APTI ijopp - Indian Journal of Pharmacy Practice

pivotal to the rational use of medicines (Weekes and This article describes initiatives in rationalBrooks, 1996) and it has been shown that effective PTCs pharmaceutical management as a part of the newlyplay a very active part in educational, communication initiated PTC's activities of Bangalore Institute ofand advisory roles when clinicians, pharmacists and Oncology (BIO). BIO was founded in 1989 as thenursing representatives work together with flagship unit of Banashankari Medical and Oncologyadministrative personnel on PTCs. Based on this proven Research Center Ltd (BMORC). BMORC, initiallyevidence from developed countries, some developing incorporated as a Private limited Company on 13countries such as Brazil (Cruz and Paola, 2006) and Laos November 1986, became a public limited company in(Vang, 2006) have actively adopted the concept of PTCs 1992. It was the first private Comprehensive Cancerin their hospitals to advocate rational therapeutics that Hospital in Bangalore and Karnataka. The idea for such apromote evidence-based medicine along with clinical hospital was initiated and is managed, by like-mindedeffectiveness and not just cost effectiveness.and dedicated cancer specialists who realized that thePharmaceutical management as proposed by theexisting facilities in the government hospitals were notManagement Sciences for Health (MSH) (Quick et al,sufficient to meet the demands and the private sector1997) and the World Health Organization (WHO)needed to step in. BMORC manages and operates BIO, ainvolves four functions: Selection, Procurement,comprehensive cancer center which started its services inDistribution and Use. This cycle requires support of legal1989 with 5 consultants and 30 beds. It is now a 145-bedand policy framework as well as management supporthospital with over 60 consultant physicians and a staffthat comprise financing, information management,strength of 546 people. BIO treats nearly 3000 newhuman resources and organization. Analytical techniquescancer patients every year, and around 110 patientsare designed in developed countries and cost-consciousreceive radiotherapy every day. Besides, the dailycountries to identify and control excess costs inoutpatient attendance exceeds 300. Nearly 1800 majorpharmaceutical management. Even by the 1980s,operations are performed every year. These numbers aredeveloped countries spent about 100 times as much onever increasing.health and 20 times as much on pharmaceuticals, on a perBIO's PTC was initiated in October 2007, with thecapita basis, when compared to developing countriesobjective of promoting rational use of medicines. The(Patel, 1983) and this trend continues to be predominant.PTC is a standing hospital committee responsible,Hence, industrialized countries have adopted techniquesthrough its chairman, to the Hospital executive board. Itto contain costs. This resulted in techniques such as ABCis a policy recommending body to the medical staff andanalysis and Therapeutic Category analysis to quantifyadministration of the hospital on matters related to thecosts and identify areas where costs could be reducedtherapeutic use of drugs. Improved health and economic(Quick et al, 1997; Quick 1982). Cost reducing strategiesoutcome of the hospital care, particularly those related toare aimed at increasing the effectiveness and efficiencythe medication remains the core objective of the PTC.of pharmaceutical supply.MethodologyABC analysis is also known as Pareto analysis. It is aPharmacy and Therapeutics Committee of BIO decidedwell-known method in inventory management, and is ato use the concept of ABC Analysis for rationalizing theuseful tool in analyzing consumption patterns and thedecisions of pharmaceutical procurement ofvalue of total consumption. A Canadian study highlightsAntineoplastic medicines to start with.the extent to which cost effectiveness evaluation is aABC analysis ranks a set of pharmaceuticals byuseful input in decision-making moving beyondcalculating the expenditure on each medicine as aexamining budgets and towards broader balancedpercentage of the total expenditure on all medicines in thebenefits of therapeutic outcomes with economicset. It is a method advocated by WHO and MSH foroutcomes (Dugal et al, 2002). This approach is a directassembling data to determine where money is being spentconsequence of growing concern about rising health care(Quick et al, 1997).costs due to pharmaceuticals as the main component of a. All items purchased are listed according to year andexpenditure (Levy and Gagnon, 2002; Fernandes, 2002). unit cost.Cost-cutting strategies from policy makers, hospital b. Consumption quantities for each are entered.administrators, and health care professionals generally c. Value of consumption is calculated for each bytargeted pharmaceutical expenditures first.multiplying the unit cost by the number of units47