Shortages of medicines: a complex global challenge

Gray, Andy; Manasse, Henri R.

doi:10.2471/blt.11.101303

Cited by 108 publications

(84 citation statements)

References 8 publications

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“…Evidence suggests that the causes vary greatly and include issues that government agencies often do not have control over, such as supplier shortages. [1] Stock-outs appear to be worsening with time globally, which presents a threat to patient wellbeing and could result in loss of life. [2] At a global level, multi-stakeholder activities to evaluate the causes of stock-outs and to develop appropriate mitigating strategies have been initiated.…”

Section: Researchmentioning

confidence: 99%

Inefficient procurement processes undermine access to medicines in the Western Cape Province of South Africa

et al. 2017

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Background. South Africa (SA) has experienced several stock-outs of life-saving medicines for the treatment of major chronic infectious and non-communicable diseases in the public sector. Objective. To identify the causes of stock-outs and to illustrate how they undermine access to medicines (ATM) in the Western Cape Province, SA. Methods. This qualitative study was conducted with a sample of over 70 key informants (frontline health workers, sub-structure and provincial health service managers). We employed the critical incident technique to identify significant occurrences in our context, the consequences of which impacted on access to medicines during a defined period. Stock-outs were identified as one such incident, and we explored when, where and why they occurred, in order to inform policy and practice. Results. Medicines procurement is a centralised function in SA. Health service managers unanimously agreed that stock-outs resulted from the following inefficiencies at the central level: (i) delays in awarding of pharmaceutical tenders; (ii) absence of contracts for certain medicines appearing on provincial code lists; and (iii) suppliers' inability to satisfy contractual agreements. The recurrence of stock-outs had implications at multiple levels: (i) health facility operations; (ii) the Chronic Dispensing Unit (CDU), which prepacks medicines for over 300 000 public sector patients; and (iii) community-based medicines distribution systems, which deliver the CDU's prepacked medicines to non-health facilities nearer to patient homes. For instance, stock-outs resulted in omission of certain medicines from CDU parcels that were delivered to health facilities. This increased workload and caused frustration for frontline health workers who were expected to dispense omitted medicines manually. According to frontline health workers, this translated into longer waiting times for patients and associated dissatisfaction. In some instances, patients were asked to return for undispensed medication at a later date, which could potentially affect adherence to treatment and therapeutic outcomes. Stock-outs therefore undermined the intended benefits of ATM strategies. Conclusion. Addressing the procurement challenges, most notably timeous tender awards and supplier performance management, is critical for successful implementation of ATM strategies.

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Section: Researchmentioning

confidence: 99%

Inefficient procurement processes undermine access to medicines in the Western Cape Province of South Africa

et al. 2017

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“…O outro fator é o desabastecimento de medicamentos, que têm sido uma preocupação global, mas, em especial, dos países em desenvolvimento e não produtores de medicamentos, além da incorporação de tecnologias que vêm gradativamente desfinanciando os sistemas de saúde desses países (GRAY;MANASSE, 2013).…”

Section: Posicionamentos Comuns Da Unasul Na Ams: Análise E Resultadosunclassified

A Unasul na Assembleia Mundial da Saúde: posicionamentos comuns do Conselho de Saúde Sul-Americano

Faria¹,

Giovanella

Bermúdez³

2015

Saúde debate

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“…Drug shortages affect various therapeutic drug classes all over the world (Balkhi et al, 2013;Gray and Manasse, 2012) and in some cases drug shortages can even jeopardize public health (Food and Drug Administration, 2011;Gogineni et al, 2013). Even though European markets are affected (Capstick et al, 2011;Giraldo et al, 2011;Tirelli et al, 2012), empirical studies unravelling the issue of drug shortages in Europe are scarce.…”

Section: Introductionmentioning

confidence: 97%