued Value Value Cum%20 PERINDOPRIL TABLET 4MG;28'S R 20.08 3000 60,226 9.03% 9.03%13 ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S R 61.65 800 49,320 7.40% 16.43%18 PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S R 2.38 20000 47,520 7.13% 23.56%2 AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG R 115.27 400 46,109 6.92% 30.48%

25 VITAMIN B6 TABLETS 25MG;500'S R 11.30 4000 45,200 6.78% 37.26%3 BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES R 36.31 1200 43,572 6.54% 43.79%

23 THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML R 10.18 4000 40,705 6.11% 49.90%15 LOPERAMIDE 2MG TABLETS;6'S R 1.22 30000 36,462 5.47% 55.37%10 GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML R 1.97 18000 35,381 5.31% 60.68%12 INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML R 33.74 1000 33,739 5.06% 65.74%6 CLOXACILLIN SODIUM FOR INJECTION500MG R 2.81 12000 33,696 5.05% 70.79%

22 TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S R 42.46 700 29,724 4.46% 75.25%4 CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S R 19.73 1500 29,596 4.44% 79.69%5 CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML R 10.75 2500 26,865 4.03% 83.72%

26 WATER FOR INJECTION PLASTIC;10ML R 0.53 50000 26,729 4.01% 87.73%14 LITHIUM CARBONATE TABLETS 250MG; 1000'S R 224.64 65 14,602 2.19% 89.92%1 AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S R 2.68 5000 13,388 2.01% 91.93%9 ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S R 83.56 160 13,370 2.01% 93.93%

21 RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S R 7.24 1400 10,130 1.52% 95.45%19 PARACETAMOL TABLETS 500MG;500'S R 16.61 600 9,968 1.50% 96.95%7 CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S R 1.91 3000 5,724 0.86% 97.81%

17 NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML R 5.66 1000 5,659 0.85% 98.66%11 IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML R 11.18 500 5,589 0.84% 99.49%24 VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE R 5.31 600 3,188 0.48% 99.97%8 DIAZEPAM TABLETS 5MG ;1000'S R 9.90 15 148 0.02% 99.99%

16 MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML R 0.68 50 34 0.01% 100.00%

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Pack Qty % of ValueVEN Description Price Issued Value Value Cum%

E PERINDOPRIL TABLET 4MG;28'S R 20.08 3000 60,226 9.03% 9.03%E ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S R 61.65 800 49,320 7.40% 16.43%N PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S R 2.38 20000 47,520 7.13% 23.56%V AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG R 115.27 400 46,109 6.92% 30.48%N VITAMIN B6 TABLETS 25MG;500'S R 11.30 4000 45,200 6.78% 37.26%E BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES R 36.31 1200 43,572 6.54% 43.79%V THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML R 10.18 4000 40,705 6.11% 49.90%N LOPERAMIDE 2MG TABLETS;6'S R 1.22 30000 36,462 5.47% 55.37%V GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML R 1.97 18000 35,381 5.31% 60.68%E INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML R 33.74 1000 33,739 5.06% 65.74%E CLOXACILLIN SODIUM FOR INJECTION500MG R 2.81 12000 33,696 5.05% 70.79%N TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S R 42.46 700 29,724 4.46% 75.25%E CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S R 19.73 1500 29,596 4.44% 79.69%E CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML R 10.75 2500 26,865 4.03% 83.72%E WATER FOR INJECTION PLASTIC;10ML R 0.53 50000 26,729 4.01% 87.73%E LITHIUM CARBONATE TABLETS 250MG; 1000'S R 224.64 65 14,602 2.19% 89.92%E AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S R 2.68 5000 13,388 2.01% 91.93%E ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S R 83.56 160 13,370 2.01% 93.93%N RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S R 7.24 1400 10,130 1.52% 95.45%E PARACETAMOL TABLETS 500MG;500'S R 16.61 600 9,968 1.50% 96.95%N CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S R 1.91 3000 5,724 0.86% 97.81%N NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML R 5.66 1000 5,659 0.85% 98.66%N IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML R 11.18 500 5,589 0.84% 99.49%E VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE R 5.31 600 3,188 0.48% 99.97%E DIAZEPAM TABLETS 5MG ;1000'S R 9.90 15 148 0.02% 99.99%N MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML R 0.68 50 34 0.01% 100.00%

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VEN ANALYSISVEN ANALYSIS

Each member should classify aii the medicine as V, E or NEach member should classify aii the medicine as V, E or N

Result compiled and an overall clasification agreed in the Result compiled and an overall clasification agreed in the DCMDCM

DCM identify and limit therapeutic duplicationDCM identify and limit therapeutic duplication

DCM examine all N items for reduce quantities purchase or DCM examine all N items for reduce quantities purchase or eliminationelimination

Reconsider proposed purchase quantities, buying V and E Reconsider proposed purchase quantities, buying V and E over N items and ensuring that safety stocks are higherover N items and ensuring that safety stocks are higher

Monitor drug ordering and stock levels for V and E items Monitor drug ordering and stock levels for V and E items more closely than for N itemsmore closely than for N items

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ABC ANALYSISABC ANALYSIS

Pharmacist prepare drug consumption data over a one-year Pharmacist prepare drug consumption data over a one-year period or shorter.period or shorter.

Present graphicallyPresent graphically

Reveal high usage items for which there are lower-cost Reveal high usage items for which there are lower-cost alternatives on the list or available in the marketalternatives on the list or available in the market Choose more cost-effective alternative drugsChoose more cost-effective alternative drugs Identify opportunities for therapeutic substitutionIdentify opportunities for therapeutic substitution Negotiate lower prices with suppliersNegotiate lower prices with suppliers

Measure the degree to which actual drug consumption Measure the degree to which actual drug consumption reflects public health needsreflects public health needs Identify irrational drug use through comparing drug consumption to Identify irrational drug use through comparing drug consumption to

morbidity patternsmorbidity patterns

Identify purchases for items not on hospital essential drug Identify purchases for items not on hospital essential drug listlist

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There are numerous methods to obtain information There are numerous methods to obtain information about drug use.about drug use.

Aggregate methods like the ABC /VEN analysis are a Aggregate methods like the ABC /VEN analysis are a useful way to gain an overview of drug use problems useful way to gain an overview of drug use problems using routine data not collected at the individual using routine data not collected at the individual patient level.patient level.

We should be aware of these tools to identify drug We should be aware of these tools to identify drug use problems and periodically utilize these tools to use problems and periodically utilize these tools to assess the current drug use situation.assess the current drug use situation.

This close analysis will produce useful information on This close analysis will produce useful information on drugs and therapeutics that will need more in-depth drugs and therapeutics that will need more in-depth evaluation evaluation

abc ven analysis 2009

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