Hospital Pharmacy Group 6

8/17/2019 Hospital Pharmacy Group 6

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Purchasing and

InventoryControl

GROUP 6

LORENZO, EIZED P!RICE D"

#LI$IRN, $EGIL #"

#ENDOZ, LE%LIE &NICE #"

#ENDOZ, #" LUR I%$EL D"

#OLIN, GERNL'N



IN!RODUC!ION

Purchasing and inventory are i()ortant to all)har(acist *ecause they are essential ele(ents o+ th(edication use syste("

unda(ental to )atient sa+ety-*ecause they i()actthe a*ility o+ the syste( to )rovide the right drug, tothe )atient, in the a(ount, *y the right route o+

ad(inistration, and at the right ti(e and +re.uently"

It a))lies to all ty)es o+ )har(acy settings includingdecentrali/ed, centrali/ed, ho(e in+usion anda(*ulatory care )har(acy o)erations"



!he or(ulary %yste( Cornerstone o+ the )urchasing and inventory control

syste("

Develo)ed and (aintained *y a co((ittee o+ (edicaland allied health sta0 called P1R#C' and !1ERPEU!IC% 2P3!4 co((ittee"

!he )roducts on the hos)ital +or(ulary dictate 5hat thehos)ital )har(acy )urchase and ee) in inventory"

#ost retail )har(acies do not rigidly restrict ite(s intheir inventory, *ecause in this setting, inventories arelargely de)endent on the dyna(ic needs o+ their )atient)o)ulation and to so(e degree, their )atients7res)ective insurance )lans"



!he or(ulary %yste(

vaila*le in )rint or online +or(ats"

E8clusively +or all health )ractitioners involved in)rescri*ing, dis)ensing, and (onitoring (edications

or(atted generally to in+or( user o+ )roductavaila*ility, the a))ro)riate thera)eutic uses andreco((ended dosing o+ (edications"

or(ulary )u*lications should re(ain current ty)ically*eing u)dated every 9: to 9; (onths at (ini(u("

I()ortant in+or(ation availa*le in the +or(ularyincludes the dosage +or(, strength, andconcentration< )acage si/e2s4< co((on side e0ects<

and ad(inistrations"



#anaging the Purchasing andInventory Control %yste(

%tate=o+=the=art )ractice in )urchasing and inventorycontrol uses co()uter and internet technology to(anage )urchasing and receiving o+ )har(aceuticals+ro( a drug 5holesaler"

!his technology includes using *ar codes and hand=

held co()uter devices +or online )rocure(ent and)urchase order generation and +or electronic receiving)rocesses"

!he *ene>ts o+ this are u)=to=the=(inute )roductavaila*ility in+or(ation, co()rehensive re)ortingca)a*ilities, accuracy, tighter inventory control ande?ciency"



Receiving and %toringPhar(aceuticals

Receiving (edication +ro( su))liers is oneo+ the (ost i()ortant )arts o+ the)har(acy o)eration"



!a*le 9:=9"

DEFINED STORAGE TEMEPATURES AND HUMIDITY

FREEZER 2=4:@A to 2=49BAC 2=49A to 9 A

COLD :A to ;AC 6A to 6A

COOL ;A to 9@AC 6A to @A

ROOM TEMPERATURE te()erature )revailing in 5oring area

CONTROLLED ROOMTEMPERATURE

:BA to :@AC 6;A to FFA

WARM BA to BA C ;6A to 9BA

EXCESSIVE HEAT any te()erature a*ove BAC 29BA4

DRY PLACE

)lace that does not e8ceed B )ercent average relative hu(at controlled roo( te()erature or the e.uivalent 5ater va

)ressure at other te()eratures"

%torage in a container validated to )rotect the article +ro((oisture va)or, including storage in *ul, is considered a dry



!he Receiving Process !his )rocess is es)ecially i()ortant +or controlled su*stances

*ecause it e0ectively esta*lishes a chec in the syste( to

(ini(i/e )otential drug=diversion o))ortunities" Receiving )ersonnel )lay a critical role in )rotecting the

)har(acy +ro( >nancial res)onsi*ility +or )roducts da(aged inshi)(ent, )roducts not ordered, and )roducts not received"

De)art(ents 5ill re.uire that )roducts received have a (ini(u(shel+ li+e o+ 6 (onths re(aining *e+ore they e8)ire"

Controlled su*stances re.uire additional )rocessing on recei)t"

Regulations s)eci>c to schedule II controlled su*stances re.uireDrug En+orce(ent d(inistration 2DE4 +or( ::: to *eco()leted on recei)t o+ these )roducts and >les se)arately 5itha co)y o+ the invoice and )acing sli) acco()anying eachshi)(ent



!he Receiving Process

!his is done *y listing the )roduct, dosage +or(,concentration-strength, )acing si/e, and .uantityon a *lan )iece o+ )a)er or the su))lier7s)acing sli)-invoice and checing o0 the line ite(receive"



!he %toring Process

Once the )roduct has *een )ro)erly received, it #U%! *estored )ro)erly

De)ending on the si/e and ty)e o+ the )har(acy o)erationthe )roduct (ay *e )laced in a *ul, central storage area ointo the active dis)ensing areas o+ the )har(acy"

Products already in stoc that have e8)ired should *eRE#OED"

%toc rotation is a )ractice 5ere )roducts that 5ill e8)ire inthe near +uture should *e highlighted and )laced in the +rono+ the shel+ or *in"

It is i()ortant inventory (anage(ent )rinci)le that )rinci)that encourages the use o+ )roducts *e+ore they e8)ire andhel)s )revent the use o+ e8)ired )roducts and 5aste"



!he %toring Process

It is sa+e to assu(e that the >rst=in, >rst=out 2IO4 (ethod o+inventory (anage(ent is a))lied 5hen it co(es to)har(aceutical )roducts"

ll stoc should *e sorted at te()erature and hu(idity levelsreco((ended *y (anu+acturers and de>ned *y the United%tates Phar(aco)eia 2U%P4



Product 1andling Considerations

Phar(acy !echnicians usually s)end (ore ti(e handling and)re)aring (edications than do )har(acies

!hey the critical res)onsi*ility o+ assessing and evaluating each)roduct +ro( *oth a content and a la*eling stand)oint"

It also )rovides the technician 5ith an o))ortunity to con>r( thathe receiving )rocess 5as )er+or(ed )ro)erly

!he technicians )lay a vital role in (ini(i/ing dis)ensing errorsthat (ay occur *ecause o+ hu(an +alli*ility

Generally the >rst in a series o+ checs involved in an accuratedis)ensing )rocess"

Pay close attention to the )roduct7s e8)iration date"




!he Role o+ the Phar(acy !echnician

Phar(acy technicians usually s)end (ore ti(e handling and)re)aring (edications than do )har(acists" !his )rovides thetechnician 5ith an o))ortunity to con>r( that the receiving)rocess 5as )er+or(ed )ro)erly"

!he )har(acy technician should read )roduct )acaging

care+ully, rather than rely on the general a))earance o+ the)roduct"

!echnicians )lay a vital role in (ini(i/ing dis)ensing errors that(ay occur *ecause o+ hu(an +alli*ility"

!he technician (ust )ay close attention to the )roduct7se8)iration date 5hen )er+or(ing )urchasing or inventory

(anage(ent roles"




Phar(acy technicians should also discuss theirconcerns 5ith co5orers and advocate changes to)roducts 5ith )oor la*eling"




Look-alike/sound-alike (LASA) products – %tocing )roducts o+si(ilar color, sha)e, and si/e could result in error i+ so(eone +ailto read the la*el care+ully"

Misleading labels H %o(eti(es the co()any na(e or logo ise()hasi/ed on the la*el instead o+ the drug na(e,concentration, or strength"

Product storage H %toring )roducts that are si(ilar in a))earancadacent to one another can result in error i+ so(eone +ails toread the la*el"



#aintaining and #anagingInventory

n inventory (anage(ent syste( is an organi/ed a))roach designed t(aintain ust the right a(ount o+ )har(aceutical )roducts in the)har(acy at all ti(es"

Inventory turn H )roducts should *e used and not re(ain on the sheDe>ne in accounting ter(s, are the +ractions o+ year that an averageite( re(ains in inventory"

si()le (eans o+ calculating inventory turns in a given )eriod is to

divide the total )urchases in that )eriod *y the value o+ )hysicalinventory taen at one )oint in ti(e"

!otal )har(aceutical )urchases +or >scal year 2'4 :B9B !"#$%&'$()#

Physical inventory value on 9:-9-:BB !(%"$((#

Calculated inventory turns ")*+ t,-e




Inventory turnover H 5ay o+ (easuring the )roductivity o+ a)har(acy7s inventory use o+ invested ca)ital" H,./ ,nventoryturnover is a sign o+ e?ciency *ecause inventory is constantlyat 5or and generating revenue" Lo0 ,nventory turnover is asign that )roduct 2ca)ital4 is sitting unused on the shel+ and is asignal o+ o)erational ine?ciency"

Inventory (anage(ent syste(s include the order book , theminimum/maximum (par) level, the Pareto (AB) anal!sis, theeconomic order "uantit! (#$%), and &ust-in-time s!stems" Each othese syste(s atte()t to (a8i(i/e inventory turnover 5hile atthe sa(e ti(e (ini(i/e inventory carrying costs 2or holdingcosts4"




C1rry,n. 2ot H all costs associated 5ith inventory invest(ent)lus storage costs, 5hich (ight include interest, insurance,ta8es, and storage e8)enses, a(ong others"



Order $oo

lso called a 01nt 3,t or 01nt 4oo5 " %i()lest +or( o+ inventory control"

Provides the least a(ount o+ organi/ed control o+ inventory<highly de)endent on the active )artici)ation o+ sta0"

Listed drugs are ordered )eriodically +ro( 5holesalers or othersu))liers"

It is co((on +or the individuals to not notice the need +or a drugor +orget to note the need on the order *oo 2causing aninventory shortage that is e(*arrassing and di?cult to (anagein the course o+ urgent or routine )atient care4"



Order $oo

Even the (ost diligent and attentive individuals can(ae (istaes *ecause the order list a))roach reliese8cessively on )eo)le7s (e(ories and individualdiscretion"

I+ too (uch is ordered, at *est, it (ay reduce inventoryturnover, 5hile at 5orst, it (ay re(ain unused on theshel+ until it e8)ires and (ust *e returned to thesu))lier" !here+ore, the order *oo syste( is usually nothe sole (ethod o+ inventory (anage(ent and is o+tenused in conunction 5ith one o+ the other syste(s(entioned )reviously"



Par=Level %yste(s

$%ED ON PRINCIPLE !1! INDIIDULINEN!OR' DRUG U%E LL% JI!1 RNGE ORKPR=LEEL

!1I% I% J1ERE RNGE I% IDEN!IIED ND#INI#U# ND #MI#U# UN!I!IE% RE %E!

#ORE %OP1I%!IC!ED !1N !1E ORDER $OO RELIE% ON PREDE!ER#INED ORDER UN!I!'ND ORDER POIN!

L%O NOJN % #INI#U#-#MI#U# %'%!E#%



Par=Level %yste(s

Can *e (anaged

9" M1nu133y

S/e36 L14e37St,25er

= develo)ed +or each inventory )roductthat identi>es the )ar=levels o+ drug to *ee)t on hand

= acts as a general guide +or sta0 to avoidrunning short on a )roduct or overstocing



:" E3e2tron,2133y Per8etu13 Inventory

= a record o+ inventory that is constantlyu)dated 5hen ite(s are added or su*tracted+ro( inventory"

= each dis)ensing transaction is su*tracted +ro(the )er)etual inventory

Par=Level %yste(s



9ut:,n:t,-e Inventory M1n1.e-ent

= a )hiloso)hy o+ inventory (anage(ent 5her)roducts are ordered and delivered at ust theright ti(e= 5hen they are needed +or )atientcare= 5ith a goal o+ (ini(i/ing 5asted ste)s,

la*or, and cost = its goal is to neither over= nor under=stoc

)roducts

Par=Level %yste(s



Econo(ic #odels Econo(ic (odels o+ inventory control

atte()t to use econo(ic and statistical(ethods to )redict the need +or drugs oveti(e""* P1reto A;C An13y,

=*ased on the ;B-:B )rinci)le that states that a))ro8i(ately ;o+ (ost )ro*le(s can *e attri*uted to roughly :BQ o+ their

)otential causes" = highlights that a relatively s(all nu(*er o+ drugs account +or

dis)ro)ortionate a(ount o+ drug usage

= essentially grou)s the inventory )roducts *y aggregate valuevolu(e o+ use into three grou)s

2, $ and C4



%* E2ono-,2 Or<er =u1nt,ty >EO=?

= another (ethod that atte()ts to (ini(i/e inventoryholding costs and ordering costs

= also no5n as the #ini(u( Cost uantity ))roach

= relies heavily on the accuracy o+ various data in)uts such

as annual )roduct usage and annual cost )er average on=hand inventory unit"

= i+ calculated accurately, it results in the (ost cost=e?cienorder .uantity

= relatively di?cult in )har(acy )ractice *ecause o+ the5ide varia*ility o+ the individual )atient7s )har(aceutical

needs"

Econo(ic #odels



Dru. Re2133

(anu+acturer, on its o5n or at the direction o+the D, 5ill occasionally recall)har(aceuticals +or reasons such as(isla*eling, conta(ination, lac o+ )otency,lac o+ adherence to the acce)ta*le Good#anu+acturing Practices, or other situations

that (ay )resent a ris to )u*lic health a )har(acy (ust have a syste( +or ra)id

re(oval o+ any recalled )roducts



Ro3e o6 FDA ,n Dru.7Pro<u2tRe2133

!he D )lays an active role in drug=recall )rocess !he D also classi>es recall actions in accordance

5ith the level o+ ris and +or(ulates recall strategieon the *ase o+ the health ha/ard )resented *y the)roduct *eing recalled

they decide on the need +or )u*lic 5arnings andassists the recalling agency 5ith )u*lic noti>catona*out the recall as needed



!o) Reasons +or Drug Recalls

9" Deviations in good (anu+acturing )rocesses at the(anu+acturer

:" %u*)otency

" %ta*ility data does not su))ort e8)iration date

" Generic drug or ne5 drug a))lication discre)ancies

@" Dissolution +ailure

6" La*el (i8=u)s

F" Content uni+or(ity +ailure

;" Presence o+ +oreign su*stances

" )1 +ailures

9B" #icro*ial conta(ination o+ non=sterile )roducts



Role of Manufacturer/Distrib

in Recalls

#" LUR

$ecause o+ their res)onsi*ility to )rotect the )u*lic



$ecause o+ their res)onsi*ility to )rotect the )u*licconsu(ers, (anu+acturers-distri*utors i()le(ent

vo3unt1ry re2133 5hen a (areted drug )roductneeds to *e re(oved +ro( the (aret"

(ethod o+ recall is (ore e?cient anensuring ti(ely consu(er )rotection

initiated

Recall notices sent in 5riting to )har(acies *y the(anu+acturer o+ the )roduct or *y drug 5holesalers

indicates

a4 the reason +or the recall*4 the na(e o+ the recalled )roductc4 the (anu+acturerd4 all a0ected lot nu(*ers o+ the )roducte4 instructions on ho5 to return the )roduct

to the (anu+acturer

On recei)t o+ the recall notice 8/1r-12y



On recei)t o+ the recall notice 8/1r-12yte2/n,2,1n 5ill chec all )har(aceuticalinventory stores to deter(ine i+ any recalled)roducts are in stoc

I+ none o+ the recalled )roducts are in sindicating @none ,n to25 is 5ritten

notice and >led in a recall log to docu(recall 5as )ro)erly

I+ a recalled )roduct is in stoc, all )roduct

gathered, )acaged, and returned to the (according to the instructions on the re

!he )acage should *e revie5ed *y the )hcharge *e+ore returning it to the (a



I+ )atients have received a recalled )roduct, the )har(acharge tae actions reco((ended *y the institution7s)olicies and )rocedures

On co()letion o+ all activity regarding the )roduct recasu((ary o+ actions taen should *e docu(ented on theletter and >led +or later access"



!he D has *een no5n the re.uest docu(eo+ all recall activities to ensure co()liance an

ulti(ately, )atient sa+ety"

!he )har(acist in charge should *e noti>ed *ehe-she 5ill need to decide 5hich, i+ any, alterna)roducts (ay need to *e )laced into inventory

thera)eutic alternatives to the out=o+=stoc ite



DRUG %1OR!GE%

#anu+acturers 5ill *e una*le to su))ly a )har(aceutical*ecause o+ various su))ly and de(and situations"

involve the ina*ility o+ the (anu+acturer to o*tain ra5(aterials, (anu+acturing di?culties related to e.ui)(en+ailure, or si()ly the ina*ility to )roduce su?cient .uantto stay ahead o+ the (aret de(and +or the )har(aceut

Drug shortages are a reality that (ust *e dealt 5ith to avoco()ro(ising )atient care"

s 5ith drug recalls, the )har(acist in charge should *e noso he-she can co((unicate drug shortages and reco((enalternative thera)ies e0ectively to )rescri*ers"



ORDERING AND BORROWI

PHARMACEUTICA

P/1r-12eut,213 Pur2/1,n. Grou



P/1r-12eut,213 Pur2/1,n. Grou

Grou) Purchasing Organi/ation 2GPO4 == #ost are health syste( )har(aci

1ealth syste(s, hos)itals, and a(*ulatory )ractices can oin together in a )grou) to leverage collective *uying )o5er and tae advantage o+ any lo5er

(anu+acturers o0er to large grou)s that can guarantee a signi>cant volu(eover long )eriods o+ ti(e 2ty)ically 9 to : years4"

Contracts (ay involve sole=source or (ultisource )roducts"

%ole=source )roducts ty)ically *rand=na(e drugs are availa*le +ro( only one (anu+acture

#ultisource )roducts

o+ten generics or su*stitute )roducts availa*le +ro( nu(erous (anu+acturers

GPOs negotiate )urchasing contracts that are (utually +avora*le to (e(grou) and to (anu+acturers" #e(*ers *ene>t +ro( lo5er drug )rices andneed +or sta0 to s)end ti(e esta*lishing and (anaging )urchasing contra)roduct vendors" #anu+acturers *ene>t +ro( a steady de(and +or )roduc)urchasing organi/ation"



GPO guarantees the )rice +or )har(aceuticals over the esta*lished contract

Jith the )urchase )rice )redeter(ined, the )har(acy can order the )roduct dthe (anu+acturer or +ro( a 5holesale su))lier"

Occasionally, (anu+acturers are una*le to su))ly a given )roduct that the )ha*uying on contract, 5hich (ay re.uire the )har(acy to *uy or su*stitute a co()roduct not on contract at a higher cost"

#ost )urchasing contracts 5ill include language to )rotect the )har(acy +ro( additional e8)enses in the event this occurs"

Generally, the (anu+acturer 5ill *e lia*le to re*ate the di0erence in cost *ac

)har(acy 5hen this occurs" !here+ore, it is i()ortant that the 8/1r-12y tdocu(ents any resulting o0=contract )urchases and shares these 5ith )har(acist in charge +or reconciliation 5ith the contracted )roduct ven

DIREC! PURC1%ING



DIREC! PURC1%ING

Involves the e8ecution o+ a )urchase order +ro( the)har(acy to the (anu+acturer o+ the drug instead o+indirectly through a 5holesaler

dvantage

94 not having to )ay handling +ees to athird=)arty 5holesaler

:4 a*ility to order on an in+re.uent *asis,and

4 a less de(anding syste( +or (onitoringinventory

Di d t



Disadvantages 94need to order larger .uantities

to tae advantage o+(anu+acture discounts

:4 need +or (ore ca)acity tostore the additional inventory,(ore cash tied u) ininventory, (ore co()licateddrug return and crediting

4need to s)end (ore ti(e to)re)are, )rocess and )ay)urchase orders to (anydi0erent co()anies, and

4the lielihood that the

(anu+acturer (ay *e distant



Purchasing through a prime vendor

allows for drugs to be received shortly before us

Purchasing +ro( a 5holesaler is a highlye?cient and cost=e0ective a))roach

to5ard )har(aceutical )urchasing andinventory (anage(ent"

Drug Jholesaler Purchasing- Pri(e



Drug Jholesaler Purchasing- Pri(eendor Purchasing

Jhen a health=syste( )har(acy agrees to )urchase (ost2BQ to @Q4 o+ its)har(aceuticals +ro( a single 5holesale co()any, a )ri(e vendor contractarrange(ent is esta*lished, and, custo(arily, a contract *et5een the )har(acand the drug 5holesaler is develo)ed"

Usually 5holesaler agree to deliver @Q to ;Q o+ the ite(s on acce)ta*leschedule and o0er a :hr-Fday )er 5ee e(ergency service" !hey also )rovidethe )har(acy 5ith electronic order entry-receiving devices, a co()uter syste(+or ordering, *ar=coded shel+ sticers, and a )rinter +or order con>r(ation

)rintouts" !hey (ay also o0er highly co()etitive discounts including those +or)re)ay(ent"

!hese 5holesaler services (ae the )ri(e vendor contracts a))ealing andresult in (ore ti(ely ordering and delivery, less ti(e s)ent creating )urchaseorders, +e5er inventory carrying costs, less docu(entation, co()uter=generatelists o+ )har(aceuticals )urchased, and overall si()li>cation o+ the credit andreturn )rocess"

$orro ing Phar(aceuticals



$orro5ing Phar(aceuticals

!here 5ill *e ti(es 5hen the )har(acy #U%! $ORROJDRUG% RO# O!1ER P1R#CIE%S

#ost institutional )har(acies have )olicies and )roceduresaddressing this situation

$orro5ing or loaning drugs *et5een )har(acies is usuallyrestricted to e(ergency situations and li(ited to authori/ed sta0

li(ited to co((ercially availa*le )roducts

#ost )har(acies have develo)ed +or(s to docu(ent and trac*orro5ed or loaned (erchandise" !hese +or(s also hel) sta0docu(ent the details i()erative to error=+ree transactions"



CON!ROLLED %U$%!NCE%



1ave s)eci>c ordering, receiving, storage, dis)ensing, inventory,record=ee)ing, return, 5aste and dis)osal re.uire(ents esta*lishedunder the la5"

!he Phar(acist7s #anual n In+or(ational Outline od the Controlled%u*stances ct o+ 9FB

%1P !echnical ssistance $ulletin on Institutional Use o+ Controlled%u*stances

In so(e )har(acies, )har(acy technicians 5or 5ith )har(acists to(anage inventory and order, dis)ense, store, and control narcotics and

other controlled su*stances"

!5o )rinci)les 9"4 Ordering and receiving %chedule II controlledsu*stances re.uires s)ecial order +or(s and additional ti(e 29= days4

:"4 these su*stances are inventoried and traced continuously via a)er)etual inventory )rocess, 5here*y each dose or )acaged unit isaccounted +or at all ti(es"

INE%!IG!IONL DRUG%



lso re.uire s)ecial ordering, inventorying, and handling )rocedures

Generally, the use o+ investigational drugs is categori/ed into t5o distincareas

9"4 in a +or(al )rotocol a))roved *y the institution

:"4 +or a single )atient on a one=ti(e *asis that has *een authori/ed *y th(anu+acturer and the D

In *oth cases Physician H ordering

Phar(acy %ta0 H inventory (anage(ent

%o(e )har(acies associated 5ith acade(ic a?liations or institutionsconducting clinical research are (anaged *y

Investigational drug service )har(acist H res)onsi*le +or ordering,dis)ensing, and inventory (anage(ent o+ investigational drugs according tthe research )rotocol

CO#POUNDED DRUG%



E8te()oraneously )re)ared in the )har(acy as indicated *yscienti>c co()ounding +or(ulas and )rocesses

#ay include oral li.uids, to)ical )re)arations, solid dosage+or(s or sterile )roducts

Re.uires that )rescri*ing )atterns and e8)iration dates *e(onitored closely *ecause (any co()ounded )roducts haveshort shel+ lives

Phar(acy technicians H (onitor )atient use o+ co()oundeddrug, )roduct e8)iration dates and identi+ying additional stocneeds

%)eci>c )har(acy technicians (ay initiate co()oundingactivities, *ut this (ay vary according to de)art(ental)rocedures

REPCGED P1R#CEU!ICL%



REPCGED P1R#CEU!ICL%

Unit=dose ta*lets and ca)sules, unit=dose oral li.uids, and so(e *ul

)acages o+ oral solids and li.uids

Each )har(acy esta*lishes stocing (echanis(s +or these )roducts anrelies on )har(acy technicians to identi+y and res)ond to )roduction anstoc needs"

Generally, designated technicians coordinate re)acaging activities, *uso(e )har(acies (ay integrate re)acaging 5ith other )har(acy

technician res)onsi*ilities" no5ledge o+ the de)art(ent7s )rocedures +or re)acaging is re.uired

)revent disru)tions in dis)ensing activities

#EDIC!ION %#PLE%



#EDIC!ION %#PLE% %torage and use o+ (edication sa()les in institutions

controversial and re.uires s)ecial handling )rocedures

!raditional inventory (anage(ent and handling )ractices dnot 5or 5ell 5ith (edication sa()les +or : reasons

9" #edication sa()les are not ordered *y the )har(acist< theare usually )rovided to )hysicians on re.uest *y the dru(anu+acturer +ree o+ charge" 'is oten occurs *itout t parmac!+s kno*ledge,

:" %a()les are not usually dis)ensed *y the )har(acy

!hese +actors (ae it di?cult to no5 5ho( to contact i+ (edication sa()le is recalled and to ensure that (edicatiosa()les are not sold

#EDIC!ION %#PLE%



#EDIC!ION %#PLE%

I+ an organi/ation allo5s sa()les, they 5ill )ro*a*ly *e storedoutside the )har(acy, and )har(acy )ersonnel 5ill *e re.uiredto register and ins)ect the stoc o+ (edication sa()les

Phar(acy technicians H o+ten res)onsi*le +or deter(ining i+ asa()le is registered 5ith the )har(acy, stored in acce)ta*le.uantities, la*eled 5ith an e8)iration date that has not *eene8ceeded, and generally stored under acce)ta*le conditions

PROPER DI%PO%L ND RE!URN OP1R#CEU!ICL%



P1R#CEU!ICL%

EMPIRED P1R#CEU!ICL%

Each year, a))ro8i(ately :Q o+ all drugs shi))ed to)har(acies are returned to the (anu+acturer

Generally, 5holesalers 5ill not give +ull credit on returns o)roducts that 5ill e8)ire 5ith 6 (onths

!o return )roducts, )har(acy )ersonnel (ust co()lete th

docu(entation re.uired *y the )roductsT (anu+acturer or5holesaler and )acage the )roduct so it can *e shi))ed

!echnicians o+ten )er+or( these duties under thesu)ervision o+ )har(acist" %o(e )har(acies contract 5ithan outside vendor 5ho co()letes the docu(entation andcoordinates the return o+ these )roducts +or a +ee

E8)ired re)acaged )har(aceuticals



Dis)osal o+ e8)ired co()ounded or re)acaged )har(aceuticals *y th)har(acy technician should *e co()leted under the su)ervision o+ the)har(acist

Phar(aceuticals co()ounded or re)acaged *y the )har(acyde)art(ent cannot *e returned and (ust *e dis)osed o+ a+ter they hae8)ired

Pro)er dis)osal )revents the use o+ su*=)otent )roducts or )roducts5ithout guaranteed sterility

E8)ired re)acaged solids can *e dis)osed o+ using the general trashre(oval syste(

E8)ired co()ounded cytoto8ic )roducts (ust *e dis)osed o+ accordingto ha/ardous 5aste re(oval )rocedures

E8)ired re)acaged



E8)ired re)acaged)har(aceuticals

Other )roducts re.uiring dis)osal rather than return areche(icals used in the )har(acy la*oratory

E8a()les

sodiu( *en/oate or sodiu( citrate 2)reservatives4

lactose or talc 2e8ci)ients4

$u0ers and active ingredients such as hydrocortisone,

tria(cinolone, neo(ycin or lidocaine )o5ders !hey should *e dis)osed o+ in accordance 5ith the )har(acy7s

ha/ardous 5aste )rocedures

E i d t ll d * t



E8)ired controlled su*stances

E8)ired controlled su*stances are dis)osed o+ uni.uely

#ay not *e returned to the (anu+acturer or 5holesaler +ocredit

!hey (ust *e destroyed and the destruction (ust *edocu(ented to the satis+action o+ the DE

DE= )rovides a s)eci>c +or( KRegistrant7s Inventory o+Drugs %urrendered +or recording the dis)osal o+ e8)iredcontrolled su*stances

Ideally, the actual dis)osal o+ e8)ired controlled su*stancshould *e co()leted *y a co()any sanctioned *y the DEor *y re)resentative o+ the state *oard o+ )har(acy

E8)ired investigational drugs




%hould *e returned to the (anu+acturer or s)onsor o+ aninvestigational drug study according to the instructions they)rovide

Investigational drugs that e8)ire *ecause o+ 8ro<u2t t14,3,tyor ter,3,ty ,ue should never *e discarded" !hese dosesshould *e retained 5ith the investigational drug stic and *eclearly (ared as e8)ired drug )roducts *ecause the

investigational study s)onsor 5ill need to revie5 and account +oall e8)ired investigational drug )roducts





Phar(aceuticals that need to *e returned *ecause o+ a ordering errorre.uire authori/ation +ro( the original su))lier and the a))ro)riate+or(s

!he Prescri)tion Drug #areting ct (andates that )har(aciesauthori/e and retain records o+ returned )har(aceuticals to )revent)otential diversion o+ )har(aceuticals

)har(acy 5ill have a )rocess +or returning (is=ordered (edication

to the )ri(e drug 5holesaler on a routine *asis, 5hich )revents theneed +or storage in the )har(acy o+ overstoced or (is=ordered)roducts

Phar(acy technician is res)onsi*le +or relevant docu(entation, >lling)a)er5or, and )acaging returned )roducts under the su)ervision othe )har(acist



UIZ



UIZ

94 !he is develo)ed and(aintained *y the P 3 ! co((ittee andthe cornerstone o+ the )urchasing and

inventory control syste("

a4 Inventory turns

*4 Pri(e vendor contracts

c4 Order $oo

d4 or(ulary

UIZ



UIZ

:4 !he )rocess o+ )lacing ne5ly ac.uired

)roducts *ehind currently stoced

(edications o+ the shel+ is called "

a4 or(ulary %yste(

*4 Electronic #edical Record %yste(c4 %toc Rotation

d4 Inventory !urns

UIZ



4 Jhich o+ the +ollo5ing syste(s o+ inventorycontrol syste( is no5n as the(a8i(u(-(ini(u( (ethod o+ inventory controlV

a4 Par=level

*4 EO a))roachc4 Pareto $C analysis

d4 Order *oo

UIZ



4 Jhich o+ the +ollo5ing inventory controlsyste(s is the least so)histicated and (ost)rone to )oor inventory controlV

a4 Par=level

*4 EO a))roach

c4 Pareto $C analysis

d4 Order *oo

UIZ



@4 Jhich o+ the +ollo5ing drugs can *ereturned to su))liers a+ter e8)irationV

a4 Pre)acaged drugs

*4 Che(ical grade )roducts

c4 Investigational drugs

d4 Controlled su*stances

!RUE or L%E



64 Purchasing drugs direct +ro( the(anu+acturers saves the )har(acies (onein co()arison to ordering +ro( 5holesalers

F4 oluntary recalls o+ )roducts initiated *ythe D are (ore e?cient and e0ective in

ensuring ti(ely consu(er )rotection thanD recalls or sei/ures initiated through

court action"

!RUE or L%E



;4 grou) )urchasing organi/ation 2GPO4guarantees the )rice +or

)har(aceuticals over the esta*lishedcontract )eriod"

4 ey goal o+ inventory (anage(ent isto (ini(i/e inventory turns, (eaning

si()ly that )roducts shouldn7t *e usedand (ust re(ain on the shel+"

UIZ !RUE or L%E



9B4 Co()ounded )roducts aree8te()oraneously )re)ared in the)har(acy as indicated *y scienti>c

co()ounding +or(ulas and

)rocesses"

Hospital Pharmacy Group 6

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Transcript of Hospital Pharmacy Group 6