A simulation model to evaluate pharmaceutical supply chain costs in hospitals: the case of a Colombian hospital

Abstract

Background Healthcare costs is one of the most studied issue in our days because of increasing demand and the aging of population. Final costs of medicines is one of the most important issue in patient treatment and determine its real value is an important task within hospitals. Simulation models and in this case system dynamics allows to build representations of reality considering the interaction of the whole variables that affect the system where first a causal loop diagram allows to represent and identify the interaction between variables for develop a stock flow diagram to determine the final results. Objective Develop a simulation model that allows decision makers in Hospitals and Governments to identify the variables that affect the final cost of medicines and to determine the legal reimbursement allowed by national agencies. Methods This paper presents a conceptual modeling framework using a causal loop diagram and a dynamic simulation model in the real case of a hospital in Colombia to explore how different internal charges for medicines affect the behavior of the final unitdose cost of medicines, considering the complexity of the pharmaceutical system. We developed a simulation model to represent and characterize the pharmaceutical supply chain in a hospital and by using real data we validate the results of the model and conclude about the supply chain of medicines in Colombia using the legal regulations as a main factor of analysis. Results and conclusions We found that in some cases the maximum reimbursement value is less than the final cost of medicines within the hospital, which means that hospitals lose money on the administration of medicines to patients. The benefit of this model is that with the result the hospital can determine the real final monetary value of medicines, including the different processes starting from the reception of the medicines, ending with the administration to patients.

<p>Public Willingness to Participate in COVID-19 Vaccine Clinical Trials: A Study from Jordan</p>

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COVID-19 and the “Stay at home” recommendation

“…[ 29 ] Instead, the research has shifted to COVID-19 investigations into finding a curative treatment are granted and facilitated by national and international research bodies, while we observe dysregulation and anarchy or probably pseudo-research in clinical studies and clinical use of drugs as off-label usage, compassionate use or clinical practice. [ 30 ]…”

Pharmaceutical supply chains and management innovation?

“…Papalexi et al (2015) focused on the implementation of the kanban system on the supply chain for a group of cooperative pharmacists proposing that the organisation can store 56.8% fewer products and spend 71.8% less money, by adopting the kanban system. Simulation modelling and outsourcing of noncritical medical supplies were examined by scholars such as Battini et al (2013) and Franco (2018), aiming at reducing inventory costs without influencing the quality of services. Danese (2006) suggested the use of Information Technology (IT) across the network for sharing and exchanging information and highlighted the significance of trust within it.…”

“…Although they found that the application of Computerised Provider Order Entry (CPOE), Electronic Medical Record (EMR) and other similar software for placing pharmaceutical orders electronically has multiple benefits, the cost of implementing those types of technology were one of the limitations (Shafique et al, 2019). In addition, Davenport (2013) and Franco (2018), who also focused on the financial aspects of innovation, suggested that organisations often hesitate to undertake an innovative approach, fearing the economic risk associated with this type of initiative specifically when attempts to be innovative fail. Considering that the cost of pharmaceuticals is too high (Cherrett et al, 2012), pharmacies do not consider that purchasing and maintaining this type of technology requires huge investments.…”