Assessment of Factors Contributing to Medicine Expiry in Rwanda: Case of the Medical Procurement and Production Division

Abstract

BackgroundRegardless of the significant efforts used and put in place to enhance supply chain performance in Rwanda, there is still poor inventory management and big loss due to expiry of medicines at Medical Procurement and Production Division (MPPD).ObjectiveTo assess the factors that contributes to expiry of medicines at MPPD and formulate recommendations for the improvement of the current situation.MethodsThis is a descriptive cross-sectional study used for 25 respondents. A questionnaire containing closed-ended questions was used focusing on factors contributing to expiries of medicines for each product category managed by MPPD from 2014-2018. Additionally, the researcher reviewed all inventory reports, including expiries for the same period under study. The study focused on targeting respondents working at MPPD as pharmacists both technical and administrative, also other non-pharmacist working in the warehouse were considered as respondents. The hard copy of questionnaire was handed over to 26 respondents and requested to provide filled questionnaire within seven days. Twenty-five respondents were able to return the filled questionnaire on time, giving 96% response rate.ResultsThe study found that in MPPD, medicines are still expiring. During five years (from 2014 up to 2018) the total expired products were valued at RWF 6,046,778,655 for all program categories: HIV commodities had the largest share 53.3%, Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products. The study found that major contributing factors for expiry of health commodities at MPPD, are ranked as follows: Supply chain management 90%, other factors 73%, Poor storage management 68% and Excessive drug supply 67%.
 ConclusionConsidering the study results, it looks like no significant effect of excessive drug supply and inventory management on the expiration of medicines at MPPD. However, the Supply Chain Management components are the most vulnerable to contribute to the expiration of medicines at MPPD. There are many changes to be done inside the institution to remedy the issue of expiration like working according to the standard operating procedures, improving the Skills of personnel in supply chain management, empowering the procurement unit with skilled personnel and improving the communication with stakeholders to facilitate the smooth and quick replenishment and distribution of the stock.
 Rwanda J Med Health Sci 2021;4(2): 281-291

Assessment of the magnitude and contributing factors of expired medicines in the public pharmaceutical supply chains of Western Ethiopia

“…This result is higher than that of a study conducted in the West Wollega Zone, where the total value of reproductive health medicines thrown away due to expiration was 357,920.52 ETB (12,323.81 US dollars) [ 34 ], and Shoa Zone, Oromia regional state, the total monetary value of wasted medicines was 500,522.09 ETB [ 17 ]. However, it was lower than a study conducted in Ruanda, which revealed that the total value of expired products for all program categories was RWF 6,046,778,655 [ 12 ]. Pharmaceuticals that have passed their expiration dates endanger the environment as well as the healthcare system.…”

“…Study conducted in Africa specially in East Africa, money lost due to expired medicines was surprising. As evidence study performed in Rwanda, a study found that the total value of expired medicines was RWF 6,046,778,655, with major contributing factors including supply chain management ranking at 90%, other factors ranking at 73%, poor storage management ranking at 68%, and excessive drug supply ranking at 67% [ 12 ]. Also, the study conducted in South Africa explored the total estimated value of financial losses due to medicine expiry was R 836 029; an estimated annual revenue loss of 0.6% of the total hospital expenditure that contributed to lack of standard treatment guideline knowledge among prescribers [ 13 ].…”

“…Globally, the availability of expired medicine in stores of supply chain and health facility is enormous [ 5 , 12 , 13 , 16 ]. Literatures explored medicine expired at different level of health facility and in different kinds.…”

Medicines Wastage and Its Contributing Factors in Public Health Facilities of South Gondar Zone, Amhara Regional State, Ethiopia

“… 19 The other contributing factors to the expiry of health commodities and wastage were a weak stock control system, and over supplying of drugs. 32 In this study, the main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine’s wastage were delivery of medicines with the near-expiry date (<6 months) to the health facilities by suppliers (Ms=4.23), excessive supply of nearly expired medicines, 32 , 33 poor coordination and communication with key stakeholders (suppliers, health bureau/office, NGOs‟s) (Ms=4.2) and availability of overstocked medicines caused by inappropriately forecasted needs of health facility (Ms=3.83) of South Gondar zone, Ethiopia.…”

Smart Identification and Notification of Drugs in Medical Pharmacy Using Iot

“…Jawaher Matar Alwashahi, Mithaq Ibrahim Alqartubi and Jawaher Hamed Alhakmani. Smart Identification and Notification of Drugs in Medical Pharmacy using IoT 5 According to [4] There is a big loss of medicine in Rwanda because of less monitoring, the purpose of this research is to evaluate the factors which can occur the expired medicine. The study research was used 25 responders, they used close-ended questions and they were focusing on factors that can produce the expired data, they focus more on the pharmacist who is working in MPPD, the highest response for this research is 96% response rate.…”