Electronic Logistic Management Information System in Public Health Facilities and Its Implications for the Medicine Supply Chain in Singida District Council, Tanzania.

The effective management of the medicine supply chain is crucial for ensuring the availability of essential medicines and supplies in public health facilities. This study aimed to determine the utilization of the electronic logistic management information system (e-LMIS) in public health facilities and its implications for the medicine supply chain. A mixed methods approach, combining both quantitative and qualitative data collection methods, was used. The study included 106 healthcare providers from 35 public health facilities in Singida District. Six key informants were interviewed using a qualitative method. Of the 106 participants, 62.3% said they were somehow competent in e-LMIS utilization. In in-depth interviews, respondents underscored the system's utility for tracking stock levels, procurements, and managing orders. Staff shortages and a lack of customized training were mentioned as major challenges hindering efficiency in managing drug supplies. This study highlighted the positive impact of e-LMIS on various aspects of the medicine supply chain, including the timely submission of orders and enhanced inventory management. Sustained management support and the regular utilization of the e-LMIS system are crucial for building and maintaining competence among healthcare providers, thereby optimizing the medicine supply chain and ultimately improving healthcare delivery.

Blockchain Adoption for Generic Drugs in the Medicine Supply Chain with Consumers' Risk-Aversion: A Game-Theoretic Model Within Chinese Legal Framework.

Background: Blockchain is expected to mitigate consumers' risk-aversion and quality uncertainty about generic drugs in medicine supply chains. This study investigates the effect of blockchain adoption for disclosing the quality information of generic drugs that compete with original drugs in the market and proposes legal measures accordingly. Methods: We employ a game-theoretic model to analyze a medicine supply chain including a generic drug manufacturer, an original drug manufacturer, and a retailer. We examine when should the supply chain members adopt blockchain for generic drugs and how blockchain affects the medicine supply chain. Results: Our results show that the quality information of generic drugs determines how blockchain adoption affects the price and sales quantity of generic and original drugs. Moreover, we observe that the generic drugs manufacturer and the retailer decide to adopt blockchain only if consumers' risk-aversion degree is sufficiently low. Also, a low risk-aversion degree can lead to higher whole supply chain's profitability with blockchain adoption, and generate a win-win-win situation of blockchain adoption for the consumers, the generic drug manufacturer, and the retailer. Conclusion: To mitigate consumers' risk aversion, the law should safeguard consumer rights. Blockchain adoption can benefit the medicine supply chain and consumers under certain conditions. However, it also requires the coordination of supply chain members' benefits and the disclosure of quality information.

Impact of COVID-19 pandemic on medicine supply chain for patients with chronic diseases: Experiences of the community pharmacists.

Problem considered: Coronavirus disease(COVID-19) outbroke towards the end of December 2019 in China, soon it started spreading rapidly to various countries leading to an outburst of pandemic. Due to the restrictions imposed to control the spread of the infection, globally the manufacturing, import and export of medicine and the healthcare services to patients with chronic illness had been affected. This study aimed to explore the perspectives of the pharmacists on the medicine supply chain for patients with chronic diseases during COVID-19 pandemic in India. Methods: This study is a prospective, qualitative research involving telephonic, semi-structured in-depth interviews. An interview guide for pharmacists was prepared and validated using "Interview Protocol Refinement" method. Purposive sampling method was used to recruit the pharmacists; a telephonic oral consent was obtained. The interview session was audio recorded and the recordings were transcribed verbatim. Further, transcripts were validated and later analysed using NVivo software. Results: A total of 8 participants were interviewed during our study. Thematic analysis of the transcripts resulted in seven main themes. The study showed that there was deficiency in medicine supply during the COVID-19 pandemic and the pharmacists faced several challenges in procuring and storing the medication, arranging for unavailable medicines, medication dispensing and provision of the services such as medicine delivery, patient counselling. There was also scarcity of manpower leading to extra workload and working overtime. Conclusion: Uninterrupted supply of essential medicine is the backbone of health care system. An effective plan and appropriate strategies are vital to combat such future emergencies.

Mathematical analysis to the variation of tumor cells density according to recovery of five organs: Kidney, liver, heart, spleen, and lung.

BACKGROUND AND OBJECTIVE: Harmonious interactions of five representative organs: kidney, liver, heart, spleen, and lung, improve metastasis and cell divisions, and abnormal cell division causes cancer cell development. The research is processed through a mathematical approach based on win-win principle of five organs to generate medicine in blood vessel. The variations of solute medicine amount in blood vessel with respect to the flow rates of injected drugs are interpreted. The alterations of tumor cells density and tumor angiogenesis factor concentration are described according to the recovery of five organs' functions. METHODS: A compartmental analysis is applied to obtain medicine concentration in blood vessel by the functional recovery of five organs considering time level ti, the reaction rate coefficient Rj, and the medicine flow rate α. Random motility and chemotaxis in response to tumor angiogenesis factor gradients are comprised to derive mathematical governing equations for tumor cells motion and a finite volume method with time-changing is adopted to obtain numerical solutions due to the complexity of the governing equations. RESULTS: Drug concentration in blood vessel grows as heart reaction rate increases, and the medicine made through the functional enhancements of five representative organs is highly influential to restrain the activity of tumor angiogenesis factor. With the growth of medicine concentration in blood vessel according to the decline of reaction rate and medicine flow rate, tumor cells reacts hypersensitively at the moment of medicines injection and the density of tumor cells approached to zero. CONCLUSIONS: Consequently, reaction rate, time level, and medicine flow rate are crucial factors in the determination of medicine amount in blood vessel and to control tumor angiogenesis factor concentration, and harmonious balanced functions among five organs based on win-win principle contribute to control the activity of tumor cells.

Pharmacist Assistants' role in medicine supply management at a primary healthcare setting.

Background: The need to improve essential medicine supply in the public sector is of paramount importance to ensure that the drugs used in treatment regimens are accessible, acceptable, safe, cost effective and affordable to the population. Aim: To assess the role of post-basic pharmacist assistants at primary healthcare clinics in order to make recommendations aimed at improving essential medicine supply management. Setting: The study covered five provinces namely: Eastern Cape, Free State, Gauteng, KwaZulu-Natal and Mpumalanga. Method: A qualitative, exploratory, descriptive research design was followed, using a semi-structured interview guide to collect data from 11 District Pharmaceutical Service Managers together with medicine availability reports review. Data analysis was performed using Colaizzi's seven steps. Results: The study found that there is a shortage of post-basic pharmacist assistants in primary healthcare clinics, which affects the management and availability of medicine supplies. Placement of the post-basic pharmacist assistants would improve medicine supply management in the primary healthcare clinics. Conclusion: At least one post-basic pharmacist assistant should be appointed at each primary healthcare clinic in order to ensure efficient medicine supply management and consistent medicine availability. Contribution: The study provides evidence that primary healthcare clinics without post-basic pharmacist assistants are more likely to have erratic medicine supply management practices and confirms that post-basic pharmacist assistants play a positive role in the medicine supply management processes in primary healthcare clinics.

Impact of the Low-Price Medicine Policy on Medicine Supply in China: An Interrupted Time-Series Analysis.

Objectives: The primary objective of the study was to assess the impact of the Low-Price Medicine Policy (LPMP) on the supply of low-price medicines (LPMs) in China. The secondary objective of the study was to describe the supply situation of LPMs from 2005 to 2018. Methods: The LPMP was launched in the third quarter of 2014 (2014Q3). An interrupted time series analysis was used to evaluate the impact of LPMP on the supply of LPMs in China. Ordinary least squares and Poisson regression models were utilized to estimate the effect of LPMP on LPMs' supply growth rate and the number of supplied LPMs. All the LPMs were divided into two subgroups: intermittent supply and continuous supply. The trend and level changes of the quarterly average growth rate and number of quarterly supplies for different LPM groups were analyzed from 2005 to 2018. Findings: For the quarterly average growth rate, before the intervention, a significant increasing trend was observed in the total group and the continuous supply subgroup; after the introduction of LPMP, the increasing trend was ceased and a significant decrease in the trend and level was noted for both the total group (trend coefficient: ß 3 = -0.0132, p < 0.01; level coefficient: ß 2 = -0.1510, p < 0.05) and the continuous supply subgroup (trend coefficient: ß 3 = -0.0133, p < 0.01; level coefficient: ß 2 = -0.1520, p < 0.05); whereas it had no significant effect for intermittent supply subgroup. For the number of quarterly supplies, after the intervention of LPMP, decline of the supply number was observed (trend coefficient: ß 3 = -0.0027, p < 0.001; level coefficient: ß 2 = -0.0584, p < 0.001); whereas the LPMP was associated with an upward trend and level (trend coefficient: ß 3 = 0.0715, p < 0.001; level coefficient: ß 2 = 0.174) for the intermittent supply subgroup. Conclusion: For most of the LPMs, LPMP did not meet the goal of stimulating LPM production. However, for severely shortage medicines (the intermittent supply subgroup), the effect of LPMP was positive. Comprehensive policies rather than just deregulating medicine price should be introduced to alleviate the situation of medicine shortage in China.

Using Pharmaceutical Benefit Scheme data to understand the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers.

OBJECTIVE: To examine the supply of smoking cessation medicines to Aboriginal and Torres Strait Islander smokers compared to non-Indigenous smokers across Australia. METHODS: We analysed the total number of smoking cessation prescriptions dispensed over three years through the Pharmaceutical Benefits Scheme (PBS) compared to those supplied nationally through the Closing the Gap (CTG) measure and also in the Northern Territory through the Remote Area Aboriginal Health Service (RAAHS) program. RESULTS: Aboriginal and Torres Strait Islander smokers were supplied with fewer smoking cessation medicines per smoker under the CTG measure compared to non-Indigenous smokers under general PBS benefits. Supply of medicines though the RAAHS program complicated the use of CTG data where higher proportions of Aboriginal and Torres Strait Islander people live in remote areas and use of the CTG measure is lower. CONCLUSIONS: Fewer smoking cessation medicines are being prescribed and then dispensed to Aboriginal and Torres Strait Islander smokers than to non-Indigenous smokers. Implications for public health: CTG and RAAHS data may be useful to monitor and evaluate the effectiveness of interventions to improve the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers. However, there are limitations and current obstacles to accessing RAAHS data would need to be removed.

Research on construction of Chinese medicinal materials supply chain collaborative management system from perspective of industrial clusters / 中草药

From the perspective of industrial clusters, the rapid development of the Chinese medicinal materials industry faces the challenges of improving quality and efficiency and transforming and upgrading. The core problem is how to improve the anti-risk ability, resilience, and competition of the Chinese medicinal material supply chain through collaborative management of the supply chain. The particularity of Chinese medicinal materials determines the formation of Chinese medicinal materials industrial clusters with specific natural, social, and industrial conditions. From the perspective of industrial clusters, the supply chain of Chinese medicinal materials also presents unique structural characteristics. Based on the analysis of the formation conditions of the traditional Chinese medicine industry cluster and the structural characteristics of the traditional Chinese medicine supply chain, on the basis of clarifying the connotation of collaborative management of the traditional Chinese medicine supply chain from the perspective of the industrial cluster, it is proposed to establish a supply chain collaborative management mechanism at the macro level, the meso level reconstructs the supply chain business process system and optimizes the supply chain function coordination mode at the micro level to build a collaborative management system for the supply chain of Chinese medicinal materials.

Experience of the support of medicine in Harmonious Mission -2018 / 药学实践杂志

Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.

Eliminating medicine waste in a Finnish university hospital - a qualitative study.

BACKGROUND: Medicine waste in hospitals leads to severe economic loss. This waste emerges for a number of reasons. Medicines are often ordered in too large quantities, which leads to stock expiring without being dispensed. Wastage can also be a consequence of poor management practices. Technical aids, such as automatic dispensers, have been suggested to reduce waste, but they too have shortcomings. Information systems can arguably contribute to waste reduction, but this area has not been widely researched.In this exploratory case study, we scrutinized the management of medicines waste in a hospital from an information systems perspective and examined how information systems are used to manage the medicine supply chain and medicine waste. Our research case was a Finnish university hospital, its central pharmacy, and, more widely, the medicine supply chain within the hospital. METHODS: This is a qualitative case study, based on data gathered through interviews and a survey and a review of other information sources, including annual reports and other relevant collateral. The study participants included pharmacy staff members and other hospital staff involved in medicine supply. The interviews were conducted in two rounds, first capturing the main themes and then exploring them further in the later study stages. RESULTS: The findings outline a picture of unfit technology and inconsistent and unreliable information. This is compensated for by manual practices and processes that cause an excessive administrative burden and ultimately increased wastage. An infrequent ordering process combined with the lack of recycling practices increase the wastage even more. CONCLUSION: Medicine supply and waste management remain a manual administrative task. Inconsistent information and unfit information systems make this task challenging, and the process relies on the medicine supply staff's experience and assumptions.

Medicine Shortages: Gaps Between Countries and Global Perspectives.

Introduction: Over the last decade, global health policies and different research areas have focused on the relevance and impact of medicine shortages. Published studies suggest there have been difficulties with access to medicines since the beginning of the 20th century, and there have been advances in our understanding and management of the problem since then. However, in view of global and regional health care concerns with shortages, we believe this phenomenon needs to be characterized and described more fully regarding the types of medicines affected, possible causes, and potential strategies to address these. The aim of this scoping review was to identify, compare if possible, and characterize the recent literature regarding the situation of medicines shortages between countries, and provide different perspectives, including a global context and national approaches. Methodology: A scoping study presented as a narrative review of the situation and findings principally based on published articles. Results: Based on the reported cases in the literature, a typology of medicines shortage and supply interruption episodes and their causes were proposed; national approaches to notify and manage the medicines shortages cases were described and classified by update frequency; principal differences between market and supply chain management perspectives of the situation were identified and global and countries' perspectives were described. Conclusion: Policy makers require solutions that prevent those cases in which the population's health is affected by episodes of medicine shortages and/or interruption in the supply chain. There is also a need to generate a glossary related to logistics management and the availability of medicines which will be useful to understand and overcome shortages. In addition, recognize that potential solutions are not only related with actions linked to research, development and innovation, but much wider. Overall, we believe this article can act as a basis for future discussions in this important area.

Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context.

Where regulation is weak, medicine transactions can be characterised by uncertainty over the drug quality and efficacy, with buyers shouldering the greater burden of risk in exchanges that are typically asymmetric. Drawing on in-depth interviews (N = 220) and observations of medicine transactions, plus interviews with regulators (N = 20), we explore how people in Ghana negotiate this uncertainty and come to trust a medicine enough to purchase or ingest it. We identify two mechanisms - attempts to mitigate uncertainty through seeking observable signs of quality and attempts to reduce informational asymmetry - that underpin cognitive assessments of a medicine's trustworthiness. However, these 'cognitive' forms of trust assessment have limited traction where uncertainty is high and trustworthiness remains unknowable, so a third mechanism comes into play: one based on affective relationships within which transactions are socially embedded. Even these, however, cannot eliminate uncertainty, because of the dispersed and under-regulated nature of wider supply chains. In conclusion, we reflect on the need for careful research on actors' practices and decision-making across supply chains to inform more effective policy and regulation.

Investigation on Current Situation of Medicine Supply in Primary Health Care Institutions of Anhui Province / 中国药房

OBJECTIVE:To provide reference for improving the efficiency of medicine supply in primary health care institutions. METHODS:By stratified random sampling,6 counties of Dabie Mountains in Anhui province were selected as sample areas. Medicine purchase data of 143 primary health care institutions in 2015 were collected from Anhui provincial centralized purchase platform. Those data were analyzed in respects of purchase and distribution of National Essential Medicine,medicines of Anhui Province Essential Medicine List and cheap medicines. By stratified random sampling,12 primary health care institutions were selected for on-site interview. The reasons for medicine distribution and insufficient distribution were investigated. RESULTS:The rate of medicine distribution in the sample areas was 82.27%,and the rate of essential medicine distribution was more than 80%. Ratio of purchase amount for national essential medicines and medicines of Anhui Province Essential Medicine List were all up to standard in different types of primary health care institutions. The rate of cheap medicine distribution was in low level(only 80%). The distribution rate had great difference in the primary health care institutions and different areas;the highest rate of medicine distribution reached 99.86%,and the lowest was only 46.18%. The results of on-site investigation showed that main reasons for insufficient distribution were the divided area distribution model had a certain influence on the market competitiveness of the distribution enterprises,and distribution enterprises strength had huge differences. CONCLUSIONS:The primary health care institutions have high awareness of National Essential Medicine System in Dabie Mountains of Anhui Province;purchase rate and overall distribution rate of essential medicine are also high. There are great differences in distribution efficiency among different areas and health care institutions,and some health care institutions cannot distribute medicine in time with full capacity. It is suggested to conduct"two-receipt system"of medicine distribution,perfect medicine distribution enterprise supervision system, establish medicine circulation information platform and lead cheap medicine supply guarantee by government,etc. Those measures can guarantee the accessibility and selectivity of the masses to essential medicines in grass-roots areas.

Dilemma and breakthrough: Innovation and development of Chinese herbal medicine supply chain / 中草药

Chinese herbal medicine supply chain as the core link of construction of Chinese herbal medicine circulation system, is currently facing the diversification of sales formats, the flow of channel reconstruction, the rapid development of electronic commerce and Chinese herbal medicine quality and safety awareness of the impact of increasing. The supply chain of Chinese herbal medicine is based on the theory of supply chain of agricultural products, but the diversity of Chinese herbal medicines, the complexity of the source and the particularity of the production and processing and maintenance processes determine that the supply chain of Chinese herbal medicine cannot simply apply the agricultural product logistics theory. By analyzing the basic connotation and current model of the supply chain of Chinese herbal medicine, this paper analyzes the theoretical difficulties and practical dilemma faced by the supply chain of Chinese herbal medicine, and puts forward the basic framework of the theory research of supply chain theory of Chinese herbal medicine, as well as supply chain operation mechanism, supply chain logistics management and supply Chain financial innovation strategy, aimed at promoting the Chinese herbal medicine supply chain theory and industrial development breakthrough.

Study on components of rapid response capabilities of emergency medicine supply / 药学实践杂志

Objective To propose conceptual framework for the components of rapid response capabilities of emergency medi -cine supply and suggestions of rapid response capabilities establishment .Methods The components framework of rapid response capa-bilities of emergency medicine supply was proposed by analyzing the problems of emergency medicine supply and locating the demand on the timeliness and accuracy of emergency medicine supply .Results Rapid response capabilities of emergency medicine supply in-clude rapid decision-making and commanding , rapid implementation and rapid adjusting .Conclusion We should proceed from post training, information platform developing , medicine standards making , professional team building and other aspects to construct rapid response capabilities of emergency medicine supply .

Study on the essential medicines supply of medical institutions at county-level in Shaanxi Province / 中国卫生政策研究

Objective: To analyze the essential medicines supply of medical institutions at county-level in Shaanxi Province and to provide empirical evidences and suggestions to improve relevant policies. Methods:A strati-fied cluster random sampling method was used to choose the institution samples. A survey was conducted to study the supply of essential medicines in 2012. Indicators include the variety and amount of essential medicines procured, the medicine shortage condition, and the rate of winning the bid for essential medicine. Results:Essential medicines ac-counted for 69 . 1% of all medicines;and procurement of essential medicines accounted for 42 . 4% of all procurement spending on medicines. Of the top 25 chemical products of essential medicines, provincial supplementary medicines accounted for 33. 9%;and among the top 25 traditional Chinese medicines of essential medicines, the provincial sup-plementary medicines accounted for 51. 9%. All 27 medical institutions faced a shortage of medicines. There were 47 kinds of essential drugs in urgent need were out of bid. Conclusion:Essential medicine supply of medical institutions at county-level is in good condition;however, more attention needs to be paid to medicine shortage. We should take measurements to standardize the process of bidding for essential medicines and strengthen the management of medi-cine shortage in order to better meet patients’ needs.

Mine Disaster Rescue and Medicine Supply before Hospitalization / 中国药房

OBJECTIVE: To provide reference for rapid and effective first aid to mine disaster before hospitalization. METHODS: The status quo of emergent rescue for mine disaster in China was reviewed. The key to rescue, main countermeasures and necessary drug of first aid before hospitalization were analyzed according to the characteristics of mine disaster and troubles of medical rescue. RESULTS & CONCLUSIONS: Ambulance corps cooperated with medical staffs to set ICU at disaster site. Scientific rescue provided by professional team can improve survival rate. Meanwhile, a perfect mine disaster rescue system should be set up.