Indexabbreviations of medicines, 35.5ABC analysis

in Asian countries, 40.16, 40.18of expenditures, 40.13–40.19in procurement, 18.15in supply strategies, 40.19

ABC/FS system, 23.15absolute monopolies, 9.4access to medicines

acceptability, 1.8–1.9affordability, 1.8–1.9 assessing, 1.11–1.12availability, 1.8–1.9challenges in, 1.12–1.18consumer products vs., 1.5costs of, 1.4–1.6defining, 1.8distribution management in, 1.11economic goals in, 1.8efficiency of, 1.13–1.16essential medicines concept in, 1.7–1.8financial sustainability and, 1.12financing strategies for, 11.13globalization of, 3.3–3.10glossary terms, 3.21governance and, 1.10–1.11, 1.13–1.16governments and, 1.17health-related goals in, 1.8history of, 2.2–2.3as human right, 3.5, 4.14indicators of, 36.11insurance benefits for, 12.11intellectual property and, 3.3–3.10lack of support systems for, 2.7monitoring, 1.11–1.12national development goals in, 1.8national medicine policies and, 1.8–1.9, 4.14public health objectives for, 1.7–1.8rational medicine use and, 1.11–1.12registration and regulation in, 1.18, 3.12–3.14selecting medications in, 1.10traditional medicine in, 5.4, 5.8, 5.12

accountabilityin health facilities, 46.4in human resources management, 51.16in national medicine policies, 4.14

accountingcomputer use for, 50.6in financial management, 41.17–41.19in health services contracts, 39.15

accounts payable and receivable, 21.20, 41.18accredited drug-dispensing outlets (ADDOs)

for access to medicines, 1.16in Tanzania, 32.6–32.9, 32.13–32.14

acquisition of medicines. See procurement of pharmaceuticals

acquisition of storage facilities, 42.8ACT. See artemisinin-based combination therapyAction Programme on Essential Drugs (WHO), 36.16–

36.17active data collection, 35.10activity-time charts, 38.14ACT UP (AIDS Coalition to Unleash Power), 2.7,

31.3ADDOs. See accredited drug-dispensing outletsadherence to treatment

complexity and duration of treatment and, 33.8determinants of, 33.9–33.10introduction to, 33.4–33.9

adjudicating tender, 21.15–21.18adjusted consumption method, 18.5, 47.9adjusting final quantities, 20.13–20.15adverse drug events (ADEs), 35.5–35.6, 35.13. See also

pharmacovigilanceadverse drug reactions (ADRs)

data on, 29.4monitoring, 6.9in pharmacovigilance, 35.3–35.4quality assurance vs., 19.7reporting, 35.15

adverse selection (in insurance), 11.11, 12.6advertising, 6.10advocacy groups, 2.7, 31.3. See also community

participation

I.2 InDEx

affordabilityin national medicine policies, 4.7, 4.9of products and services, 1.8–1.9of traditional medicine, 5.4

Afghanistan, 31.7, 45.6African countries

adherence to ART in, 28.10Bamako Initiative in, 31.9community-based health insurance in, 12.13counterfeit medicines in, 19.9health facility medicine use in, 28.8health insurance in, 12.16HIV/AIDS treatment in, 18.10human resources in, 51.10nGO essential medicines services in, 8.15pharmaceutical production in, 7.5price of services in, 41.3registration of medicines in, 6.13retail drug seller education in, 32.4RxSolution in, 50.12scaling up ART in, 20.8supply management training in, 52.15training networks in, 52.13TRIPS flexibilities in, 3.11voluntary licensing in, 3.9

aggregation of data, 28.4, 28.9–28.11aggregation of demand, 18.13AIDS Coalition to Unleash Power. See ACT UPAIDS Medicines and Diagnostics Service (WHO), 2.6AIDS Research Alliance, 5.14AIDS treatment. See HIV/AIDS treatmentair waybills, 24.7–24.8allocative efficiency, 10.9–10.10, 11.3Alma Ata Declaration of 1978, 31.2alphabetizing stock, 44.13alternative distribution channels, 6.13–6.14alternative medicine. See traditional medicine (TM)American Hospital Formulary Service (AHFS), 16.10,

40.21American Society of Health-System Pharmacists, 45.4AMR. See antimicrobial resistanceAnatomical, Therapeutic, and Chemical (ATC)

classifications, 16.13, 28.4, 40.21annual purchasing, 23.12–23.13, 23.15annualized capital costs, 10.13antibiotics

health facilities’ use of, 28.9rational prescribing, 29.5, 29.12–29.16reviewing use of, 29.16standard treatment guidelines and, 29.8

antimalarials, 33.16. See also artemisinin-based combination therapy (ACT)

antimicrobial resistance (AMR)in Chile, 27.11

in Kenya, 40.15prevalence, 27.6rational medicine use vs., 27.5–27.6, 27.14

antiretroviral therapy (ART)adherence to treatment in, 28.10, 33.4assessing management of, 36.4–36.5in Brazil, 9.9computer use in, 50.14controlling theft of, 43.3costs of, 1.13, 9.9effectiveness of, 1.5Electronic Dispensing Tool for, 49.6history of, 2.6human resources crisis and, 51.2–51.7, 51.12–51.16in Kenya, 30.4, 37.17, 48.4–48.5, 51.6medication counseling for, 33.6and pharmacovigilance, 35.9pricing of, 9.9, 9.11quantifying pharmaceutical requirements for, 20.8in Rwanda, 17.15in South Africa, 46.11in Uganda, 47.3voluntary licensing and, 3.9

antiretrovirals (ARVs). See antiretroviral therapy (ART)appeal periods (in tendering), 21.18appropriate medicine use by consumers. See consumer use

of medicinesappropriate use of medicines. See rational medicine useArab countries, 28.11ARI (acute respiratory infection), 17.9ART programs. See antiretroviral therapy (ART)artemisinin-based combination therapy (ACT)

costs of, 1.13effectiveness of, 1.10problems with, 2.6and rational medicine use, 27.6rational use of, 33.14

ARVs (antiretrovirals). See antiretroviral therapy (ART)

Asian countriesABC analysis in, 40.16, 40.18counterfeit medicines in, 19.9health facility medicine use in, 28.8tablet and capsule embossing in, 43.7transparency assessments in, 36.12TRIPS flexibilities in, 3.11

assessmentsin pharmaceutical management planning, 38.7–38.9in pharmaceutical procurement, 18.11in pricing policies, 9.15–9.16of retail drug outlets, 28.18

ATC. See Anatomical, Therapeutic, and Chemical (ATC) classifications

audits, 18.12, 18.16, 35.12

InDEx I.3

Australiachoosing standard treatments in, 17.8national medicine policies in, 4.16Pharmaceutical Advisory Council in, 4.16pharmaceutical benefits scheme in, 9.7pharmaco-economics in, 10.8rural pharmacy program of, 51.5–51.6treatment guidelines in, 17.5

Australian Prescriber, 34.6automated medication dispensing, 45.9autonomous supply agencies, 8.7–8.10, 18.16availability. See also access to medicines

in inventory management, 23.7of medicines and supplies, 31.5of products and services, 1.8–1.9

average consumption, 23.16average cost per unit, 10.13average inventory-holding costs, 23.6

balance sheets, 41.18–41.19Bamako Initiative, 31.3, 31.9bank guarantees, 24.7bar coding, 19.15Basic Support for Institutionalizing Child Survival

(BASICS), 1.17, 31.12, 32.4, 32.14Basic Surgical Instruments Supply Kit, UnICEF, 47.8batch certificates, 19.13batch number registration, 43.7benchmarks, in drug use review, 29.11–29.12, 29.14Benin, 31.9best practices

for donor financing, 14.4for management, 37.6–37.11for retail drug sellers, 32.5–32.7

BIAC. See Business and Industry Advisory Committee to the OECD

bilateral agencies, 14.5bilateral donors, 14.8bilateral trade agreements, 3.13Bill & Melinda Gates Foundation. See Gates Foundationbills of lading, 24.7–24.8bin cards, 23.4bioavailability, 19.4–19.5Biopharmaceutical Classification System, 19.5BnF. See British National FormularyBolar exception, 3.7, 3.12Bolivia, 12.6–12.8Bosnia, 15.4bottom-up management approach, 13.12, 38.5–38.6brand premiums, 9.18branded off-patent medicines, 9.9–9.10brand-name drugs, 17.13Brazil

access indicators in, 36.11

diarrhea treatment in, 28.17information management in, 49.13medication counseling in, 30.9pricing policies in, 9.9

break-even analysis, 41.9bribery control, 43.9–43.11British National Formulary (BnF)

on CD-ROM, 50.16essential medicines lists in, 16.7, 16.10, 16.13on PDAs, 17.14, 50.9treatment guidelines in, 17.3

British Pharmacopoeia, 19.8budgets

for building storage facilities, 42.8–42.9for facilities, 29.15in financial management, 41.10–41.12gap analysis in, 11.10of governments, 11.7–11.10in health services contracts, 39.15and inventory management, 23.18for laboratory services, 47.4operating, 41.16per capita, 11.10performance reports on, 41.17requirements for, 20.4service-level projections for, 20.4–20.5, 20.26–20.28template for, 48.18transfers in, 12.8

building storage facilities. See storage facilitiesbulk storage, 46.3, 46.4Buscando remedio (treatment guidelines, nicaragua),

17.5business ethics, 32.12Business and Industry Advisory Committee to the OECD

(BIAC), 3.17buyer strategies to decrease prices, 9.14–9.17

CAM (complementary and alternative medicine). See traditional medicine (TM)

Cambodiaaccess indicators in, 36.11health services contracts in, 39.12kit systems in, 26.14medication counseling in, 30.9supply of medicines in, 26.14tuberculosis treatment in, 31.14

Canada, 50.9capacity

of staff. See human resources management (HRM)in supply strategies, 8.17training programs for, 52.3

capacity-building framework, 52.3capital costs, 10.13capitalization requirements, 13.9–13.10

I.4 InDEx

capitationpayments, 12.7–12.8reimbursements based on, 29.17systems, 9.19

capsule imprinting, 43.7cardiovascular diseases, 1.5career development, 44.17, 51.20CAREshops (Ghana), 1.16, 32.9Caribbean countries

health facility medicine use in, 28.8health insurance in, 12.16oral vs. injectable antibiotics in, 29.13scheduled purchasing in, 23.14TRIPS flexibilities in, 3.11

carriage and insurance paid (CIP), 21.7, 21.16, 39.5carrying costs, 22.16case payments, 12.8case records review, 28.11–28.12cash planning, 41.12–41.14categories of pharmaceuticals, 3.3CD-ROMs, 50.16–50.18Center for Pharmaceutical Management (CPM), 36.7centers for medicine information. See medicine

informationcentral medical stores (CMS)

balance sheets for, 41.19in financial planning, 41.3–41.7government vs. RDF budgets in, 41.5income and expense reports for, 41.18introduction to, 1.15managing. See medical stores managementin namibia, 44.3operating budgets for, 41.16price structure in, 41.11procurement for, 18.16in supply strategies, 8.7in Zimbabwe, 25.15

certificates of origin (COs), 24.7certificates of quality (CQs), 24.7certification of products, 19.10–19.14change management, 37.15–37.20, 38.7children

BASICS for, 1.17C-IMCI for, 31.6and consumer use of medicines, 33.5drug management for, 28.12, 31.11–31.12health services for, 12.7health services for mothers and, 1.5, 12.7PMTCT for, 20.9treatment for, 31.6, 31.12UnICEF and. See UnICEF

Chile, 27.11chloramphenicol, 2.2–2.3chloroquine, 2.2

chlorpromazine, 2.2cholera treatment, 20.6chronic diseases, 1.5CIF (cost, insurance, and freight), 18.24, 21.7, 21.16, 39.5C-IMCI (Community Integrated Management of

Childhood Illness), 31.6CIP. See carriage and insurance paidclassification

Anatomical, Therapeutic, and Chemical, 28.4of biopharmaceuticals, 19.5of cases, 28.6of diseases, 20.19, 28.6of medical store stock, 44.12–44.13of pharmaceuticals, 6.13Pharmacologic-Therapeutic, 40.21of therapeutics, 16.10–16.13

clearing agents, 24.3–24.4climatic factors, 22.12, 22.14clinical evidence, 17.6clinical guidelines. See treatment guidelinesclinical newsletters, 29.9clinical triggers, 35.11clioquinol, 2.3CMS. See central medical storescoaching, 37.13–37.14Cochrane Collaboration, 34.5codeine, 17.13cold-chain requirements, 44.11cold storage, 44.10collating tender offers, 21.15–21.16commercial terms, 39.7Commission on Intellectual Property Rights, Innovation

and Public Health, 3.17commissioning storage facilities, 42.16–42.17committees

for medicine selection. See drug and therapeutics committees (DTCs)

national medicine, 40.12commodities

codes for, 44.13–44.15in donor financing, 14.10

communication with consumers. See also communicationsbehavioral theory in, 33.20commercial interests and, 33.20constraining factors in, 33.20–33.21cultural factors in, 33.21by drug-dispensing outlets, 33.9education campaigns for, 33.19–33.20factors influencing, 33.18–33.21information technology and, 33.20infrastructure for, 33.20interventions in, 33.14–33.18mass media and, 33.20on medicine use, generally, 33.10

InDEx I.5

on medicine-use problems, 33.12–33.14methods for, 33.22neighbor-to-neighbor, 33.16new prescription information, 33.15plans for, 33.18policies for, 33.20principles of, 33.10–33.11professional interests and, 33.20provider-patient, 33.4–33.6for revolving drug funds, 13.18–13.19social factors in, 33.20–33.21social marketing and, 33.14strategies for, 33.11–33.18

communicationswith consumers. See communication with consumersin distribution management, 22.16in management information systems, 49.12in medical stores, 44.4–44.5in monitoring and evaluation, 48.12in procurement, 18.19–18.20in program management, 37.14

community-based health insurancein Africa, 12.13overview of, 12.12–12.15pharmaceutical benefits in, 12.4in Uganda, 12.15

community-based organizations, 2.7Community Drug Management for Childhood Illness

(C-DMCI), 28.12, 31.11–31.12Community Health Fund (CHF) (Tanzania), 12.12community health workers (CHWs), 31.5–31.9, 32.10,

46.12Community Integrated Management of Childhood Illness

(C-IMCI), 31.6community participation

access to medicines via, 31.5case management and, 31.7childhood illness treatment via, 31.6, 31.12environments enabling, 31.14–31.15facility-based health services and, 31.7–31.8health professionals and, 31.10health programming and, 31.10–31.14investigating medicine use via, 28.13–28.14meaning of, 31.3–31.4monitoring health services via, 31.13–31.14needs assessments via, 31.10–31.11organization of, 31.13outreach services and, 31.5–31.7pharmaceutical management and, 31.5–31.9planning of, 31.13pneumonia treatment and, 31.8preventive health care and, 31.5rational medicine use and, 27.8, 31.8–31.9in revolving drug funds, 13.12–13.13

comparative costs (in contracting), 39.12–39.13comparative expenditure analysis, 11.10comparative pricing, 13.15comparison

data, 48.19of financing strategies, 11.13–11.15groups, 28.20in pharmaco-economic analysis, 10.11of supply strategies, 8.13–8.14

competitionfailure of, 8.5in market-based economies, 9.3–9.6, 10.5in negotiations, 18.7, 18.12–18.14, 21.16

complementary and alternative medicine (CAM). See traditional medicine (TM)

Comprehensive Plan for the Treatment and Care of HIV and AIDS (South Africa), 46.11

compulsory licensing, 3.6–3.8, 3.12computer use

for accounting, 50.6in antiretroviral therapy, 50.14data analysis via, 50.11data protection, 50.17–50.18databases, 50.6for desktop publishing, 50.6drug use reviews via, 50.14e-communications via, 50.14–50.16for financial reports, 50.13formulary manuals and, 50.11functional lists/outputs via, 50.13geographic information via, 50.8glossary terms, 50.21–50.23in Haiti, 50.14hardware, 50.8for information management, 49.11–49.12inventory management via, 50.11, 50.13local area networks for, 50.3, 50.7maintenance of, 50.16–50.18manual systems vs. for quantification, 20.9–20.10for medicine information, 50.14–50.16multilocation reports via, 50.13onboard transport vehicles, 25.10order reports via, 50.13for periodic analyses, 50.4pharmaceutical management via, 50.3, 50.18pharmacy management via, 50.11for presentations, 50.6procurement via, 50.11product master files, 50.22–50.24product registration via, 50.14product reports via, 50.13quantifying pharmaceutical requirements via, 50.9–

50.11for referral systems, 46.11

I.6 InDEx

sales reports via, 50.13software for. See softwarefor spreadsheets, 50.6staff for, 50.16–50.17for statistics, 50.6tender reports via, 50.13utility programs for, 50.7website development in, 50.16–50.17wide area networks for, 50.7for word processing, 50.6

Conference of Experts on the Rational Use of Drugs, 27.2

consignments, 24.7–24.8construction of storage facilities, 42.13–42.17consultants, 14.16–14.17, 42.5consumables kits, 47.9consumer use of medicines. See also rational medicine use

adherence to treatment in, 33.4–33.10assessment guide for, 33.23availability of information and, 33.8–33.9children and, 33.5communications for. See communication with

consumerscomplexity and duration of treatment in, 33.8counseling and, 33.6DOTS strategy for, 33.8, 33.11enablers in, 33.11in health care facilities, 33.9incentives for, 33.11lack of resources and, 33.6–33.8need for encouraging, 33.2–33.4organizations related to, 33.24–33.25pictograms on labels for, 33.25prepackaging of medicines in, 33.10problems in, 33.3provider-patient communications on, 33.4–33.6in TB treatments, 33.8

consumerscommunications with. See communication with

consumerseducation posters for, 33.9ignorance and uncertainty of, 12.6interviews of, 28.13opinions of, 13.15, 13.19organizations of, 27.13, 29.4products for, 1.5use of medicine by. See consumer use of medicines

consumption methodadjusted, 47.9cross-checking results in, 20.12–20.13for quantifying pharmaceutical requirements, 20.3–

20.5, 20.15–20.18reordering formulas in, 23.20–23.21reporting in, 22.5–22.6

contracting for health services. See also contracting for pharmaceuticals

accounting in, 39.15budgets in, 39.15in Cambodia, 39.12communications in, 39.16comparative costs in, 39.12–39.13cost analysis in, 39.13development in, 39.14–39.16duration of contracts in, 39.15feasibility assessment for, 39.11–39.14grounds for termination in, 39.15health system indemnity in, 39.15insurance in, 39.16management of, 39.15monitoring contracts in, 39.16noncompliance penalties in, 39.15overview of, 39.2–39.3payment terms in, 39.15performance indicators in, 39.14, 39.15pharmacy benefits in, 39.3private-sector capacity in, 39.13–39.14property rights in, 39.15provider qualifications in, 39.14reporting in, 39.15review procedures in, 39.15scope of service in, 39.15staffing in, 39.15in supply strategies, 8.13tender management in, 21.13–21.14, 39.14–39.16

contracting for insurance, 12.5contracting for pharmaceuticals. See also contracting for

health servicesbid bonds in, 39.9–39.10commercial terms in, 39.7currency in, 39.6–39.7default penalties in, 39.10deferred payment in, 39.7in distribution management, 22.17exchange rates in, 39.6experience in, 39.10expiry dates in, 39.9feasibility assessment for, 39.11–39.14financial capability in, 39.6labeling and nomenclature in, 39.8letters of credit in, 39.7manufacturing approvals in, 39.8packaging in, 39.8–39.9patent provisions in, 39.10payment terms in, 39.7performance bonds in, 39.9–39.10pharmacy benefit programs in, 39.3price comparisons in, 39.6price validity in, 39.7

InDEx I.7

purchase quantities in, 39.6quality assurance in, 19.14–19.15quality standards in, 39.7–39.8shelf life in, 39.9shipment dates in, 39.10in tender management, 21.18terms in, 39.3–39.11trade terms in, 39.5–39.6

contracting for storage facilities, 42.15contraindications, in standard treatment guidelines, 17.7controlled environments for storage, 46.5controlled substances, 45.10–45.12, 46.5–46.6controlling demand, 11.3controlling pharmaceutical expenditures. See expenditures

for pharmaceuticalscoordinated informed buying, 18.11co-packaging, 19.18co-payment, 12.7, 12.9–12.10corrosives, 46.6corruption, 1.6, 1.13–1.14, 4.6, 4.8, 4.17–4.18, 6.10, 8.17,

10.9, 11.9, 36.12, 43.13COs. See certificates of origincost analysis

in distribution management, 22.16–22.17in expenditures for pharmaceuticals, 40.2–40.3in financial planning, 41.9in health services contracts, 39.13of laboratory supplies, 47.12

cost, insurance, and freight (CIF), 21.16Costa Rica, 40.8cost-benefit analysis (CBA)

in pharmaceutical management, 10.11, 10.12in planning, 38.10of security efforts, 43.12

cost-effective distribution systems, 22.3cost-effectiveness analysis (CEA), 10.11–10.14, 17.8cost-minimization analysis (CMA), 10.11cost-recovery, 13.7–13.8, 13.16costs

bar graphs of, 29.15creating gap in access to medicines, 2.2–2.3escalation of, 11.11, 12.6in financial management, 41.9–41.10information on, 29.13–29.14of kit systems, 26.8–26.9of medicines, 1.4–1.6of medicines in insurance, 12.9–12.11in pharmaceutical management, 10.10–10.14in procurement of pharmaceuticals, 18.5–18.6rational medicine use and, 27.6in revolving drug funds, 13.10of security management, 43.12–43.13in storage facility construction, 42.5–42.6in supply strategies, 8.17

of supply systems assessment, 36.8of transportation, 22.14of treatments, 17.7–17.8

cost-utility analysis, 10.11–10.12COT packages. See course-of-therapy (COT) packagescounseling, 33.6. See also educationcounterfeit medicines

in African countries, 19.9in Asian countries, 19.9legislation on and regulation of, 6.14–6.15quality assurance vs., 19.9in the United States, 19.9WHO on, 19.9

course-of-therapy (COT) packagesin dispensing practices, 30.13–30.14expenditures for, 40.21–40.24fees for, 13.14in hospital pharmacies, 45.12–45.13in rational prescribing, 29.17in revolving drug funds, 13.14

CPM. See Center for Pharmaceutical ManagementCQs. See certificates of qualitycrisis management, 37.5, 38.7critical path method analysis, 38.17–38.18Croatia, 3.19, 15.4cross-contamination, 30.3currency exchange, 18.22cyclic counting, 23.5

DALY. See disability-adjusted life-yeardangerous drugs, 45.10–45.12Dangerous Drugs Act (DDA), 45.10data

aggregation of, 28.4, 28.9–28.11analysis of. See data analysisin management information systems, 49.4, 49.7–49.11,

49.15on medicine use, 28.4–28.6in pharmacovigilance, 35.10–35.12protection of, 3.7–3.9, 3.12, 50.17–50.18qualitative vs. quantitative, 36.14for rational prescribing, 29.11–29.12on supply systems, 36.17–36.18

data analysisin assessing supply systems, 36.18–36.19computer production of, 50.11in pharmacovigilance, 35.11–35.15

Data Sheet Compendium, 34.8databases, 50.6, 50.22–50.24DDDs. See defined daily dosesDebt Relief Initiative, 14.11decapitalization, 13.21decentralization of supply system, 8.16–8.18default penalties in contracts, 39.10

I.8 InDEx

deferred payments in contracts, 39.7defined daily doses (DDDs)

in COTs, 40.24in investigating medicine use, 28.10–28.11in rational prescribing, 29.4by WHO, 40.21

deliverycollection systems vs., 22.13–22.14cost of, 23.18direct systems for, 1.15, 8.10, 18.16intervals of, 26.13–26.14in purchasing contracts, 21.6–21.7schedules for, 22.14, 26.12–26.13of supplies, 22.5–22.6vouchers for, 44.24

demand and supplyin inventory management, 23.7in pricing policies, 9.2–9.3in revolving drug funds, 13.13

Democratic Republic of Congo, 31.7Department of Essential Medicines and Pharmaceutical

Policies (WHO), 2.8dependent demand systems, 23.4design

desktop publishing, 50.6of interventions, 28.17–28.18of pharmacovigilance systems, 35.6–35.10of program management systems, 37.16of storage facilities, 42.5, 42.9–42.14 of treatment guidelines, 17.14

deterioration costs, 40.6determinants of quality, 19.6–19.7developing countries

accredited drug-dispensing outlets in, 32.6–32.9financing strategies in, 11.5–11.6national medicine policies of, 4.5R&D for new medicines in, 3.19–3.20retail drug sellers in. See retail drug sellerstraining programs in, 52.10TRIPS and, 3.6, 3.10

developmentdonor financing for, 14.3–14.5loans for, 11.7, 11.12–11.13

devolution in supply systems, 8.17dgMarket, 21.10diagnostic commodities, 47.6–47.7diagnostic criteria, 17.7diagnostic guidelines, 47.6diagnostic kits, 47.9diarrhea treatment

financing of, 12.7guidelines for, 17.3–17.4investigating use of, 28.6, 28.11–28.13, 28.17mortality rates vs., 2.11, 11.9

pharmaceutical requirements for, 20.23rational use in, 27.4–27.5, 27.10–27.11sentinel reporting for, 48.5

digressive markups, 9.19Diocesan Hospital Pharmacies (DHPs) (Ghana), 45.14direct costs, defined, 41.9direct delivery (non-CMS) systems

introduction to, 1.15in procurement, 18.16in supply strategies, 8.10

direct observation, 35.11direct requisition systems, 26.13directly observed treatment, short course. See DOTSdisability-adjusted life-year (DALY), 10.12disaster relief

in earthquakes, 26.4for emergencies, 20.5for Indian Ocean tsunami, 15.7, 26.4

discrepancy reports, 46.10dispensed selling prices, 9.11–9.12dispensers, attributes of, 30.3–30.5dispensing practices

accuracy vs. speed in, 30.10COTs in, 30.13–30.14counters in, 30.14counting tablets/capsules in, 30.7, 30.14in developing countries. See retail drug sellersin distribution cycle, 22.5–22.6electronic tablet counters in, 30.14environment impacting, 30.2–30.3factors influencing, 30.12inspection checklist for, 30.11labeling in, 30.3, 30.6–30.7, 30.12–30.13limitations in, 29.20–29.21management of, 30.10–30.11, 49.6packaging in, 30.8, 30.11–30.12pan weighing scales in, 30.14patient counseling and, 30.8–30.10pharmacy personnel in, 30.14–30.16precautions in, 30.14prescriptions in, 30.5–30.6process of, 30.5–30.10quality assurance in, 19.18, 30.14rational medicine use and, 27.7–27.8rational prescribing in, 29.15record keeping in, 30.7stock containers in, 30.6–30.7untrained sellers and, 30.15–30.16

disposable laboratory supplies, 47.7–47.8disposal of pharmaceuticals, 44.16, 45.14–45.15distance learning, 52.6distribution management

for access to medicines, 1.11administrative problems in, 22.18

InDEx I.9

channels in, 6.13–6.14climatic factors in, 22.14communications in, 22.15–22.16cost analysis in, 22.16–22.17cycle of, 22.4–22.6delivery schedules in, 22.14delivery vs. collection systems in, 22.13–22.14distribution routes in, 22.12, 22.14features of, 22.7–22.8glossary terms, 22.18–22.21goals of, 22.3–22.4for hospital pharmacies, 45.7–45.8improving systems in, 22.18information systems in, 22.15–22.16kit systems in, 26.3–26.5of laboratory supplies, 47.11–47.14logistics managers in, 22.14–22.15mapping demand in, 22.11networks for, 22.8–22.9performance monitoring in, 22.16–22.17private-sector option in, 22.17–22.18push and pull systems for, 22.9–22.10and rational prescribing, 29.11resources for, 22.14–22.16resupply intervals in, 22.10–22.11seasonal variations in, 22.18staffing levels in, 22.15storage in, 22.11–22.13supply entry points in, 22.12and supply strategies, 8.3–8.4transport in, 22.13–22.14, 22.18treatment guidelines and, 17.14vehicle usage in, 22.14volume increases in, 22.18

Doha Declaration, 3.5, 3.10Dominican Republic, 20.6donations of equipment and supplies, 15.9, 47.16–47.17donations of pharmaceuticals

experiences with, 15.4–15.5good practices for, 15.10–15.11guidelines for, 15.6–15.9labeling in, 15.8management of, 15.9medicine selection in, 15.8packing in, 15.8policies for, 15.9–15.11problems with, 15.2–15.6in public-private partnerships, 15.11–15.12quality assurance in, 15.8shelf life of products, 15.8

donor financingbest practices for, 14.4bilateral agencies and, 14.5bilateral donors in, 14.8

challenges in, 14.3–14.5commodities in, 14.10consultants in proposals, 14.16–14.17Debt Relief Initiative and, 14.11effectiveness of, 14.11–14.13evaluations in, 14.17financial assistance via, 14.8–14.10and financing strategies, 11.12–11.13Gates Foundation and, 14.20–14.21government policy on, 14.14grant resources in, 14.9health care reforms and, 14.14impact of projects and, 14.14multilateral donors in, 14.9multilateral institutions and, 14.5nGOs and, 14.5–14.6performance-based funding in, 14.13poverty reduction strategy papers in, 14.12–14.13private foundations in, 14.6, 14.9, 14.15progress reports in, 14.17project formulation for, 14.15–14.16public-private partnerships and, 14.6–14.8research funds in, 14.10–14.11sector-wide approach in, 14.11–14.12securing, 14.13–14.14sources of, 14.5–14.8study tours in, 14.10sustainability of, 14.14technical expertise in, 14.10training in, 14.10types of assistance in, 14.8–14.11Un agencies in, 14.9

donor-supported global procurement agencies, 18.8dosage forms, 19.4, 44.13DOTS (directly observed treatment, short course)

for consumer use of medicines, 33.8, 33.11in Dominican Republic, 20.7in nepal, 22.8in tuberculosis treatment, 26.4

DRAs. See drug regulatory authoritiesdrug abuse, 45.15Drug and Therapeutics Bulletin, 29.9, 34.6drug and therapeutics committees (DTCs)

in Afghanistan, 45.6in hospital pharmacies, 45.4–45.7in Kenya, 29.16for procurement of pharmaceuticals, 18.19for rational medicine use, 27.12for rational prescribing, 29.3, 29.10–29.13, 29.16training programs for, 52.10

drug bulletins, 34.6, 34.12–34.14drug dumping. See donations of pharmaceuticalsdrug monographs, 17.12drug regulatory authorities (DRAs), 19.3, 19.13–19.14

I.10 InDEx

drug seller franchising, 32.10drug seller initiatives. See retail drug sellersdrug shop accreditation in Tanzania, 32.6Drug Shop Provider Association tool kit (MSH), 32.13drug use restrictions, 45.7drug use reviews (DURs)

computer use in, 50.14in hospital pharmacies, 45.7in rational prescribing, 29.4, 29.11–29.12, 29.14–29.15in United States, 29.14–29.15

DTCs. See drug and therapeutics committeesduka la dawa baridi (Tanzania), 32.6–32.7duration of contracts, 39.15DURs. See drug use reviewsDVDs, 50.16–50.18

earthquake relief, 26.4East Timor, 15.4e-communications, 50.14–50.16economic characteristics of pharmaceuticals, 9.6–9.10economic efficiency, 10.9economic evaluation, 10.11economic goals, 1.8economic incentives, 7.7economic interventions and prescribing, 29.5, 29.17economic issues and revolving drug funds, 13.7, 13.22economic markets, 9.3economic order intervals (EOI), 23.21–23.22economic order quantity (EOQ), 23.21–23.22economics for pharmaceutical management

allocative efficiency in, 10.9–10.10annualized capital costs in, 10.13average cost per unit in, 10.13capital costs in, 10.13competition in, 10.5concepts of, 10.3–10.4cost-benefit analysis in, 10.11, 10.12cost-effectiveness analysis in, 10.11–10.14cost-minimization analysis in, 10.11costs in, 10.10–10.14cost-utility analysis in, 10.11, 10.12efficiency concepts in, 10.9–10.10ethics in, 10.6evaluating products in, 10.10–10.14externalities in, 10.5goals in, 10.4–10.5government–private sector interactions on, 10.7–10.9incentives in, 10.2, 10.4marginal costs in, 10.2, 10.4, 10.13market failure in, 10.7merit goods in, 10.5opportunity costs in, 10.3–10.4pharmaco-economic evaluations in, 10.13in private sector, 10.5–10.9

productive efficiency in, 10.9in public sector, 10.4–10.5rational medicine use and, 27.9–27.10recurrent costs in, 10.13resource allocation in, 10.3scale in, 10.6scarcity in, 10.2–10.3scope in, 10.6sensitivity analysis in, 10.13technical efficiency in, 10.9–10.10total costs in, 10.13variable costs in, 10.13

E-Drug, 50.15education. See also training programs

for rational medicine use, 27.9–27.10, 27.12–27.13, 33.19

for rational prescribing, 29.3–29.10of retail drug sellers, 32.3–32.4, 32.11

educational initiatives for medical and pharmacy students (survey), 34.7

efficiencyaccess to medicines and, 1.13–1.16economic, 10.9–10.10in financing strategies, 11.13national medicine policies and, 4.4

Egypt, 27.4El Salvador

access indicators in, 36.11medication counseling in, 30.9pharmaceutical donations in, 15.4tender management in, 21.4

elasticityof demand, 9.3–9.4of prices, 9.3of supply, 9.3

e-learning, 52.7–52.8Electronic Dispensing Tool (MSH), 49.6electronic tablet counters, 30.14emergencies

health kits for, 15.7in inventory management, 23.20kit systems for, 26.2–26.3quantifying pharmaceutical requirements for, 20.5storage facilities and, 42.13trays for, 46.12

emergent supply problems diagnosis, 36.3enablers, 31.15, 33.11endorsement of medicine policies, 4.14–4.15EOI. See economic order intervalsEOIs. See expressions of interestEOQ. See economic order quantityEpi Info, 50.6e-procurement, 18.6–18.7equal misery strategy, 40.12–40.13

InDEx I.11

equipmentcost of, 22.16defined, 47.3for laboratory services, 47.6, 47.15–47.16maintenance of, 47.16management of, 47.16for medicine information centers, 34.10starter kits of, 47.9in storage facilities, 42.17

equityin financing strategies, 11.13national medicine policies and, 4.4in revolving drug funds, 13.12–13.7, 13.22in supply strategies, 8.5

equity pricing, 9.10Eritrea, 15.4erythromycin, 2.2Essential Drugs Monitor, 2.4, 2.8essential medicines

adoption of, 1.10budget gap analysis for, 11.10concept of, 1.7–1.8, 2.3–2.6, 16.2–16.4expenditure trend analysis for, 11.10financing strategies for, 11.6–11.7lists of. See essential medicines listsmorbidity and mortality rates and, 1.5in national medicine policies, 4.7–4.8, 4.14organizational roles in. See organizational rolesper capita budgets for, 11.10political visibility and, 11.10quantification of need for, 11.10in revolving drug funds. See revolving drug funds

(RDFs)right to health and, 4.14selection of, 16.2–16.4transparency assessment and, 11.10WHO on, 2.8

essential medicines lists. See also essential medicinesacceptance of, 16.14context of, 16.6–16.8defined daily doses in, 40.24development of, 16.8–16.10essential medicines concept and, 16.2–16.4in Ghana, 17.5implementing and updating, 16.14in procurement, 18.11–18.13for rational medicine use, 27.12for rational prescribing, 29.3for retail drug sellers, 32.11revising, 16.12VEn analysis and, 40.12by WHO. See WHO Model List of Essential Medicines

Essential Medicines Monitor, 2.4, 2.8essential supplies and equipment lists, 47.4–47.5, 47.11

estimated- vs. fixed-quantity contracts, 21.6–21.7estimates of pharmaceutical needs, 18.12, 18.15Estimating Drug Requirements, 20.8, 20.18, 20.23Estonia, 6.4ethical guidelines

in investigating medicine use, 28.6for medicine promotion, 34.8in the private sector, 10.6

Ethiopiaessential drugs list in, 16.6, 16.10pharmaceutical management for ART in, 36.4–36.5security efforts in, 43.12theft of ARVs in, 43.3

European Pharmacopoeia, 19.4, 19.8evaluation

in donor financing, 14.17of economics, 10.11of interventions, 28.19–28.22monitoring and. See monitoring and evaluationof monitoring systems, 48.7of pharmaceutical products (economic), 10.10–10.14pharmaco-economic, 10.13of projects, 38.17–38.18of suppliers, 21.12–21.13of tender offers, 21.16

evergreening of medications, 3.6exceptions to rights conferred (TRIPS Article 30), 3.7excess stock, 23.18exchange rates, 39.6, 41.8exclusive marketing rights (TRIPS Article 70.9), 3.9exemptions (to user fees and costs), 13.16–13.17expenditures for pharmaceuticals

ABC analysis in, 40.13–40.19acquisition price comparisons in, 40.24acquisitions costs in, 40.5analyzing costs, tools for, 40.2–40.3COTs in, 40.21–40.24deterioration and spoilage costs in, 40.6equal misery strategy in, 40.12–40.13expiry costs in, 40.6expiry dates analysis in, 40.28–40.30financial opportunity costs in, 40.6in financing strategies, 11.6–11.10glossary terms, 40.31hidden-cost analysis in, 40.30–40.31inventory-holding costs in, 40.5–40.6, 40.9inventory pipeline in, 40.7–40.9lead-time analysis in, 40.26–40.28loss from inventory in, 40.6modeling effect of alternatives in, 40.5obsolescence costs in, 40.6operating costs in, 40.6payment-time analysis in, 40.26–40.28performance indicators in, 40.9

I.12 InDEx

preferential weighting in, 40.12price comparison analysis in, 40.24–40.26, 40.26purchasing costs in, 40.6–40.8revenues vs., 13.14shortage costs in, 40.8supply system vs. private-sector prices in, 40.26supply systems in, 40.5therapeutic category analysis in, 40.19–40.24total cost analysis in, 40.3–40.9transport costs in, 40.6trend analysis of, 11.10VEn analysis in, 40.9–40.13wastage costs in, 40.6

expense ratios, 23.6expiry costs, 40.6expiry dates

analysis of, 40.28–40.30in contracting for pharmaceuticals, 39.9in health facilities, 46.6

exponential smoothing, 23.21–23.22exporters, 21.11expressions of interest, 39.14externalities

in economics, 10.5in pricing policies, 9.5in supply strategies, 8.5

face-to-face contact, 29.9facility-based health services, 31.7–31.8facility-level pharmacovigilance, 35.8facility pharmaceutical budgets, 29.15FDA. See Food and Drug Administrationfeasibility assessments

for contracts, 39.11–39.14of local pharmaceutical production, 7.8–7.10in management planning, 38.10for revolving drug funds, 13.6of small-scale pharmaceutical production, 45.14

feasibility phase of planning, 42.6–42.8feedback

in management information systems, 49.7in monitoring and evaluation, 48.13for rational prescribing, 29.10–29.11

fees for services, 12.8FEFO. See first-expiry/first-outfield observation in assessment, 36.17–36.18field supervision, 48.7FIFO. See first-in/first-outfinancial incentives, 27.13financial opportunity costs, 40.6financial planning and management

accounting in, 41.17–41.19assets in, 41.15balance sheets in, 41.18–41.19

budgeting in, 41.10–41.12, 41.17cash planning in, 41.12–41.14checklist for, 41.15computer reports in, 8.17, 50.13costing in, 41.9–41.10exchange rates in, 41.8expenditures in, 41.12, 41.15funding levels in, 41.12global. See global financinggovernment systems and, 41.3–41.6income and expense reports in, 41.17–41.18inflation in, 41.8legislation and regulation in, 6.16long-range, 41.6–41.9national medicine policies and, 4.7, 4.9operating budgets in, 41.16of pharmaceutical programs, 37.10prices in, 41.8–41.10in procurement, 18.10–18.12receipts in, 41.15reporting in, 41.17–41.19resources in, 41.12, 41.14–41.17by retail drug sellers, 32.12of revolving drug funds, 13.7–13.11, 13.17–13.18of stock accounts, 41.18strategies in. See financing strategiessupply strategies and, 8.3–8.4sustainability in, 1.12, 11.3–11.4, 18.21–18.22

financing health insurance, 12.4–12.5financing strategies. See also financial planning and

managementaccess to medicines and, 11.13administrative requirements in, 11.14allocative efficiency in, 11.3budget gap analysis in, 11.10community prepaid insurance in, 11.11comparative expenditure analysis in, 11.10comparison of, 11.13–11.15controlling demand in, 11.3development of, 11.14–11.16development loans in, 11.12–11.13donor financing in. See donor financingefficiency in, 11.13equity in, 11.13for essential medicines, 11.6–11.7, 11.9–11.10expenditure trend analysis in, 11.10foreign aid in, 11.5–11.6government budgets in, 11.8–11.10health expenditures in, 11.4–11.7health insurance in, 11.10–11.12health services use and, 11.10high disease burdens and, 11.5income levels and, 11.4–11.7increasing resources in, 11.4

InDEx I.13

insurance coverage in, 11.5, 11.11–11.12local financing in, 11.12medical savings accounts in, 11.11medicine sales in, 11.7–11.8per capita medicine consumption in, 11.6per capita pharmaceutical budgets in, 11.10pharmaceutical expenditures in, 11.6–11.10political visibility and, 11.10private health insurance in, 11.11in private sector, 11.7–11.8in public sector, 11.8–11.10quantification of medicine needs in, 11.10rational medicine use and, 11.13social health insurance and, 11.11sustainability in, 11.3–11.4, 11.13technical efficiency in, 11.3transparency assessment in, 11.10user fees in, 11.7–11.8voluntary financing in, 11.12

fire prevention, 42.13, 44.16, 46.7first aid, 44.19first-expiry/first-out (FEFO), 30.3, 46.6first-in/first-out (FIFO), 30.3five-year plans, 38.15fixed-dose combinations (FDCs), 19.18, 26.4fixed location systems, 44.10fixed margins, 9.19fixed medicine allowances, 26.15flammables, 44.10, 46.6floor pallets, 44.15–44.16flow of stock and information, 44.5–44.9fluid location systems, 44.12focus group discussions, 28.15–28.16focused supervision, 37.16Food and Drug Administration (FDA)

on pharmacovigilance, 35.10on quality assurance, 19.3on safety of medicines, 2.10

force field analysis, 37.17–37.18forecasting requirements. See quantifying pharmaceutical

requirementsforeign exchange rates, 13.9formative research, 29.21–29.22, 32.9formulary lists, 16.7, 16.10, 18.11–18.13, 29.9formulary manuals

brand-name drugs in, 17.13computer production of, 50.11definition of, 16.7development of, 17.12–17.13distribution of, 17.14drug information in, 17.11drug monographs in, 17.12ease of use of, 17.13for hospitals, 17.13

implementing, 17.14–17.15information in, 17.10–17.11lists of, 17.17in medicine selection, 16.7–16.10national committees for, 17.12nonessential medicines in, 17.12–17.13production of, 17.14revision of, 17.12size of, 17.13treatment guidelines and. See treatment guidelines

formulary systems, 16.7, 45.5–45.7forwarding agents, 24.3–24.4framework contracts, 23.15franchising, 32.7–32.10fraud control, 43.11–43.12free trade agreements, 3.14funding, 18.21–18.22, 34.15. See also financing strategiesfungibility, 14.3

GACPs. See Good Agricultural and Collection PracticesGantt charts, 38.14–38.16Gates Foundation, 14.5–14.6, 14.20–14.21GAVI Alliance, 14.5–14.6GDF. See Global Drug FacilityGDP. See gross domestic productgeneric medicines

history of, 2.4intellectual property laws and, 3.6introduction to, 3.3pricing policies for, 9.8–9.9procurement of, 18.11promoting use of, 33.17selection of, 16.5–16.6

geographic information systems (GIS), 50.8Ghana

access to medicines in, 1.16–1.17, 36.11CAREshop franchise in, 32.9education campaign in, 33.19imprest systems in, 22.12medication counseling in, 30.9national medicine policy of, 4.6small-scale pharmaceutical production in, 45.14standard treatment guidelines in, 17.5, 29.8

GIS. See geographic information systemsGlobal Atlas of the Health Workforce, 51.4Global Drug Facility (GDF), 26.4, 47.8–47.9global financing. See also donor financing

effectiveness of, 14.11–14.13Gates Foundation and, 14.20–14.21private foundations for, 14.15progress reports in, 14.17project formulation for, 14.15–14.16sources of, 14.5–14.8types of, 14.8–14.11

I.14 InDEx

Global Fund to Fight AIDS, Tuberculosis and Malariafor access to medicines, 1.14antiretroviral therapy and, 2.6financing strategies and, 4.9human resources crisis and, 51.7indicators and, 1.11–1.12laboratory supplies from, 47.11prequalification of suppliers and, 21.5quantifying pharmaceutical requirements by, 20.8

Global Initiative on Health Technologies (WHO), 47.3–47.4

global market for pharmaceuticals, 3.2–3.3global monitoring of quality, 19.8global positioning systems (GPS), 50.8–50.9Global Strategy and Plan of Action on Public Health,

Innovation and Intellectual Property, 3.14globalization

of intellectual property standards, 3.3–3.10of legislation and regulation, 6.3–6.6local production vs., 7.5–7.6of pharmaceutical industry, 2.10–2.11pricing policies and, 9.19–9.20

GLPs. See good laboratory practicesGMPs. See good manufacturing practicesGood Agricultural and Collection Practices (GACPs),

5.12Good Governance for Medicines (WHO)

access to medicines and, 1.10–1.11codes of conduct by, 51.16transparency assessments by, 36.12by WHO, 43.3

good laboratory practices (GLPs), 5.12good manufacturing practices (GMPs)

legislation and regulation of, 6.8by local producers, 7.3–7.7quality assurance in, 19.7–19.8sterile production in, 45.13WHO on, 19.13

governance. See Good Governance for Medicinesgovernments

donor financing and, 14.14finance systems of, 41.3–41.6intervention of, 9.17–9.19medicine policies of. See national medicine policiesprivate sector and, 10.7–10.9regulation of medicine use by, 27.13resource allocation by, 10.3revolving drug funds and, 13.8–13.9role in health care of, 8.5–8.7traditional medicine policies of, 5.8

GPS. See global positioning systemsgrants, 14.9, 41.6gross domestic product (GDP), 11.4, 11.8Guidelines for Drug Donations, 15.5–15.6

Guinea, 26.8, 31.9Gujarat state (India), 15.4

HAI. See Health Action InternationalHaiti, 15.5, 50.14handheld computers, 50.9harmonization of regulations, 6.3–6.6, 14.4Health Action International (HAI)

Drug Prices Project of, 3.17on essential medicines, 2.4on essential medicines concept, 2.8on pricing policies, 9.11–9.15

Health for All Australians, 4.16health care

contracting for. See contracting for health servicesexpenditures for, 11.4–11.7programming, 31.10–31.14reforms of, 14.14systems for. See health care systemsuse of services for, 11.10

health care systemscredibility of, 19.7indemnity of, 39.15rational medicine use and, 27.6–27.7traditional medicine and, 5.9, 5.12–5.13, 5.15types of, 5.9

health facility pharmaceutical management. See also hospital pharmacy management

accountability in, 46.4adherence of medicines in, 33.9antibiotic use in, 28.9arranging stock in, 46.6–46.7bulk storage in, 46.2, 46.4checklist for, 46.14–46.15cleaning in, 46.7computerized referral systems in, 46.11conditions of storage in, 46.3–46.5controlled environments in, 46.5controlled substances in, 46.5–46.6corrosives in, 46.6cost of maintaining stock in, 46.3discrepancy reports in, 46.10expiry dates in, 46.6fire prevention in, 46.7flammables in, 46.6home-based care kits in, 46.12inpatient dispensing in, 46.11–46.12inventory control in, 46.2–46.3, 46.7–46.9managing, generally, 46.2–46.3maximum stock approach in, 46.8ordering stock in, 46.7–46.9outpatient dispensing in, 46.11prepackaging of medicines in, 46.11receiving stock in, 46.9

InDEx I.15

record keeping in, 46.7–46.9refrigeration in, 46.5rotating stock in, 46.4, 46.6security in, 46.4, 46.7in small facilities, 46.9staff training in, 46.12stock distribution in, 46.4, 46.9–46.12storage areas in, 46.3–46.7stores in, 22.8, 22.14theft control in, 43.11, 46.5–46.6

health insuranceadverse selection in, 11.11community prepaid, 11.11cost escalation in, 11.11for essential medicines, 11.7moral hazard in, 11.11pharmaceutical benefits in. See insurance for

pharmaceuticalsprivate health insurance in, 11.11rational prescribing and, 29.17skimming in, 11.11social, 1.13

health savings accounts. See medical savings accounts (MSAs)

health services. See health careHealthy Skepticism, 2.8Heavily Indebted Poor Countries (HIPC), 14.11herbal medications, 5.5–5.7, 6.13Herzegovina, 15.4hidden-cost analysis, 40.30–40.31high disease burdens, 11.5HIPC. See Heavily Indebted Poor Countrieshistorical perspectives

access to medicines in, 2.2–2.3AIDS, tuberculosis, and malaria in, 2.6–2.7essential medicines concept in, 2.3–2.6generic pharmaceuticals in, 2.4intellectual property laws in, 3.4–3.5miracle medicines in, 2.2pharmaceutical industry in, 2.4–2.5rational medicine use in, 2.5–2.6Un agencies in, 2.3–2.4WHO leadership in, 2.3–2.4

HIV/AIDS treatmentantiretrovirals for. See antiretroviral therapy (ART)community participation in. See community

participationcompulsory licensing in, 3.8cost of, 1.13diagnostics standards for, 47.6, 47.11essential medicines lists and, 1.5, 16.4, 16.11historical perspectives on, 2.6–2.7human resources crisis in, 51.5microbicides for, 6.16

pharmacovigilance and, 35.9prevention of mother-to-child transmission, 36.4quantifying pharmaceutical requirements for, 20.9regional collaboration for, 18.10in Rwanda, 17.15in Tanzania, 12.12, 36.10, 38.6, 38.13traditional medicine for, 5.6vaccines for, 3.18voluntary licensing in, 3.9in Zambia, 47.14

holograms, in security management, 19.13home-based care kits, 46.12hospital formularies

management of, 45.5–45.7manuals for, 17.13rational medicine use and, 27.12rational prescribing and, 29.3

hospital pharmacy managementafter-hours pharmacies in, 45.12automated dispensing in, 45.9bulk ward stock systems for, 45.8controlled substances in, 45.10–45.12COTs in, 45.12–45.13dangerous drugs in, 45.10–45.12disposal of pharmaceuticals in, 45.14–45.15drug abuse in, 45.15drug and therapeutics committees in, 45.4–45.7drug use review in, 45.7individual medication orders in, 45.8–45.9inpatient medications in, 45.7–45.12leakage control in, 45.15medication distribution systems for, 45.7–45.8medication treatment records in, 45.9–45.10medication use in, 45.3multiple department systems in, 45.5nonsterile production in, 45.13organization of services in, 45.4patient medication profiles in, 45.9personnel in, 45.4physical organization in, 45.4purchasing in, 45.3repackaging medications in, 45.12–45.13, 45.15small-scale production in, 45.12–45.14software for, 50.11staff responsibilities in, 45.3–45.4sterile production in, 45.13–45.14stock management in, 45.3theft control in, 43.10–43.11therapeutic substitutions in, 45.6–45.7unit-dose medicines in, 45.9ward inspections in, 45.10, 45.12

housekeeping, 44.15–44.17How to Estimate Warehouse Space for Drugs, 42.7How to Investigate Drug Use in Health Facilities, 28.7

I.16 InDEx

How to Investigate the Use of Medicines by Consumers, 28.13How to Use Applied Qualitative Methods to Design Drug

Use Interventions, 28.14human resources management (HRM). See also staffing

accountability in, 51.16assertiveness vs. cooperation in, 51.25–51.26assessing strength of, 51.9–51.11avoiding styles in, 51.25–51.26collaborating styles in, 51.26communication channels in, 51.21–51.22competing styles in, 51.25compromising styles in, 51.26conducting meetings in, 51.27–51.28conflict management in, 51.25–51.26crisis in human resources and, 51.2–51.7delegation in, 51.26–51.27disciplining staff in, 51.23–51.25distribution of staff in, 51.3fairness in, 51.18–51.19feedback skills in, 51.21–51.22job descriptions in, 51.22–51.23leadership in, 51.11in medical stores, 44.17migration of personnel in, 51.3motivation in, 51.17–51.21nonverbal communications in, 51.21norms approach in, 51.15performance in, 51.15–51.17, 51.20performance-based financing in, 51.19preservice training in, 51.3recruitment in, 51.14–51.15retention in, 51.17–51.21role of, 51.7–51.9staff pressures in, 51.18staff requirements in, 51.11–51.15supervisory systems in, 51.17work priorities in, 51.19workload approach in, 51.15

human rights, 3.5, 4.14humidity control, 44.10hypertension, 28.12

i+Solutions, 52.13IBRD. See International Bank for Reconstruction and

DevelopmentICB. See international competitive biddingICIUM. See International Conferences on Improving Use

of MedicinesICD. See International Classification of DiseasesICDRA. See International Conference on Drug Regulatory

AuthoritiesICH. See International Conference on Harmonisation

of Technical Requirements for Registration of Pharmaceuticals for Human Use

IDA. See International Development Association; International Dispensary Association

IFPMA. See International Federation of Pharmaceutical Manufacturers and Associations

IGPA. See International Generic Pharmaceutical Allianceimpact assessments

in donor financing, 14.14evaluation and, 48.8indicators in, 14.13in pharmaceutical planning, 38.10–38.11in pharmaceutical programs, 37.11in revolving drug funds, 13.13

importationclearing agents in, 24.3–24.4controls on, 7.7–7.8documents for, 24.5–24.8forwarding agents in, 24.3–24.4insurance claims in, 24.8managing, 24.2–24.3port clearing in, 24.3–24.8units for, 24.4

imprest systems, 22.12incentives

in consumer use of medicines, 33.11for participation in treatment, 31.15payments as, 12.8in pharmaco-economics, 10.2, 10.4for retail drug sellers, 32.11–32.12

incremental ordering costs, 23.6indemnity insurance, 12.5independent demand systems, 23.4in-depth interviews, 28.14–28.16India

access indicators in, 36.11ADR reporting in, 35.15medication counseling in, 30.9pharmaceutical production in, 7.6procurement systems in, 36.7

Indian Ocean tsunami, 15.7, 26.4indicators

of access, 36.11in management information systems, 49.10–49.11of medicine use, 28.7–28.9of performance, 36.14–36.15, 39.15, 40.9in pharmaceutical management, 36.16–36.17pharmaceutical and supply, 48.11–48.12of process, 14.13, 48.8of reliability, 48.9of staffing needs, 51.15

indigenous knowledge protection, 5.13indirect costs, 41.9Indonesia

education on medicine use in, 33.19essential medicine supply in, 8.17

InDEx I.17

health facility medicine use in, 28.9rational prescribing in, 29.13, 29.18treatment guidelines in, 17.9tsunami relief in, 15.7, 26.4

industrial feasibility study, 7.9industry organizations, 2.9inflation, 41.8informal distribution channels, 6.13–6.14informant interviews, 36.17information

collection of for assessments, 36.15–36.18in distribution management, 22.15–22.16failure of, 8.5for management. See management information systemson medicines. See medicine informationin program management, 37.10targets, 36.10, 36.14–36.15

information technology (IT), 33.20, 42.12infrastructure

for communication with consumers, 33.20in pharmaceutical production policy, 7.6for retail drug sellers, 32.11

Initiative on Adherence to Antiretrovirals, of InRUD, 28.10, 33.9

injectable vs. oral antibiotics, 29.13injection overuse, 27.4inpatient medications, 45.7–45.12, 46.11–46.12InRUD. See International network for the Rational Use of

Drugsinsecticide-treated nets (ITns), 31.5in-service education, 29.7–29.8inspections

dispensing practices checklist for, 30.11in distribution cycles, 22.5legislation and regulation of, 6.8in medical stores, 44.7, 44.16of pharmaceutical shipments, 19.15–19.16

Institute for Safe Medication Practices, 35.10institutional perspectives. See organizational rolesinsurance

for health care. See health insurancefor importation, 24.8for inventory, 24.7for medicines. See insurance for pharmaceuticals

insurance for pharmaceuticalsaccess to medicines and, 12.11adverse selection in, 12.6appropriate schemes for, 12.17–12.18budget transfers for, 12.8capitation payment for, 12.7–12.8case payments for, 12.8community based, 12.4, 12.12–12.15co-payment for, 12.7cost escalation in, 12.6

cost of medicines in, 12.9–12.11defining, 12.3fees for services and, 12.8financing, 11.5, 12.4–12.5glossary terms, 12.19–12.20health or medical savings accounts in, 12.4, 12.16–12.17incentive payments for, 12.8market failure in, 12.5monopolies in, 12.5–12.6moral hazard in, 12.6prepayment for, 12.5private, 12.4, 12.14–12.16problems with, 12.5–12.6provider payment mechanisms for, 12.6–12.8public, 12.3–12.4purchasing health care services and, 12.5rational medicine use in, 12.11reform of, 12.18revenue collection and, 12.4risk pooling and, 12.4–12.5social health insurance and, 12.3–12.4, 12.11–12.12universal health coverage and, 12.2–12.3

integrationof health care systems, 5.9of supply chain systems, 18.8

intellectual property lawbilateral trade agreements and, 3.12–3.13Bolar exception in, 3.7, 3.12compulsory licensing in, 3.6–3.8, 3.12constraints to, 3.10–3.14Doha Declaration on, 3.5, 3.10exceptions to rights in, 3.7exclusive marketing rights in, 3.9free-trade agreements and, 3.14generic medicines and, 3.6globalization of, 3.3–3.10glossary terms, 3.21history of, 3.4–3.5international patent laws in, 3.14issues for policy makers, 3.15parallel importation in, 3.7, 3.12patents in, 3.3, 3.6, 3.12, 3.14pharmaceutical categories and, 3.3pharmaceutical industry and, 2.10pharmaceutical market and, 3.2–3.3R&D for new medicines and, 3.16–3.20regulation of medicines in, 3.12–3.14test data protection in, 3.7–3.9, 3.12on traditional medicine, 5.13–5.14transitional arrangements and, 3.6TRIPS and, 3.5–3.6, 3.12–3.13, 3.14voluntary licensing in, 3.7, 3.9

Intellectual Property Watch, 3.17Interagency Emergency Health Kit, 15.7, 26.3

I.18 InDEx

Interagency Guidelines for Establishing a Model Quality Assurance System, 21.5

Interagency Pharmaceutical Coordination Group, 2.8interchangeability of medicines, 6.12Intergovernmental Working Group on Public Health, 3.17International AIDS Vaccine Initiative, 3.18International Bank for Reconstruction and Development

(IBRD), 14.8international benchmarking, 9.18International Classification of Diseases, 10th Revision, 28.6International Classification of Diseases (ICD), 20.19international competitive bidding (ICB), 21.16International Conference on Drug Regulatory Authorities

(ICDRA), 6.4International Conference on Harmonisation of Technical

Requirements for Registration of Pharmaceuticals for Human Use (ICH), 6.4–6.6, 19.3

International Conference on Primary Health Care, 1.7International Conferences on Improving Use of Medicines

(ICIUM), 1.17, 2.5, 28.20International Development Association (IDA), 14.8International Dispensary Association (IDA), 26.12, 40.26International Drug Price Indicator Guide

defined daily doses in, 40.24for monitoring prices, 9.14pharmaceutical donations and, 15.10for price comparison analysis, 40.25–40.26pricing policies and, 9.12for procurement, 21.11quantifying pharmaceutical requirements in, 20.13

International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), 2.5, 3.17

international financing. See global financingInternational Generic Pharmaceutical Alliance (IGPA),

3.17International HIV/AIDS Alliance, 2.7, 31.3International Medical Products Anti-Counterfeiting

Taskforce, 19.9International network for the Rational Use of Drugs

(InRUD)on dispensing practices, 27.8historical perspectives on, 2.5organizational roles of, 2.8–2.9on rational prescribing, 29.12

International nonproprietary names (Inns)of essential medicines, 16.5in medicine selection, 16.2promoting use of, 33.17in tender lists, 21.14–21.15

International Pharmaceutical Federation (FIP), 51.5–51.7International Pharmacopoeia, 19.4, 19.8international procurement, 18.7, 21.7–21.8, 21.11International Red Cross (IRC), 26.3International Society of Drug Bulletins (ISDB), 2.9, 34.11

international wholesale exporters, 21.11Internet, 2.10–2.11, 34.3interrupted time series, 28.21interventions

in communication with consumers, 33.14–33.18to improve medicine use, 27.9–27for medication adherence, 33.12–33.13for rational prescribing. See interventions for rational

prescribinginterventions for rational prescribing

economic, 29.5, 29.17educational, 29.3–29.10focus and target of, 29.5managerial, 29.5, 29.10–29.17regulatory, 29.5, 29.17–29.21strategies for, 29.21–29.22system oriented, 29.5targeted, 29.4–29.5

intrauterine devices (IUDs), 20.13inventory

control of. See inventory controlholding costs, 40.5–40.6, 40.9managing. See inventory managementpipelines for, 40.7–40.9shrinkage of, 23.6taking, 44.9

inventory control. See also inventory managementin distribution cycle, 22.5–22.6in health facilities, 46.2–46.3, 46.7–46.9in medical stores, 44.2–44.3models for, 23.11–23.16in security management, 43.6, 43.8

inventory managementABC/FS system in, 23.15annual purchasing in, 23.12–23.13, 23.15average consumption in, 23.16average inventory-holding costs in, 23.6benefits vs. costs in, 23.8bin cards in, 23.4budget status in, 23.18computer use in, 50.11confidence in, 23.7consumption-based reordering in, 23.20–23.21context of, 23.4–23.7control in. See inventory controlcyclic counting in, 23.5demand and supply in, 23.7dependent demand systems in, 23.4deviation of consumption in, 23.22–23.23economic order in, 23.21–23.22emergency warning levels in, 23.20excess stock in, 23.18expense ratios in, 23.6exponential smoothing in, 23.21–23.22

InDEx I.19

framework contracts in, 23.15incremental ordering costs in, 23.6independent demand systems in, 23.4inventory shrinkage in, 23.6“Kardex” systems in, 23.4for laboratory services, 47.14–47.15lead times in, 23.16, 23.22–23.23ledger systems in, 23.4materials requirements in, 23.4maximum stock levels in, 23.16–23.17minimum-maximum stock levels in, 23.19–23.20minimum orders in, 23.18modified optional replenishment in, 23.20net sales to inventory in, 23.6ordering costs in, 23.7pack sizes in, 23.18performance indicators in, 23.6perpetual purchasing in, 23.14–23.15procurement period in, 23.17projecting demands in, 23.17pull vs. push systems in, 23.4quantity discounts in, 23.18reorder frequencies in, 23.11–23.16reorder levels in, 23.16reorder quantities in, 23.16–23.19reordering formulas in, 23.19–23.21reordering mathematical models in, 23.21–23.23rising delivery costs in, 23.18safety stock in, 23.8–23.11, 23.16scheduled purchasing in, 23.13–23.15selection of items to stock, 23.7–23.8service-level stock in, 23.8–23.11shortage costs in, 23.7short-dated products in, 23.19stock position in, 23.17storage space in, 23.19theft in, 23.19transport costs in, 23.7unit costs in, 23.7VEn analysis in, 23.7vertical file cards in, 23.4wastage in, 23.19

investigating medicine useaggregation of data in, 28.4, 28.9–28.11ATC system in, 28.4case records review in, 28.11–28.12classifying cases in, 28.6in communities, 28.13–28.14comparison groups in, 28.20consumer interviews in, 28.13data sources in, 28.4–28.6defined daily doses in, 28.10–28.11designing interventions in, 28.17–28.18ethical issues in, 28.6

evaluating interventions in, 28.19–28.22focus group discussions in, 28.14–28.16in-depth interviews in, 28.14–28.16interrupted time series in, 28.21measurements in, 28.4–28.7need for, 28.2–28.4of oral rehydration solution, 28.6per capita use in, 28.9–28.10prescription practices in, 28.10–28.11in private sector, 28.12–28.13problems and interventions in, 28.14–28.19proportion of pharmaceutical budgets in, 28.10prospective studies in, 28.4qualitative methods for, 28.14–28.16quantitative methods for, 28.5, 28.7–28.14questionnaires in, 28.14–28.16retrospective studies in, 28.4sample sizes in, 28.6scope of data in, 28.4simulated patient surveys in, 28.14–28.16standard treatment guidelines in, 28.6stratification in, 28.6structured observations in, 28.14–28.16substitutable product use in, 28.9surveys in, 28.21units of analysis in, 28.6WHO indicators in, 28.7–28.9

invitations to bid, 21.13IPRsonline.org, 3.17IRC. See International Red Crossirrational medicine use. See also rational medicine use

adverse impact of, 27.5–27.6examples of, 27.3–27.5factors underlying, 27.6–27.8

ISDB. See International Society of Drug Bulletinsisoniazid, 2.2IT. See information technologyitem-by-item analysis, 42.7ITns. See insecticide-treated nets

Java, 48.16job descriptions, 49.14Joint Clinical Research Centre (JCRC) (Uganda), 47.3Joint Medical Stores (JMS) (Uganda), 8.15

“Kardex” systems, 23.4Kenya

antibiotic use review in, 29.16antimicrobial resistance in, 40.15ART programs in, 30.4, 37.17, 48.4–48.5community health workers in, 32.10drug seller franchising in, 32.10education about antimalarials in, 33.16emergency hiring plans in, 51.16

I.20 InDEx

essential medicines lists in, 16.11–16.12human resources in, 51.6kit systems in, 26.5, 26.11medication counseling in, 33.6medication treatment records in, 45.10monitoring medicine fees in, 48.7rational prescribing in, 29.18retail drug seller education in, 32.4traditional medicine in, 5.6

Kenya Forestry Research Institute, 5.6kit systems

appropriateness of, 26.9, 26.14contents of, 26.9–26.11costs of, 26.8–26.9delivery of, 26.12–26.14direct requisitions and, 26.13as distribution strategy, 26.3–26.5for emergency situations, 26.2–26.3fixed medicine allowances vs., 26.15health units receiving, 26.9implementation of, 26.9–26.14introduction to, 1.11for laboratory services, 47.8–47.9management training for, 26.13medicines in, 26.9–26.11modified optional replenishment vs., 26.14number of kits in, 26.11–26.12open requisitioning vs., 26.15ordering within defined limits vs., 26.15packing of, 26.12planning flow chart for, 26.10predefined lists vs., 26.15procurement for, 26.12pros and cons of, 26.5–26.8quality assurance and, 19.18rational medicine use in, 26.13record keeping for, 26.12–26.13stockouts in, 26.13success conditions for, 26.9transitioning from, 26.13, 26.14–26.15waste in, 26.13

Knowledge Ecology International, 3.17Kuwait, 9.15Kyrgyzstan, 34.14

labelsin dispensing practices, 30.3–30.7, 30.12–30.13in pharmaceutical contracts, 39.8pictograms on, 33.25

laboratory servicesbudgets for, 47.4consumables kits in, 47.9diagnostics selection for, 47.6–47.7disposable items for, 47.7–47.8

distribution of, 47.11–47.14donations and, 47.16–47.17equipment in, 47.9, 47.15–47.16essential supplies list example, 47.11health care packages and, 47.4inventory management for, 47.14–47.15kits for, 47.8–47.9management systems for, 47.6–47.15medical supplies for. See medical suppliesmicroscope kits in, 47.9national policies for, 47.4–47.6procurement of, 47.10quality assurance for, 47.10quality testing of pharmaceuticals, 19.17quantification of supplies for, 47.9–47.10reusable items for, 47.7–47.8safe disposal for, 47.15standardization of equipment for, 47.5–47.6strategic planning for, 47.4

laboratory triggers, 35.10landed prices, 9.11LAns. See local area networksLao People’s Democratic Republic (P.D.R.)

MTP methodology in, 52.12national medicine policies in, 4.10pharmaceutical regulation in, 6.14rational medicine use in, 27.11rational prescribing in, 29.18transparency assessments in, 36.12

Latin American countriescholera treatment in, 20.6health facility medicine use in, 28.8health insurance in, 12.16price comparison analysis in, 40.25quantifying pharmaceutical requirements in, 20.13supply efficiency in, 40.9TRIPS flexibilities in, 3.11

lawsenforcement of, 43.9on intellectual property. See intellectual property lawson pharmaceuticals. See legislation on

pharmaceuticalson revolving drug funds, 13.12on traditional medicine, 5.15

layout of storage facilities, 42.12–42.13LCs. See letters of creditLDCs. See least developed countrieslead time

analysis, 40.26–40.28in inventory management, 23.16for procurement, 20.11

leakage control, 45.15learning methods, 37.8, 52.6–52.8. See also educationleast developed countries (LDCs)

InDEx I.21

TRIPS and, 3.6, 3.10Lebanon, 15.5ledger systems, 23.4legal reference method of quality assessments, 19.16legislation on pharmaceuticals. See also regulation of

pharmaceuticalsadministrative control in, 6.15–6.18adverse drug reactions and, 6.9advertising and, 6.10in the Americas, 6.5classifying pharmaceuticals in, 6.13clinical-use information and, 6.10on counterfeit medicines, 6.14–6.15on distribution channels, 6.13–6.14drafting, 6.6–6.7elements of, 6.7evolution of, 6.3–6.4financing and, 6.16globalization of, 6.3–6.6guiding principles for, 6.16harmonization of, 6.3–6.6on herbal medicines, 6.13inspections and, 6.8interchangeability of medicines in, 6.12key provisions of, 6.7–6.10licensing of medicines in, 6.8, 6.10–6.13marketing authorization, 6.10–6.13medicine promotion and, 6.10on microbicides for HIV/AIDS, 6.16need for, 6.2pharmacopoeias in, 6.6pharmacovigilance in, 6.8–6.10production policies and, 7.7quality of medicines and, 6.10registration of medicines and, 6.10–6.13regulations vs. guidelines and, 6.2–6.3resources required for, 6.15, 6.16revising, 6.6–6.7role of, 6.2–6.7roles of stakeholders in, 6.8safety of medicines and, 6.10sanctions in, 6.10on substandard medicines, 6.14–6.15supply strategies and, 8.18on traditional medicines, 6.13TRIPS and, 6.3–6.4

legislative frameworks, 4.6–4.7letters of credit (LCs), 24.7, 39.7Level One Drug Inspectors’ Handbook, 19.11levels of care, 17.4licensure requirements

regulation of, 6.8, 6.10–6.13limited medicines lists, 29.18–29.20limited procurement lists, 29.11

Lithuania, 15.5load handling, 44.14–44.15loading bays, 42.12local agents, 21.7–21.8local area networks (LAns), 50.3, 50.7local importers and distributors, 21.11local procurement, 18.7local production. See production policies “local-to-global” supply chains, 18.8location of stock within zones, 44.10–44.12location of survey samples, 9.14Logframe Handbook, 14.16LogFrame project planning method, 38.18logistical framework approach (LFA), 38.18logistics

definition of, 22.3in distribution management, 22.14–22.15for storage facilities, 42.6

long-range financial planning, 41.6–41.9loss adjustments, 20.11, 40.6

maintenancein computer use, 50.16–50.18of equipment, 47.16of storage facilities, 42.17of transport vehicles, 25.12–25.13

Makerere University, 51.10, 52.13malaria treatment. See also Global Fund to Fight AIDS,

Tuberculosis and MalariaACT for. See artemisinin-based combination therapy

(ACT)community participation in, 31.12essential medicines for, 1.5historical perspectives on, 2.6–2.7quantifying pharmaceutical requirements for, 20.20,

20.22Malawi, 4.13, 17.14Malaysia, 9.13, 36.12Mali, 31.9management information systems

accuracy in, 49.12actions based on, 49.17in Brazil, 49.13communications in, 49.12components of, 49.5–49.7computerizing, 49.11–49.12data in, 49.4, 49.7, 49.10–49.11, 49.15definition of, 49.2–49.3designing, 49.7–49.13dispensing practices tool for, 49.6EMP status reports for, 49.20feedback reports in, 49.7flow of documents in, 49.8forms and records for, 49.9

I.22 InDEx

functions of, 49.3–49.4implementing, 49.13–49.17importance of, 49.2–49.5indicators in, 49.11interpreting information in, 49.16–49.17in namibia, 49.11needs of users in, 49.5pilot testing of, 49.10presenting information from, 49.15–49.16pyramid of, 49.4record-keeping documents in, 49.7representativeness vs. comprehensiveness in, 49.10revising, 49.7–49.13software for, 49.12staff in, 49.12–49.13in tender management, 21.19

management of human resources. See human resources management (HRM)

management of laboratory services, 47.6–47.15management of medical supplies, 47.6–47.15management of medicine information centers, 34.11–

34.15management of pharmaceuticals

community participation and, 31.5–31.9computers in. See computer usedispensing practices in, 30.10–30.11distribution in. See distribution managementeconomics for. See economics for pharmaceutical

managementfinances in. See financial planning and managementgoals for, 1.8in health facilities. See health facility pharmaceutical

managementhealth services contracts in. See contracting for health

servicesin hospital pharmacies. See hospital pharmacy

managementimprest systems in, 22.12information for. See management information systemsinventory in. See inventory managementin medical stores. See medical stores managementpharmacovigilance in, 35.7planning for. See planning for managementprocurement in. See procurement of pharmaceuticalsin programs. See program managementin revolving drug funds, 13.17–13.18security in. See security managementsupply strategies in, 8.16–8.18supply systems assessments in, 36.3–36.5tender in. See tender managementtraining programs for. See training programstransport in. See transport managementwaste in, 1.7

management science methods, 38.17–38.18

Management Sciences for Health (MSH)and access to medicines, 1.16Drug Shop Initiative tool kit of, 32.13organizational roles of, 2.9–2.10pharmaceutical indicators by, 36.16–36.17price data by, 20.13Quantimed, 20.9training programs by, 52.13

manufacturers of pharmaceuticalscontracting with, 39.8medicine information from, 34.6–34.9organizations of, 2.5, 3.17practices of. See good manufacturing practices (GMPs)in tender management, 21.11

marginal costs and benefits, 10.2, 10.4, 10.13market

economic, 9.3failure of economic, 9.4–9.6, 10.7, 12.5global pharmaceutical, 3.2–3.3power of economic, 9.6production policies and, 7.7supply strategies and, 8.5

marketing of pharmaceuticals, 6.10–6.13, 32.12MARs. See medication administration recordsMartindale: The Extra Pharmacopoeia, 16.13, 28.5mass media, 33.20maternal health services, 1.5, 12.7. See also childrenmaximizing buying power, 9.16maximum stock levels, 23.16–23.17MDGs. See Millennium Development GoalsMDRI. See Multilateral Debt Relief InitiativeMDR-TB. See multidrug-resistant tuberculosismeasles treatment, 1.5mechanical equipment specifications, 42.13mechanized warehouses, 42.2Médecins Sans Frontières (MSF), 3.17–3.18, 26.3media communications, 13.19medical commodities. See medical suppliesmedical devices, defined, 47.3Medical Letter on Drugs and Therapeutics, 16.13, 29.9,

29.14, 34.6–34.7medical savings accounts (MSAs), 11.11, 12.4, 12.16–12.17Medical Stores Department (MSD) (Tanzania), 8.8, 22.11Medical Stores Limited (MSL) (Zambia), 8.9medical stores management

alphabetizing stock in, 44.13career development in, 44.17classifying stock in, 44.12–44.13cleaning in, 44.15–44.16, 44.19cold storage in, 44.10cold-chain options in, 44.11commodity codes in, 44.13delivery vouchers in, 44.24disposing of stock in, 44.16

InDEx I.23

dosage forms in, 44.13FIFO and FEFO in, 44.8fire precautions in, 44.16first aid in, 44.19fixed location systems in, 44.10flammables in, 44.10floor pallets in, 44.15flows in, 44.5–44.9fluid location systems in, 44.12housekeeping in, 44.15–44.17human resources in, 44.17humidity control in, 44.10inspections in, 44.7, 44.16inventory in, 44.2–44.3, 44.9load handling in, 44.14–44.15location of stock in, 44.10–44.12manual vs. computerized systems in, 44.3materials management information in, 44.2–44.5order allocation in, 44.8order assembly in, 44.8order delivery in, 44.8–44.9order picking in, 44.8organizational chart for, 44.18packaging specifications in, 44.15pallet racking in, 44.15performance monitoring in, 44.2, 44.4–44.5pest control in, 44.15–44.16procedures manuals in, 44.17random bins in, 44.13receiving reports in, 44.23register of requisitions in, 44.24requisition/issue vouchers in, 44.23rest areas in, 44.19security in, 44.10, 44.17semifluid location systems in, 44.12shelving in, 44.15space requirements in, 44.7staff facilities in, 44.17–44.19stock receipts in, 44.5–44.7stock records in, 44.4, 44.21–44.24storing and handling stock in, 44.7, 44.13–44.15supervising staff in, 44.17temperature control in, 44.9–44.10theft control in, 43.10therapeutic classifications in, 44.12training staff in, 44.17warehouse management in, 44.2zoning stock within stores in, 44.9–44.10

medical suppliesconsumables kits, 47.9cost analysis for, 47.12disposable items, 47.7–47.8distribution of, 47.11–47.14donations and, 47.16–47.17

equipment, 47.9, 47.15–47.17essential lists of, 47.11inventory management of, 47.14–47.15kits of, 47.8–47.9for laboratory services, 47.7–47.8management systems for, 47.6–47.15microscope kits, 47.9national policies for, 47.4–47.6procurement of, 47.10product specifications for, 47.13quality assurance for, 47.10quantification of, 47.9–47.10reusable items, 47.7–47.8safe disposal of, 47.15selection of, 47.6–47.7

medication administration records (MARs), 45.9–45.10medication counseling, 33.6medication errors, 35.4–35.5, 35.14–35.15medication order systems, 45.8–45.9medication order triggers, 35.10–35.11medication safety terms, 35.6medication treatment records, 45.9–45.10medication use. See rational medicine usemedicinal plants protection, 5.13medicine information

centers for, 34.9–34.11, 34.11–34.15,Cochrane Collaboration for, 34.5computer use, 50.15–50.16drug bulletins for, 34.12equipment needed for, 34.10evaluating sources of, 34.3–34.6, 34.12–34.13funding issues in providing, 34.15information sources on, 34.17Internet and, 34.3library of references on, 34.6managing centers for, 34.11–34.15manufacturer provided, 34.6–34.9proactive outreach for providing, 34.11–34.12promotion of medicines vs., 34.7–34.9services providing, 34.10–34.11setting up centers for, 34.9–34.11sites for centers for, 34.9–34.10sources of, 34.14staff providing, 34.10training in, 34.12types of, 34.2–34.9

medicine sales, 11.7–11.8, 29.17medicine selection

and access to medicines, 1.10committees for. See drug and therapeutics committees

(DTCs)criteria for, 16.4–16.5essential medicines concept in, 16.2–16.4essential medicines lists in, 16.6–16.14

I.24 InDEx

formulary manuals in, 16.7–16.10generic medicines in, 16.5–16.6glossary terms, 16.16quality assurance in, 19.10–19.11for rational prescribing, 29.11registered medicines in, 16.7in revolving drug funds, 13.17–13.18sources of information on, 16.13in tender management, 21.10therapeutic classifications in, 16.10–16.13treatment guidelines in, 16.8–16.10

medicine useby consumers. See consumer use of medicinesdata on, 28.4investigating. See investigating medicine useby prescribers. See rational prescribingrational. See rational medicine use studies in health facilities, 28.7–28.9

medicines lists. See essential medicines listsmedium-term expenditure frameworks (MTEFs), 14.12MEDLInE database, 50.9MEDS. See Mission for Essential Drugs and Supplies

(Kenya)MEMS. See Mission for Essential Medical Supplies

(Tanzania)meningitis treatment, 29.8–29.9merit goods, 10.5methadone maintenance therapy (MMT), 45.10, 45.13Methodology for Assessing Procurement Systems, 21.24Mexico, 29.19microbicides for HIV/AIDS, 6.16microscope kits, 47.9Millennium Development Goals (MDGs)

donor financing and, 1.13, 11.3, 14.2essential medicines concept in, 2.8performance indicators in, 36.14–36.15

MIMS. See Monthly Index of Medical SpecialtiesMinilab assessments, 19.16minimum-maximum stock-level formulas, 23.19–23.20minimum orders, 23.18Mission for Essential Drugs and Supplies (MEDS)

(Kenya), 8.15, 38.8Mission for Essential Medical Supplies (MEMS)

(Tanzania), 8.11MMT. See methadone maintenance therapyModel List of Essential Medicines (WHO)

essential medicines concept in, 2.8introduction to, 1.7medicine selection and, 16.5–16.13national medicine policies and, 4.8standard treatment guidelines and, 17.3therapeutic category analysis and, 40.21

modified optional replenishment, 23.20, 26.14Mongolia, 15.10, 27.4

monitoring and evaluationbudget template for, 48.18community participation for, 31.13–31.14comparison data in, 48.19complexity in, 48.17defining, 48.2designing, 48.6–48.8existing systems and, 48.19feedback in, 48.13field supervision in, 48.7follow-up action from, 48.13–48.15of health services contracts, 39.14–39.16indicators for, 48.7–48.12inputs in, 48.8measurability in, 48.8of medicine fees, 48.7methods in, 48.3–48.6objectivity in, 48.19outcomes in, 48.8outputs in, 48.8overambitiousness in, 48.17pitfalls of, 48.17–48.19in pricing policies, 9.12–9.14, 9.16processes in, 48.8in program management, 37.10–37.11for rational prescribing, 29.10reliability of indicators in, 48.9resources required for, 48.17, 48.19of retail drug sellers, 32.12of revolving drug funds, 13.19routine reporting in, 48.3–48.5, 48.7self-monitoring in, 48.16sentinel sites in, 48.5–48.6SMART objectives in, 48.11special studies in, 48.6–48.7supervisory visits for, 48.3, 48.8of suppliers in tender management, 21.13of supply systems, 36.3of training programs, 52.16validity of indicators in, 48.9

monitoring-training-planning (MTP) method, 52.11–52.13

monopolistic competition, 9.4monopoly, in pharmaceutical market, 9.4monopoly power, in insurance benefits programs, 12.5–12.6monopsony, 9.4–9.6, 18.9, 18.12–18.14Monthly Index of Medical Specialties (MIMS), 34.8monthly requisitions and deliveries, 22.15moral hazard, 11.11, 12.6morbidity method

for quantifying pharmaceutical requirements, 20.3–20.5, 20.12–20.13, 20.18–20.24

for quantifying supplies, 47.9–47.10Mozambique, 14.12, 15.5

InDEx I.25

MSAs. See medical savings accountsMSH. See Management Sciences for HealthMTEFs. See medium-term expenditure frameworksMTP. See monitoring-training-planning) methodmultidrug-resistant tuberculosis (MDR-TB), 49.13Multilateral Debt Relief Initiative (MDRI), 14.11multilateral institutions, 14.5,14.9multiple-payer insurance, 12.4multisectoral planning, 38.6multisource medicines. See generic medicinesmutual health organizations, 12.12

namibiacentral medical stores in, 44.3human resources in, 51.4–51.5, 51.12–51.13management information systems in, 49.11medicine information center in, 34.11pharmaceutical management in, 36.5pharmaceutical regulation in, 6.12

narcotics consumption, 28.11national Coordinating Council for Medication Error

Reporting and Prevention (United States), 35.4national development goals, 1.8national essential medicines lists, 16.5–16.11, 16.15national formulary manuals, 16.7national Health Insurance Scheme (nHIS) (Ghana), 17.5national Insurance for Mothers and Children (SnMn)

(Bolivia), 12.7national medicine policies (nMPs)

access to medicines and, 1.8–1.9, 4.14accountability and, 4.14affordability and, 4.7, 4.9in Australia, 4.16components of, 4.5–4.9constraints to, 4.18corruption and, 4.18definition of, 4.3–4.5drafting of, 4.13endorsement of, 4.14–4.15essential medicines in, 4.8, 4.14evaluating, 4.7, 4.17–4.18facilitating factors for, 4.18financial strategies for, 4.7, 4.9flexibility in, 4.15formulation of, 4.12–4.15goals of, 4.4goals and objectives in, 4.13human resources and, 4.7, 4.9human rights and, 4.14implementing, 4.15–4.17in Lao PDR, 4.10launching, 4.15legislative and regulatory framework for, 4.6–4.7macroeconomics and, 4.18

of Malawi, 4.13monitoring, 4.7, 4.17–4.18opposition to, 4.18political will and, 4.18priorities in, 4.9–4.12rational medicine use and, 4.7, 4.9, 27.12rational prescribing and, 29.3research and, 4.7resources and, 4.18stakeholders in, 4.5–4.6structure of, 4.3, 4.11supply strategies and, 4.7–4.8support for, 4.15, 4.18technical cooperation in, 4.7technical expertise and, 4.18transparency and, 4.14values and, 4.18in Yemen, 4.17

national-level pharmacovigilance, 35.8–35.9national medicines committees (nMCs), 40.12national policies for laboratory services, 47.4–47.6national policies for medical supplies, 47.4–47.6needs assessments

in program management, 37.16for storage facilities, 42.4in training programs, 52.4

neglected diseases, 3.16–3.18neighbor-to-neighbor education, 33.16nepal

community case management in, 31.7distribution challenges in, 22.8education on medicine use in, 33.19rational prescribing in, 29.19

The netherlands, 6.4The New Emergency Health Kit, 15.6new Zealand, 9.5nGOs. See nongovernmental organizationsnicaragua, 17.5, 34.14nigeria, 1.17, 28.12, 32.4NIH Consensus Development Conference Statement on the

Management of Hepatitis B, 34.6nMPs. See national medicine policiesnoncompliance penalties in contracts, 39.15nonessential medicines, 17.12–17.13, 40.10nonformulary medicines, 45.8nongovernmental organizations (nGOs)

for access to medicines, 1.11, 1.17assessing supply systems of, 36.11–36.15donor financing and, 14.5–14.7, 14.15–14.18essential medicines services of, 2.8, 8.15expenditures of, 40.27importation by, 24.8not-for-profit services of, 8.14–8.15price comparison analysis in, 40.27

I.26 InDEx

procurement by, 18.6–18.9and supply systems, 8.8, 8.11, 8.13transport fleets of, 25.8, 25.12

nonprofit procurement agencies, 18.8–18.9nonsterile production of pharmaceuticals, 45.13nordic ATC system, 16.10norway, 2.3not-for-profit pharmaceutical services, 8.14–8.15nystatin, 2.2

obsolescence costs, 40.6OECD. See Organisation for Economic Co-operation and

DevelopmentOECS/PPS. See Organisation of Eastern Caribbean States

Pharmaceutical Procurement Serviceoligopolistic competition, 9.4open requisitioning, 26.15open tender

managing, 21.15for procurement, 18.6restricted tender vs., 21.4storage facilities and, 42.15

operating budgets, 41.10, 41.16operating costs, 13.8, 40.6operational plans, 38.10–38.11opinion leaders for prescribing practices, 29.10opinion surveys, 13.19opportunity costs, 10.2–10.4options analysis, 36.4, 38.9–38.10oral rehydration solution (ORS) or therapy (ORT), 20.6,

27.4–27.5, 28.6, 31.12oral vs. injectable antibiotics, 29.13orders of medicines and supplies

allocating, 44.8assembling, 44.8cost of, 23.7defined limits for, 26.15dispatch and delivery of, 44.8–44.9picking, 44.12quantities in, 43.11reports on, 50.13value calculations of, 42.7

Organisation of Eastern Caribbean States Pharmaceutical Procurement Service (OECS/PPS), 16.10, 40.24–40.25

Organisation for Economic Co-operation and Development (OECD), 7.8

organizational charts, 44.18organizational roles

of advocacy groups, 2.7of community-based organizations, 2.7intellectual property laws and, 2.10of nGOs, 2.8–2.9of pharmaceutical industry, 2.9–2.11

of regulatory bodies, 2.9of Un agencies, 2.8

original brands, 3.3ORS. See oral rehydration solutionORT. See oral rehydration therapyoutpatient departments, 43.11outpatient dispensing, 46.11

pack sizes, 23.18packaging

for dispensing, 30.11–30.12materials for, 30.8in pharmaceutical contracts and tenders, 39.8–39.9specifications for, 44.15of supply kits, 26.12

packing lists, 24.7Pakistan, 27.4pallet racking, 42.13, 44.15Pan American Health Organization (PAHO), 6.5, 18.9,

18.14Pan American network for Drug Regulatory

Harmonization (PAnDRH), 6.5pan weighing scales, 30.14Papua new Guinea

kit system in, 26.6pharmaceutical contracting in, 39.13pharmaceutical tender in, 21.14

parallel health care systems, 5.9parallel importation, 3.7, 3.12participatory mapping, 31.11Partnership for Maternal, newborn & Child Health, 14.7passive data collection, 35.10patents

in bilateral trade agreements, 3.12history of, 2.4intellectual property laws, 3.6in pharmaceutical contracts, 39.10in pharmaceutical sector, 3.3in pricing policies, 9.8R&D for new medicines and, 3.16

patientscounseling for, 30.8–30.10education of, 29.10, 33.3–33.6kits for, 26.4medication profiles of, 45.9rational medicine use by, 27.8revolving drug funds and, 13.14, 13.18–13.19treatment guidelines for, 17.3, 17.6

paymentscurrency for, 39.6–39.7reliable mechanisms for, 18.9–18.12, 18.22terms for, 39.7, 39.15

payment-time analysis, 40.26, 40.28PDAs. See personal digital assistants

InDEx I.27

pedigrees of products, 19.13penicillin, 1.3, 2.2PEPFAR. See U.S. President’s Emergency Plan for AIDS

Reliefper capita health expenditures, 1.6per capita medicine consumption, 11.6, 28.9–28.10per capita pharmaceutical budgets, 11.10performance

in assessing supply systems, 36.5, 36.14–36.15in distribution management, 22.16–22.17funding based on, 14.13in health services contracts, 39.14–39.15in inventory management, 23.6in medical stores, 44.2, 44.4–44.5in pharmaceutical contracts, 39.9–39.10in program management, 37.2–37.3targets for, 48.10–48.11

periodic-order contracts, 21.6–21.7perpetual purchasing, 23.14–23.15personal digital assistants (PDAs), 17.14, 50.3, 50.9personnel. See human resources management (HRM)PERT. See project evaluation and review techniqueperverse financial incentives, 29.4pest control, 44.15–44.16Pharmaceutical Benefits Schedule (PBS) (Australia), 10.8pharmaceutical companies. See pharmaceutical industryPharmaceutical Health and Rational Use of Medicines

(PHARM), 4.16pharmaceutical industry

changes in, 2.9–2.11globalization and, 2.10–2.11historical perspectives on, 2.4–2.5intellectual property laws and, 2.10Internet and, 2.10–2.11national medicine policies and. See national medicine

policies (nMPs)organizational roles in, 2.9–2.11patents and, 3.3pricing policies in, 9.10public-private initiatives and, 2.10

Pharmaceutical Procurement Service (PPS) (Eastern Caribbean), 23.14

Pharmaceutical Research and Manufacturers of America (PhRMA), 3.17

pharmaceuticalsassessing supply systems for. See supply systems

assessmentdistribution of. See distribution managementexpenditures for. See expenditures for pharmaceuticalsfinancing for. See financing strategiesindicator (tracer), 48.11–48.12insurance benefits for. See insurance for pharmaceuticalslegislation on. See legislation on pharmaceuticalsmanagement of. See management of pharmaceuticals

manufacturers of. See manufacturers of pharmaceuticalspricing policies for. See pricing policiesprocurement contracts for. See contracting for

pharmaceuticalsproduct registration for, 50.14production policies for. See production policiesprograms for. See program managementquality assurance for. See quality assurance for

pharmaceuticalsregistration of, 29.17–29.18requirements for. See quantifying pharmaceutical

requirementssupply kits for. See kit systemssupply management for. See supply managementsupply strategies for. See supply strategiestender for. See tender management

pharmacies in hospitals. See hospital pharmacy management

pharmacists, 27.13, 37.4pharmaco-economic analysis, 9.16, 10.8, 10.13–10.14Pharmacologic-Therapeutic Classification, 40.21pharmacology education, 29.6–29.7pharmacopoeias, 6.6pharmacovigilance

ADE/product quality problem form, 35.13ADR reporting in, 35.15adverse drug events and, 35.3, 35.5–35.6adverse drug reactions and, 35.3–35.4, 35.6data collection and use in, 35.10–35.15definition of, 35.2–35.3designing systems for, 35.6–35.10at facility level, 35.8framework for, 35.8at international level, 35.10medication errors and, 35.4–35.5, 35.14–35.15at national level, 35.8–35.9in public health programs, 35.9–35.10regulation for, 6.8–6.10roles of partners in, 35.9safe medication practices, 35.16in traditional medicine, 5.12trigger detection methods in, 35.11

pharmacy benefit programs, 39.3Pharmacy Education Taskforce Action Plan 2008–10, 51.7pharmacy personnel

dispensing practices of, 30.14–30.16human resources crisis and, 51.4–51.7pharmacists, 27.13, 37.4

PharmWeb, 50.15Philippines, 9.15, 36.12Physicians’ Desk Reference, 34.8pictograms, 33.8–33.9, 33.25pilot testing, 13.13, 49.10pipeline calculations, 13.10

I.28 InDEx

planning for managementactivity-time charts in, 38.14assessments in, 38.7–38.9for community participation, 31.13components of, 38.13crises and, 38.7criteria for, 38.10failure of, 38.19–38.21feasibility assessment for, 38.10five-year plans in, 38.15framework of, 38.7–38.8goals of, 38.4, 38.9LogFrame projects in, 38.18management science in, 38.17–38.18multisectoral teams for, 38.6objectives of, 38.4–38.5operational plans in, 38.10–38.11options analysis in, 38.9–38.10process of, 38.2–38.6of programs, 37.8–37.11, 38.2–38.6, 38.11–38.14progress checks in, 38.17progress review cycles in, 38.19for rational medicine use, 38.12of revolving drug funds, 13.6software for, 38.18–38.19of storage facilities. See storage facilitiesstrategic, 38.2–38.3, 38.6–38.11of supply systems assessments, 36.18–36.19teams for, 38.5–38.6three-year plans in, 38.16top-down vs. bottom-up, 38.5

PMTCT. See prevention of mother-to-child transmissionpneumonia treatment, 31.8PolicyMaker, 36.14political mapping, 36.14polypharmacy, 27.3pooled procurement, 18.8–18.9, 18.14poor-quality pharmaceuticals, 19.7–19.8port clearing. See also importation

contracting for, 24.3in distribution cycle, 22.5documents for, 24.5, 24.7expediting, 24.5–24.8overview of, 24.5theft control in, 43.10

postqualification of suppliers, 21.4poverty reduction strategy papers, 14.12–14.13PPS. See Pharmaceutical Procurement Service (Eastern

Caribbean)predictive accuracy, 20.4prefabricated buildings, 42.4, 42.8–42.9, 42.14–42.15preferential weighting, 40.12prepackaging of medicines. See also kit systems

in consumer use of medicines, 33.10

in dispensing practices, 30.13–30.14in health facilities, 46.11

prequalification of medicines, 19.12prequalification of suppliers

by Global Fund to Fight AIDS, Tuberculosis and Malaria, 21.5

in tender management, 21.4–21.5, 21.11–21.12by UnICEF, 21.5by WHO, 21.4–21.5, 21.12

prequalification tendering, 42.15prescribers, 27.7–27.8, 27.12prescribing rationally. See rational prescribingprescription fees, 13.14prescription patterns. See dispensing practicesPrescrire International, 34.6presentations

computer use for, 50.6on supply systems assessments, 36.19in training programs, 52.15

preservice education, 29.6–29.7prevention of mother-to-child transmission (PMTCT),

20.9, 36.4–36.5preventive health care, 31.5price comparison analysis, 9.12–9.14, 40.24–40.27prices

controlling, 9.18dispensed selling, 9.11–9.12landed, 9.11levels of, 41.8per unit, 18.3–18.5policies for. See pricing policiesprivate-sector vs. public supply system, 40.26and rational prescribing, 29.15retail, 9.11in revolving drug funds, 13.13–13.17setting of, 29.17, 41.9–41.10subsidies for, 13.9theory for determining, 9.2–9.3wholesale, 9.11

price/volume agreements, 9.17pricing policies

assessing, 9.15–9.16brand premiums in, 9.18branded off-patent medicines in, 9.9–9.10buyer strategies in, 9.14–9.17buying power in, 9.16capitation systems in, 9.19demand and supply in, 9.2–9.3digressive markups in, 9.19elasticity in, 9.3–9.4fixed margins in, 9.19for generic medicines, 9.8–9.9globalization and, 9.19–9.20government intervention and, 9.17–9.19

InDEx I.29

international benchmarking in, 9.18markets and, 9.3–9.6monitoring prices in, 9.12–9.14, 9.16negotiating prices in, 9.16package agreements in, 9.16–9.17for patented medicines, 9.8pharmaceutical companies and, 9.10pharmaco-economic analysis in, 9.16price comparisons and, 9.12–9.14price controls in, 9.18price/volume agreements in, 9.17profit controls in, 9.18rebates in, 9.17reference pricing in, 9.18supply chain factors in, 9.10–9.13survey samples in, 9.14tariffs and taxes in, 9.18–9.19tendering and, 9.16theory of price determination in, 9.2–9.3variable pricing in, 9.10–9.12WHO/HAI method in price monitoring, 9.14–9.15

primary contracts, 21.7primary distributor systems, 8.11–8.12, 18.17primary health kits, 22.11, 26.13primary production of pharmaceuticals, 7.3primary suppliers of pharmaceuticals, 21.11prime vendor supply systems, 8.11private foundations, 14.6, 14.9, 14.15private health insurance, 11.11, 12.4, 12.14–12.16private sector

distribution of medicines and supplies in, 22.4, 22.17–22.18

economics in, 10.5–10.9financing strategies in, 11.7–11.8health services contracts in, 39.13–39.14medicine use in, 28.12–28.13prices in, 40.26public sector and. See public-private partnershipssuppliers in, 8.3, 18.17supply systems in, 8.12, 8.18, 36.12–36.13

pro forma invoices, 24.7problems with medicine use

analyzing, 33.14identifying, 33.12–33.13interventions in, 28.14–28.20prioritizing, 33.13

procurement cost estimates, 20.13procurement information systems, 21.19–21.24, 44.3–

44.4procurement of pharmaceuticals

ABC analysis in, 18.15acquisitions costs in, 40.5aggregating demand in, 18.13annual audit of, 18.12, 18.16

assessment of, 18.11, 36.7autonomous supply agencies in, 18.16central medical stores in, 18.16committees for, 18.19competitive, 18.7, 18.12, 18.14computers and, 50.11coordinated informed buying in, 18.11costs in, 18.3–18.6currency exchange in, 18.22cycle of, 18.3–18.4direct delivery systems and, 18.16in distribution cycle, 22.5essential medicines or formulary lists and, 18.11–18.13estimates of need in, 18.12, 18.15financial management in, 18.10–18.12financial sustainability in, 18.21–18.22funding sources for, 18.21–18.22generic medicines in, 18.11global agencies for, 18.8glossary of terms, 18.22–18.26 good practices for, 18.10–18.16Internet and, 18.6–18.7for kit systems, 26.12“local-to-global” supply chains in, 18.8manuals for, 18.20–18.21market information and, 18.19–18.20medicine selection committees in, 18.19methods for, 18.6–18.10monopsony commitment in, 18.9, 18.12, 18.14nonprofit agencies for, 18.8–18.9open tender in, 18.6payment mechanisms in, 18.9–18.12, 18.22percentage fees in, 18.9periods for, 20.11, 23.17pooled, 18.8–18.9, 18.14prices in, 18.3–18.6primary distributor systems in, 18.17private suppliers in, 18.17quality assurance in, 18.12, 18.16quantification for, 20.4–20.5rational prescribing in, 29.11regional collaboration in, 18.10–18.11reorder frequencies in, 18.5reporting on, 18.12, 18.16, 21.21–21.23responsibilities in, 18.18–18.19restricted tender in, 18.6reverse auction in, 18.6–18.7in revolving drug funds, 13.18staffing requirements in, 18.19supervision of, 18.18suppliers in, 18.12–18.14technical assistance for, 18.20–18.21tender management in, 18.19, 21.3therapeutic category analysis in, 18.15

I.30 InDEx

tracking performance in, 18.20transparency in, 18.12, 18.15unit prices in, 18.3–18.5VEn analysis in, 18.15visible vs. hidden costs in, 18.5–18.6volume in, 18.12–18.13written procedures for, 18.12, 18.15

procurement and supply management, 18.20, 36.2–36.3, 47.11

product identification technology, 19.15product master files, 50.22–50.24product problem reporting systems, 19.18–19.20production policies

duties and import controls in, 7.7–7.8economic incentives in, 7.7globalization and, 7.5–7.6infrastructure in, 7.6local production and, 7.3–7.10market factors in, 7.7for primary production, 7.3public-private partnerships in, 7.8public sector in, 7.10regulatory and legal provisions in, 7.7on role of producers, 2.9–2.11for secondary production, 7.3for tertiary production, 7.3

productive efficiency, 10.9profit controls, 9.18program management

best practices in, 37.6–37.11change management in, 37.15–37.20coaching in, 37.13–37.14crisis management in, 37.5cycle of, 37.8–37.11decision making in, 37.12–37.13focused supervision in, 37.16force field analysis in, 37.17–37.18glossary of terms, 37.21 interactive system design in, 37.16leadership in, 37.2–37.8managers in, 37.3–37.8monitoring and evaluation in, 37.10–37.11needs assessment in, 37.16negotiating in, 37.14–37.15operations supervision in, 37.5for performance, 37.2–37.3phased implementation in, 37.16–37.17planning phase of, 37.8–37.10, 38.2–38.3, 38.11–

38.14priority setting in, 37.11–37.12problem solving in, 37.12–37.13skills in, 37.6, 37.11–37.15time management in, 37.12traditional vs. modern approaches to, 37.5

Programme for International Drug Monitoring (WHO), 35.10

progress reviewscycle of, 38.19in donor financing, 14.17for management planning, 38.17for rational medicine use, 48.14

project briefs, 42.10–42.11project evaluation and review technique (PERT), 38.17–

38.18project planning, 38.17–38.19projecting demand, 23.17–23.18promotion of medicines, 6.10, 34.7–34.9prospective studies, for investigating medicine use,

28.4provider-patient communications, 33.4–33.6provider payment mechanisms, 12.6–12.8proxy consumption method of quantification, 20.3–20.5,

20.24–20.26public health services. See also public sector

access to medicines via, 1.3, 1.7–1.8expenditure goals for, 10.4insurance, 12.3–12.4pharmacovigilance in, 35.9–35.10R&D for new medicines in, 3.18

public-private partnershipsdonor financing and, 14.6–14.8initiatives for, 2.10and production policy, 7.8for R&D for new medicines, 3.18for storage facilities, 42.5, 42.15

public sector. See also public health servicesin distribution management, 22.4economics in, 10.4–10.5financing strategies in, 11.8–11.10private-sector and. See public-private partnershipsproduction of pharmaceuticals in, 7.10spending in, 11.4–11.5supply systems and, 8.11

PubMed, 50.15pull distribution systems, 22.10pull vs. push inventory systems, 23.4push distribution systems, 22.9–22.10

QALY. See quality-adjusted life-yearqualitative data, 36.14, 36.18qualitative research methods, 28.14–28.16quality assurance

in access to medicines, 1.8for health care services, 27.5for laboratory services, 47.10for medical supplies, 47.10in procurement, 18.12, 18.16records in, 21.20

InDEx I.31

retail drug sellers and, 32.11–32.13in revolving drug funds, 13.18in tender management, 21.18–21.19for traditional medicine, 5.5, 5.8–5.9, 5.11–5.15

quality of pharmaceuticalsadverse reactions vs., 19.7assessing, 19.4, 19.16bar coding in, 19.15batch certificates for, 19.13bioavailability and, 19.4–19.5certification of products for, 19.10, 19.12–19.14contract specifications in, 19.14–19.15co-packaging and, 19.18counterfeits vs., 19.9determinants of, 19.6–19.7dispensing practices and, 19.18, 30.14drug regulatory authorities and, 19.13–19.14failure of, 19.5–19.7fixed-dose combinations and, 19.18framework for, 19.2–19.4global monitoring of, 19.8good manufacturing practices in, 19.7–19.8holograms in, 19.13inspection of shipments in, 19.15–19.16laboratory testing for, 19.17legal reference method in, 19.16legislation and regulation of, 6.10Minilab assessments of, 19.16monetary waste vs., 19.7monitoring, 19.18–19.20personnel in, 19.20practical approaches to, 19.8–19.10procurement and, 19.10–19.15product identification technology in, 19.15product pedigrees and, 19.13product problem reporting systems in, 19.18–19.20product recalls and, 19.20radio frequency identifications in, 19.13, 19.15resource organizations for, 19.22for shipped products, 19.15–19.17specialized instruments in, 19.16–19.17stability in, 19.5storage and, 19.17–19.18strength or potency in, 19.4supply systems and, 19.20therapeutic windows in, 19.16–19.17tiered assessments of, 19.16–19.17training personnel in, 19.20transport and, 19.17–19.18treatment kits and, 19.18uniformity of dosage in, 19.4validated laboratory assessments of, 19.16

Quality Control Methods for Medicinal Plant Materials, 5.12

quality-adjusted life-year (QALY), 10.12quantification of laboratory and medical supplies, 47.9–

47.10quantifying pharmaceutical requirements

action plans for, 20.6–20.8actual consumption vs. theoretical need in, 20.5adjusting final quantities in, 20.13–20.15applications of, 20.4–20.5centralized vs. decentralized approaches to, 20.8–20.9changes impacting, 20.11computers and, 20.9–20.10, 50.9–50.11consumption method for, 20.3–20.5, 20.15–20.18cross-checking results of, 20.11–20.13lead time effects in, 20.11loss adjustments, 20.11medicines lists in, 20.10morbidity method for, 20.3–20.5, 20.18–20.24predictive accuracy in, 20.4proxy consumption method for, 20.3–20.5, 20.24–20.26reconciling final quantities in, 20.13–20.15safety stock in, 20.11service-level projections in, 20.4–20.5, 20.26–20.28supply pipeline in, 20.10for tenders, 21.10time estimates for, 20.10

Quantimed, 20.9, 50.11quantitative data, 36.14quantitative research methods, 28.5, 28.7–28.14questionnaires, use in research, 28.14–28.16

R&D for new medicinesalternative paradigms for, 3.19–3.20in developing countries, 3.19–3.20intellectual property law and, 3.16–3.20for neglected diseases, 3.16–3.18public-private partnerships for, 3.18technology transfer in, 3.18–3.19trends in, 3.16

radio frequency identification (RFID), 19.13, 19.15randomized clinical trials, 34.5Rapid Pharmaceutical Management Assessment, 36.18ration kit systems, 26.2, 26.16. See also kit systemsrational medicine use

access to medicines and, 1.11–1.12antimicrobial resistance and, 27.5–27.6, 27.11, 27.14community participation and, 27.8, 31.8–31.9by consumers. See consumer use of medicinescosts and, 27.6defining, 27.2–27.3dispensers and, 27.7–27.8drug and therapeutics committees for, 27.12education for, 27.12–27.13essential medicines lists for, 27.12financial strategies for, 11.13, 27.13

I.32 InDEx

glossary of terms, 27.14–27.15 governments and, 27.13health systems impacting, 27.6–27.7historical perspectives on, 2.5–2.6hospital formularies for, 27.12information sources on, 27.14insurance and, 12.11interventions for, 27.10–27.14irrational use vs., 27.3–27.8injection overuse vs., 27.4in kit systems, 26.13licensure requirements and, 27.12national medicine policies and, 4.7, 4.9, 27.11national multidisciplinary bodies for, 27.12pharmacists and, 27.13planning for, 38.12polypharmacy vs., 27.3prescribing for. See rational prescribingprofessional associations for, 27.12in revolving drug funds, 13.18social marketing for, 33.14standard treatment guidelines for, 27.12strategies for, 27.9–27.14and traditional medicine, 5.8, 5.14–5.16underuse of effective medicines vs., 27.5unsafe medicines vs., 27.4–27.5wrong medicines vs., 27.4

rational prescribingof antibiotics, 29.16benchmarks for, 29.11capitation-based reimbursement and, 29.17clinical newsletters for, 29.9conceptual framework for, 29.2–29.4consumer organizations for, 29.4core strategies for, 29.3–29.4cost bar graphs for, 29.15cost information in, 29.13–29.14COTs in, 29.17data for, 29.11–29.12defined daily doses in, 29.4dispensing practices and, 29.15, 29.20–29.21drug and therapeutics committees for, 29.3, 29.10–

29.13, 29.16drug use reviews in, 29.4, 29.11–29.12, 29.14–29.15economic interventions for, 29.5, 29.17educational interventions for, 29.3–29.10essential medicines lists and, 29.3face-to-face contact and, 29.9facility budgets and, 29.15feedback for, 29.10–29.11formative vs. intervention studies in, 29.21–29.22group educational activities for, 29.8–29.9hospital formularies and, 29.3illustrated materials for, 29.9

in-service education for, 29.7–29.8insurance and, 12.10, 29.17interventions for, generally, 29.4–29.5, 29.21–29.22licensure requirements and, 29.3limited medicines lists and, 29.18–29.20limited procurement lists for, 29.11managerial interventions for, 29.5, 29.10–29.17medicine formularies for, 29.9medicine use and. See rational medicine usemonitoring, 29.10national medicine policies and, 29.3opinion leaders and, 29.10patient charts and, 29.11patient education and, 29.10perverse financial incentives vs., 29.4preservice education, 29.6–29.7prices and, 29.15, 29.17printed materials for, 29.9registration of pharmaceuticals and, 29.17–29.18regulations for, 29.3–29.5, 29.17–29.21restrictions in, 29.20selection of medicines in, 29.11social marketing for, 29.22standard treatment guidelines and, 29.3, 29.8, 29.15supervision for, 29.8, 29.10system-oriented interventions for, 29.5targeted interventions for, 29.4–29.5training for, 29.3–29.7

RDFs. See revolving drug fundsrebates, 9.17rebids, 21.7recalling products, 19.20receiving

bays, 46.3reports on, 44.23shipments, 22.5

RECOMBIVAx HB (hepatitis B vaccine, recombinant), 35.4

record keepingin dispensing practices, 30.7documents for, 49.7in health facilities, 46.7–46.9for kit systems, 26.12–26.13by retail drug sellers, 32.11in tender management, 21.19–21.23

recurrent costs, 10.13reference manuals. See formulary manualsreference pricing, 9.18refrigeration, 46.5Regional Technical Resource Collaboration (RTRC),

52.13register of requisitions, 44.24registration of pharmaceuticals

essential medicines lists and, 16.7

InDEx I.33

in importation, 24.7legislation on, 6.10–6.13

regulation of pharmaceuticals. See also legislation on pharmaceuticals

access to medicines and, 1.18definition of, 10.7national medicine policies and, 4.6–4.7production policies and, 7.7for rational medicine use, 27.9–27.10for rational prescribing, 29.3–29.5, 29.17–29.21traditional medicine in, 5.8, 5.10–5.11, 5.15

regulation of retail drug sellers, 32.4–32.5, 32.11regulation of storage facilities, 42.8reimbursement insurance systems, 12.5reordering

formulas for, 23.19–23.21frequency in, 18.5, 23.11–23.16levels, 23.16mathematical models for, 23.21–23.23quantities in, 23.16–23.19

repackaging medications, 45.12–45.13, 45.15reporting

in financial management, 41.17–41.19in health services contracts, 39.15on procurement of pharmaceuticals, 18.12, 18.16on supply systems, 36.19

requirements for pharmaceuticals. See quantifying pharmaceutical requirements

requisitions, 22.5–22.6, 44.23research

donor financing of, 14.10–14.11human resources development and, 4.9in national medicine policies, 4.7in tender management, 21.11on traditional medicine, 5.15

research and development of new medicines. See R&D for new medicines

resourcescontrol of, 41.14–41.17in distribution management, 22.14–22.16government allocation of, 10.3human. See human resources management (HRM)for monitoring and evaluation, 48.17, 48.19national medicine policies and, 4.18regulatory authorities and, 6.15

respiratory infections, 1.5restricted tender, 18.6, 21.4–21.5restrictions on prescribing, 29.20resupply intervals, 22.10–22.11retail drug sellers

accreditation and, 32.6–32.9best practices for, 32.5–32.7business ethics and, 32.12in developing countries, generally, 32.2–32.3

education of, 32.3–32.4, 32.11essential medicines lists and, 32.11financial management by, 32.12formative research for, 32.9–32.11franchising and, 32.7–32.10improving practices of, 32.9–32.13incentives for, 32.11–32.12infrastructure of, 32.11marketing and communications for, 32.12monitoring and supervision of, 32.12popularity of as source of health care, 32.2–32.3problems with, 32.3quality assurance and, 32.11–32.13record keeping by, 32.11regulation of, 32.4–32.5, 32.11social marketing and, 32.5staff qualifications, 32.11stakeholder engagement in, 32.5, 32.11–32.12, 32.14strengthening role of, 32.3–32.5in supply strategies, 8.15–8.16tool kit for, 32.13

retail prices, 9.11retrospective studies, 28.4, 36.17reusable medical supplies, 47.7–47.8revenue collection, 12.4, 13.8reverse auctions, 18.6–18.7revolving drug funds (RDFs)

administration of, 13.7, 13.13balance sheets for, 41.19bottom-up vs. top-down implementation of, 13.12capitalization requirements for, 13.9–13.13cash planning in, 41.12–41.14community involvement in, 13.12cost-recovery in, 13.7–13.8cost savings in, 13.10costs vs. revenues in, 13.14course-of-therapy fees in, 13.14decapitalization of, 13.21definition of, 13.4demand and supply in, 13.13economic issues and, 13.7, 13.22equity of access in, 13.12–13.17, 13.22exemptions in, 13.16–13.17experiences with, 13.4–13.6external funding for, 13.8–13.9feasibility assessment for, 13.6–13.7financial management of, 13.7–13.11, 13.14, 13.17–

13.18financing mechanisms in, 11.2, 11.13–11.15foreign exchange rates and, 13.9government funding for, 11.7–11.8, 13.8–13.9, 41.3–

41.6guidelines for, 13.22health staff preparation for, 13.18–13.19

I.34 InDEx

impact evaluation of, 13.13implementation planning for, 13.12–13.13, 13.22income and expense reports for, 41.18inventory control in, 13.18kit systems and, 26.8legal issues in, 13.12local control of, 13.22management of, 13.9, 13.17–13.18media communications about, 13.19medicine fees in, 13.14–13.15monitoring, 13.19monthly sales in, 13.10–13.11operating budgets for, 13.8, 41.16opinion surveys for, 13.19organizational issues in, 13.11–13.12patients and, 13.14, 13.18–13.19pilot testing of, 13.13pipeline calculations for, 13.10pitfalls and lessons of, 13.19–13.22planning and implementing, 13.6political issues and, 13.6–13.7prescribing patterns in, 13.14price subsidies in, 13.9pricing in, 13.13–13.17procurement in, 13.18protection mechanisms in, 13.16public preparation for, 13.18–13.19quality assurance in, 13.18rational medicine use in, 13.18referral systems in, 13.13revenues in, 13.8, 13.13selection of medicines in, 13.17–13.18situation analysis for, 13.6–13.7start-up financing for, 13.9supervision and, 13.19supply management in, 13.11–13.12, 13.17–13.18user fees in, 13.6–13.7, 13.20–13.22vertical health programs and, 41.3

RFID. See radio frequency identificationrifampicin, 7.6right to health, 4.14risk pooling in insurance, 12.4–12.5Roll Back Malaria Partnership, 2.6–2.7, 14.7RTRC. See Regional Technical Resource CollaborationRwanda

HIV/AIDS treatment in, 17.15performance-based financing in, 51.19pharmaceutical donations in, 15.5pharmaceutical management in, 36.5

RxSolution (MSH), 50.12

safety of medicinesInstitute for Safe Medication Practices (United States),

35.10

perceived, 5.4–5.5regulation of, 6.10terms for, 35.6of traditional medicine, 5.8–5.9, 5.15

safety stockin inventory management, 23.8–23.11, 23.16in procurement, 20.11in quantifying pharmaceutical requirements, 20.18

Samoa, 5.14sample sizes in research studies, 28.6scaling up programs, 20.3–20.5scheduled-delivery purchasing, 21.6–21.7scheduled purchasing, 23.13–23.15schedules of requirements, 21.14–21.15Science and Development network (SciDev.net), 3.17SEAM Program. See Strategies for Enhancing Access to

Medicinessecondary contracts, 21.7secondary production, 7.3secondary suppliers, 21.7sector-wide approach (SWAp), 14.11–14.12security management

batch number registration in, 43.7breaches in, 43.3–43.5bribery control in, 43.9–43.11capsule imprinting in, 43.7cost of, 43.12–43.13fraud control in, 43.11–43.12guidelines for, 42.12–42.13in health facilities, 43.11, 46.4, 46.7in hospitals, 43.10–43.11imprinting packaging for, 43.7inventory control in, 43.6, 43.8law enforcement and, 43.9in medical stores, 43.10, 44.9–44.10, 44.17order quantities and, 43.11in outpatient departments, 43.11in ports, 43.10selection of medicines and, 43.11supplier selection and, 43.11tablet embossing in, 43.7theft control in, 43.4–43.9in transport management, 43.10unique identifiers in, 43.6–43.7

selection of medicines. See medicine selectionsemifluid location systems, 44.12Senegal, 31.8sensitivity analysis, 10.13sentinel sites, 48.5–48.6service level

budget requirements for, 20.4–20.5, 20.26–20.28to operating units, 23.8–23.11stock in, 23.8–23.11

severity index for medication errors, 35.14

InDEx I.35

Shandong province, China, 9.15shelf life of medicines, 39.9shelving, 42.14shipment dates, 39.10shortage costs, 23.7, 40.8short-dated products, 23.19short-list tendering, 42.15SIAMED, 50.14Sierra Leone, 43.8simulated patient surveys, 28.14–28.16Singapore, 12.17single-payer insurance, 12.4single-source medicines, 9.8site planning, 34.9–34.10, 42.5, 42.8–42.10situation analysis, 13.6–13.7, 36.4skimming in insurance, 11.11small-scale production of pharmaceuticals, 45.12–45.14SMART objectives

in management planning, 38.5, 38.13in monitoring and evaluation, 48.11in training programs, 52.5

smartphones, 50.3SnMn. See national Insurance for Mothers and Childrensocial health insurance

introduction to, 1.13, 11.11pharmaceutical benefits in, 12.3–12.4rational medicine use in, 12.11–12.12supply strategies and, 8.3

social marketingcommunication with consumers and, 33.14for rational prescribing, 29.22retail drug sellers and, 32.5

social welfare perspectives, 8.5software

custom, 50.7generally, 50.9–50.14general-purpose, 50.5–50.6for management information, 49.12for networks, 50.7open source, 50.7–50.8options and guidelines for, 50.5for planning, 38.18–38.19special-purpose commercial, 50.6for supply management, 50.13

South Africa, 5.7, 46.11South Centre, 3.17splitting tender awards, 21.7spoilage costs, 40.6spreadsheets, 50.6sputum collection, 47.9Sri Lanka, 15.7stability of pharmaceuticals, 19.5staffing. See also human resources management (HRM)

for computer use, 50.16–50.17

for distribution management, 22.15in health facilities, 46.12in health services contracts, 39.15in hospital pharmacies, 45.3–45.4for management information systems, 49.12–49.13in medical stores, 44.17–44.19in medicine information centers, 34.10for procurement, 18.19in retail drug outlets, 32.11in storage facilities, 42.8for supply management, 17.3

standard deviations, 23.22–23.23standard operating procedures, 30.5–30.10standard performance indicators, 40.9standard treatment guidelines (STGs)

benefits of, 17.3clinical evidence and, 17.6compliance with, 17.9contraindications in, 17.7costs in, 17. 7–17.8defined, 17.2development of, 17.3–17.9diagnostic criteria in, 17.7distribution issues and, 17.14drafting, 17.7drug information in, 17.9first choice treatments in, 17.7formulary manuals and. See formulary manualsin Ghana, 29.8implementing, 17.14–17.15indexes in, 17.9information in, 17.7–17.9investigating medicine use and, 28.6levels of care in, 17.4–17.6in medicine selection, 16.8–16.10for meningitis, 29.8monitoring, 17.10production issues in, 17.5rational medicine use and, 27.12rational prescribing and, 29.3, 29.8, 29.15 referral criteria in, 17.9reviewing and editing, 17.7side effects in, 17.7use of, 17.5, 17.9–17.10

standardization of equipment, 47.5–47.6Starting or Strengthening a Drug Bulletin: A Practical

Manual, 34.14state wholesale monopolies, 8.3–8.4sterile production, 45.13–45.14STGs. See standard treatment guidelinesstock

accounts of, 41.18alphabetizing, 44.13arrangement of, 46.6–46.7

I.36 InDEx

classifying, 44.12–44.13cost of maintaining, 46.3in dispensing practices, 30.6–30.7disposing of expired or damaged, 44.16FEFO and FIFO for, 44.8flow of, 44.5–44.9in health facilities, 46.9–46.12in hospital pharmacies, 45.3, 45.8in kit systems, 26.13location of, 44.10–44.12maximum approach to, 46.8in medical stores. See medical stores managementordering, 46.7–46.9placement of, 23.17, 46.4, 46.9–46.12receipts for, 44.5–44.7receiving, 46.9records for, 44.4, 44.21–44.24rotating, 46.4, 46.6storing. See storage facilitiesunpacking, 46.9zones for in storage, 44.9–44.10

Stop TB, 2.6, 14.7, 26.4storage facilities

acquisition of, 42.9ancillary accommodations in, 42.12budgeting for, 42.8–42.9building, 42.5, 42.8commercial buildings for, 42.8commissioning of, 42.16–42.17construction of, 42.13–42.14, 42.16consultants for planning, 42.5contracts for procuring, 42.15conventional procurement of, 42.14cost of, 22.16–22.17, 42.5–42.6defects liability in, 42.17design-and-build model for, 42.5, 42.14designing, 42.9–42.14distribution management and, 22.5–22.6, 22.11–22.13emergency responses and, 42.13energy efficiency in, 42.11environmental conservation and, 42.11equipment in, 42.17ergonomic considerations in, 42.14fire protection for, 42.13glossary of terms, 42.17–42.19in health facilities, 46.3–46.7inception phase of, 42.4–42.6information technology and, 42.12inventory management and, 23.19item-by-item analysis of, 42.7layout of, 42.12–42.13loading bays in, 42.12maintenance of, 42.17manual warehouses, 42.2

materials for, 42.6mechanical equipment for, 42.13mechanized warehouses, 42.2in medical stores, 44.7, 44.13–44.15needs assessment for, 42.5open tendering for, 42.15order value calculations for, 42.7pallet racking in, 42.13payments for, 42.16prefabricated buildings for, 42.4, 42.8, 42.14–42.15prequalification tendering for, 42.15production information for, 42.10project-planning stage for, 42.14–42.16public-private partnerships for, 42.5, 42.15quality assurance and, 19.17–19.18regulatory requirements for, 42.8schematic designs for, 42.9–42.10security guidelines for, 42.12–42.13shelving in, 42.14short-list tendering for, 42.15site considerations for, 42.5, 42.8–42.9size of, 42.6–42.8special conditions in, 42.12staff needs in, 42.8storage methods in, 42.10–42.11storerooms as, 42.2supervision of building of, 42.16telecommunications in, 42.12temporary buildings as, 42.8tender for, 42.14–42.16turnkey model for, 42.5, 42.14–42.15types of, 42.2, 42.6valuations for, 42.16volume of shipments in, 42.7

strategic planningfor laboratory services, 47.4in pharmaceutical management, 38.2–38.3, 38.6–38.11in program management, 37.10for rational medicine use, 27.9–27.14for training programs, 52.9

Strategies for Enhancing Access to Medicines (SEAM) Program (MSH)

on access indicators, 36.11and accredited drug-dispensing outlets in Tanzania,

1.16, 32.6–32.8, 32.13–32.14and CAREshops in Ghana, 1.16, 32.9in El Salvador, 21.4on patient counseling, 30.9pharmaceutical assessments by, 36.9–36.10quality assurance and, 19.11supply assessments by, 36.13supply systems and, 8.11

strength or potency of medicines, 19.4streptomycin, 2.2

InDEx I.37

structured observations in qualitative data collection, 28.14–28.16

study tours, 14.10Studying a Study and Testing a Test, 34.3substandard medicines, 6.14–6.15substitutable product use, 28.9Sudan, 13.3, 15.5sulfonylureas, 2.2supervision

field, 48.7focused, 37.16in medical stores, 44.17monitoring and evaluation and, 48.3, 48.8of pharmaceutical programs, 37.5of procurement, 18.18for rational prescribing, 29.8, 29.10of revolving drug funds, 13.19of storage facility construction, 42.16

suppliersqualification and monitoring of, 18.13–18.14quality assurance by, 19.11–19.12security and, 43.11and tender management, 21.10–21.13

supply chainsintegrated, 18.8managing, 40.26pricing policies and, 9.10–9.13in service contracts, 39.13

supply managementABC analysis in, 40.19contracting services for, 8.13costs in, 40.5–40.9critical path method in, 38.17efficiency in, 40.9entry points in, 22.12indicators in, 48.11–48.12kits in, 26.2national medicine policies and, 4.7–4.8pipelines in, 20.10in revolving drug funds, 13.17–13.18strategies for. See supply strategiessystems for. See supply systemstreatment guidelines and, 17.3

supply strategiesautonomous supply agencies, 8.7–8.10capacity in, 8.17central medical stores in, 8.7comparison of, 8.6, 8.13–8.14competition failure in, 8.5corruption and, 8.17costs in, 8.17decentralization in, 8.16–8.18delegation in, 8.16devolution in, 8.17

direct delivery in, 8.10distribution systems in, 8.3–8.4equity in, 8.5for essential medicines, 8.18externalities in, 8.5financing, 8.3–8.4, 8.17for-profit services in, 8.15–8.16fully private systems, 8.4fully public systems, 8.3government role in, 8.5–8.7health systems and, 8.16–8.18information failure in, 8.5market economy perspectives in, 8.5not-for-profit services in, 8.14–8.15primarily private systems in, 8.12primary distributor systems in, 8.11–8.12private channels in, 8.14–8.16private financing of public suppliers in, 8.3private suppliers of public services in, 8.3privatization in, 8.17quality of medicines in, 8.17retail sales outlets in, 8.15–8.16social health insurance in, 8.3social welfare perspectives in, 8.5state wholesale monopolies in, 8.3–8.4sustainable changes in, 8.18–8.19vertical systems in, 8.14

supply systemsassessing. See supply systems assessmentexpenditures for pharmaceuticals in, 40.5private-sector prices and, 40.26quality assurance in, 19.20for revolving drug funds, 13.11–13.12

supply systems assessmentapproaches to, 36.6–36.8cost of, 36.8–36.9data in, 36.14, 36.17–36.19document reviews in, 36.17emergent problems in, 36.3field observation in, 36.17–36.18functionality in, 36.9–36.12government commitment in, 36.6information collection in, 36.10, 36.14–36.18monitoring interventions and, 36.3objectives for, 36.6options analysis in, 36.4performance indicators in, 36.14–36.15planning and management of, 36.18–36.19policy formulation and, 36.3political mapping in, 36.14prerequisites for, 36.5–36.6private-sector capacity in, 36.12–36.13procedures for, 36.6qualified teams for, 36.6

I.38 InDEx

qualitative data in, 36.14, 36.18quantitative data in, 36.14reasons for, 36.2–36.5reports on, 36.19retrospective record review in, 36.17situational diagnosis in, 36.4structure of, 36.5–36.9time frames in, 36.8–36.9unstructured, 36.6using results of, 36.19–36.20

sustainabilityof access. See access to medicinesof donor financing, 14.14in financing strategies, 11.3–11.4in supply strategies, 8.18–8.19

SWAp. See sector-wide approachSWOT analysis, 38.9

tablet embossing, 43.7Tajikistan, 9.15Tanga AIDS Working Group (Tanzania), 5.6Tanzania

access to medicines in, 1.16, 36.11accredited drug-dispensing outlet program in, 32.13–

32.14consumer education in, 33.9drug shop accreditation in, 32.6HIV/AIDS/TB programs in, 12.12, 38.6, 38.13medication counseling in, 30.9PDA use in, 50.9primary health kits in, 22.11, 26.13quality assurance in, 19.11supply assessments in, 36.10, 36.13supply strategies in, 8.11traditional medicine in, 5.6

tariffs, 7.7, 9.18–9.19taxes, 9.18–9.19TB (tuberculosis). See tuberculosis (TB) treatmentTeacher’s Guide to Good Prescribing, 29.6, 34.3teams

multidisciplinary, 13.12multisectoral, 38.6

technical assistance, 18.20–18.21technical cooperation, 4.7, 14.16–14.17technical efficiency, 10.9–10.10, 11.3technical expertise, 4.18–4.19, 14.10technical medicine information, 34.7–34.9technology transfer, 3.18–3.19telecommunications, 42.12temperature control, 44.9–44.10tender management

accounting in, 21.20adjudication in, 21.15–21.18appeal periods in, 21.18

boards for, 18.19collating offers in, 21.15–21.16computer reports in, 50.13contracts in, 21.13–21.14, 21.18, 39.14–39.16defining needs in, 21.9–21.10documents in, 21.13–21.15estimated- vs. fixed-quantity contracts in, 21.6–21.7evaluating suppliers in, 21.28format and scope of tender in, 21.3–21.9frequency of, 21.8–21.9instructions to bidders in, 21.13international agencies and, 21.12international laws governing, 21.18international procurement and, 21.7–21.8, 21.11international wholesale exporters and, 21.11invitations to bid in, 21.13local agents and, 21.7–21.8local importers and distributors in, 21.11management information systems in, 21.18medicine selection in, 21.10monitoring supplier performance in, 21.13open periods in, 21.15open tender offers in, 21.15pharmaceutical manufacturers and, 21.11prequalification of suppliers in, 21.12primary/secondary contracts vs. rebids in, 21.7primary vs. secondary suppliers in, 21.11procurement reports in, 21.23procurement systems in, 21.19–21.24product records in, 21.19–21.20purchase orders in, 21.21–21.22qualified suppliers in, 21.11–21.12quality assurance in, 21.18–21.20quantification in, 21.10records in, 21.19–21.23requirements in, 21.14–21.15research- vs. nonresearch-based producers in, 21.11restricted vs. open tender in, 21.4–21.5special criteria in, 21.16–21.18splitting tender awards in, 21.7for storage facilities, 42.14–42.16suppliers in, 21.10–21.13technical specifications in, 21.13–21.14tender lists in, 21.14–21.15tertiary production, 7.3timing in, 21.8–21.9trial purchases in, 21.13

test data protection, 3.7–3.9, 3.12test pricing, 13.15tetracycline, 2.2Thailand, 9.15, 36.12thalidomide, 2.3theft control

in health facilities, 46.5–46.6

InDEx I.39

in security management, 43.4–43.9therapeutic category analysis, 18.15, 40.19–40.24therapeutic classification systems, 16.10–16.13, 44.12therapeutic equivalence, 3.3, 45.6–45.7therapeutic windows, 19.16–19.17therapeutics information. See medicine informationTherapeutics Information and Pharmacovigilance Center

(TIPC) (namibia), 34.11thrombolytics, 17.8tiered quality assessments, 19.16–19.17time management, 37.12TM. See traditional medicinetool kit for drug sellers, 32.13Tools for Planning and Developing Human Resources for

HIV/ AIDS and Other Health Services, 51.8top-down planning, 38.5–38.6total cost analysis, 40.3–40.9total costs, 10.13, 18.5Trade-Related Aspects of Intellectual Property Rights. See

TRIPStrade terms (InCO), 39.5–39.6traditional medicine (TM)

accessibility of, 5.4, 5.8, 5.12affordability of, 5.4changing role of, 5.2–5.4efficacy of, 5.8–5.12, 5.15government policy on, 5.8–5.9herbals in, 5.5–5.7for HIV/AIDS, 5.6incorrect usage of, 5.5indigenous knowledge protection in, 5.13–5.14intellectual property rights in, 5.13–5.14national health care systems and, 5.9, 5.12–5.13, 5.15national medicine policies and, 5.10–5.11perceived safety of, 5.4–5.5pharmacovigilance in, 5.12plant protection in, 5.13providers of, 5.14–5.15quality of, 5.5, 5.8–5.12, 5.15rational use of, 5.8, 5.14–5.16reasons for using, 5.4–5.5regulation of, 5.8, 5.10–5.12, 5.15, 6.13research on, 5.15risks of, 5.5–5.7safety of, 5.8–5.9, 5.15

Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases (THETA) (Uganda), 5.6–5.7

training programsaudiovisual aids in, 52.9brainstorming in, 52.6, 52.8case studies in, 52.6, 52.8demonstrations in, 52.6, 52.8in developing countries, 52.10

distance learning in, 52.6and donor financing, 14.10for drug and therapeutics committees, 52.10e-learning in, 52.7–52.8follow-up activities for, 52.10group exercises in, 52.7–52.8implementing, 52.9–52.16for improving performance, 52.4for in-country counterparts, 52.11–52.12learning methods in, 52.6–52.8lectures in, 52.7–52.8logistics checklist, 52.20materials for, 52.7in medical stores, 44.17in medicine information, 34.12monitoring and evaluation of, 52.16monitoring-training-planning for, 52.11–52.12by MSH, 52.10, 52.13needs and knowledge assessments in, 52.4networks for, 52.13objectives of, 52.3, 52.4–52.5observation trips for, 52.11personal style of trainers in, 52.15–52.16presentations in, 52.15on quality assurance, 19.20for rational prescribing, 29.3–29.7role-playing in, 52.7–52.8seating arrangements for, 52.14self-paced, 52.7sequencing topics in, 52.7simulation games in, 52.7SMART objectives in, 52.5strategies for, 52.9subject areas in, 52.4–52.5in supply management, 52.15by WHO, 52.13worksheets in, 52.7–52.8

transparencyassessing, 11.10, 36.12national medicine policies and, 4.14in procurement, 18.12, 18.15

transport managementalternatives in, 25.5average drops per vehicle in, 25.13contracting out, 25.8, 25.14–25.15costs in, 22.16–22.17, 25.6, 25.14–25.15, 40.6donation of vehicles in, 25.6–25.8driver training in, 25.11fleet mix in, 25.4fuel in, 25.9in-house transport in, 25.3–25.6, 25.15inventory management and, 23.7lease of vehicles in, 25.8motorcycles in, 25.11

I.40 InDEx

onboard computers in, 25.10performance measurements in, 25.6, 25.13–25.14plans for, 25.5–25.7private-sector issues in, 25.14problems in, 22.18purchase of vehicles in, 25.6quality assurance and, 25.15–25.17refrigerated vehicles in, 25.9–25.10rental of vehicles in, 25.8route planning in, 25.3–25.5safety in, 25.16schedule planning in, 25.3–25.5temperature control in, 25.9theft control in, 43.10vehicle acquisition and disposal in, 25.6–25.10vehicle capacity usage in, 25.13vehicle maintenance in, 25.12–25.13vehicle operating costs in, 25.14vehicle replacement policy in, 25.8–25.9vehicle security in, 25.11–25.12vehicle selection in, 25.9–25.10vehicle use in, 25.10–25.12waste products in, 25.13workshops in, 25.12–25.13

TREAT Program for antiretroviral therapy (Uganda), 47.3

Treatment Action Campaign (TAC) (South Africa), 31.3

treatment guidelines. See standard treatment guidelinesTRIPS (Trade-Related Aspects of Intellectual Property

Rights)access to medicines and, 3.14–3.16Article 6 of, 3.7Article 30 of, 3.7Article 31 of, 3.6–3.7Article 39.3 of, 3.7, 3.9Article 40 of, 3.7Article 70.9 of, 3.9bilateral trade agreements vs., 3.12expertise development under, 3.15history of, 2.10inability to use, 3.11key concepts in, 3.5–3.6national legislation and, 6.3–6.4pharmaceutical production and, 7.6regional cooperation under, 3.16TRIPS-plus provisions, 3.14using flexibilities of, 3.10–3.11

tsunami relief, 15.7, 26.4tuberculosis (TB) treatment

community participation in, 31.14diagnostic kits for, 47.9distribution challenges for, 22.7–22.8in the Dominican Republic, 20.7

history of, 2.6–2.7inaccurate blood tests for, 47.7medicine use in, 1.5, 33.8multidrug resistance in, 49.13and patient kits, 26.4in Tanzania, 38.6, 38.13

Tunisia, 6.4turnkey model, 42.5, 42.14–42.15

Ugandaantiretroviral therapy in, 47.3community-based health insurance in, 12.15counterfeit medicines in, 19.9essential supplies and equipment in, 47.11health facility medicine use in, 28.9PDA use in, 50.9retail drug outlets in, 28.18retail drug seller education in, 32.4traditional medicine in, 5.6

underuse of medicines, 27.5UnICEF

Community Integrated Management of Childhood Illness by, 31.6

on disposable syringes, 47.7–47.8on essential medicines concept, 2.4, 16.3kit systems by, 26.12prequalification of suppliers by, 21.5role in program development, 2.8Surgical Instruments Supply Kit by, 47.8

unit prices of products, 18.3–18.5, 23.7UnITAID

for access to medicines, 1.14for HIV/AIDS medicines and commodities, 2.6donor financing and, 14.7–14.9unit-dose medicine distribution, 45.9

United nationsChildren’s Fund. See UnICEFConference on Trade and Development (UnCTAD), 2.4and donor financing, 14.8–14.9history of health agencies of, 2.3–2.4Industrial Development Organization of (UnIDO), 2.4Joint United nations Programme on HIV/AIDS

(UnAIDS), 47.6, 51.5Millennium Development Goals of. See Millennium

Development Goals (MDGs)UnESCO, 51.7

United StatesAIDS relief by. See U.S. President’s Emergency Plan for

AIDS Relief (PEPFAR)drug use reviews in, 29.14–29.15Food and Drug Administration of. See Food and Drug

Administration (FDA)international development by. See U.S. Agency for

International Development (USAID)

InDEx I.41

limited medicines lists in, 29.20medicine use by senior citizens in, 12.10national Library of Medicine, 50.15nonformulary medicine use in, 45.8President’s Malaria Initiative, 1.14

unit of analysis, 28.6universal health coverage, 12.2–12.3University of California, Berkeley, 5.14untrained medicine sellers, 30.15–30.16U.S. Agency for International Development (USAID)

on human resources crisis, 51.8–51.9on pharmaceutical assessments, 36.9pharmaceutical management indicators by, 36.16–36.17

U.S. Code of Federal Regulations, 6.6U.S. Pharmacopoeia, 19.8U.S. President’s Emergency Plan for AIDS Relief

(PEPFAR)antiretroviral therapy and, 2.6, 47.3introduction to, 1.14quantifying pharmaceutical requirements by, 20.8

use of medications. See medicine useuser fees

for essential medicines, 11.7in financing strategies, 11.7–11.8introduction to, 13.2–13.6local retention of, 13.6–13.7, 13.22

USP Drug Information, 50.16

vaccines, 2.2, 3.18validating prescriptions, 30.5variable costs, 10.13variable item fees, 13.14variable pricing, 9.10vehicle usage, 22.14VEn (vital, essential, nonessential) analysis

essential medicines lists and, 40.12and expenditures for pharmaceuticals, 40.9–40.13in inventory management, 23.7in procurement, 18.15

Venezuela, 6.4vertical supply systems, 8.14, 41.3Vietnam, 45.13Vioxx, 2.10volume

in distribution management, 22.18in procurement, 18.12–18.13in storage facilities, 42.7

voluntary counseling and testing (VCT), 36.4–36.5, 47.14voluntary licensing, 3.7, 3.9

warehouse management, 44.2. See also storage facilitieswaste

cost of, 40.6eliminating, 1.6–1.7

in inventory management, 23.19in kit systems, 26.13

website development, 50.16–50.17WHO. See World Health OrganizationWHO Model Formulary, 17.3, 17.12–17.14WHO Monographs on Selected Medicinal Plants, 5.14WHO Operational Package for Assessing, Monitoring and

Evaluating Country Pharmaceutical Situations, 36.18WHO Traditional Medicine Strategy: 2002–2005, 5.8wholesale exporters, 21.11wholesale prices, 9.11wide area networks (WAns), 50.7WISn (workload indicator of staffing need), 51.15Women Fighting AIDS in Kenya, 5.6word processing, 50.6work planning, 37.10, 38.2–38.3, 38.14–38.17World Bank

bidding documents by, 39.9donor financing and, 14.8–14.10on national medicine policies, 4.3on open tender, 18.6performance bonds by, 39.9on pharmaceutical production, 7.3–7.4, 7.9procurement through loans by, 18.21

World Development Report, 36.14World Health Assembly (WHA), 3.14, 3.17–3.18World Health Organization (WHO)

on access to medicines, 1.3on adherence to treatment, 33.4, 33.9–33.10assessing governance, 1.11banning inaccurate blood tests for TB, 47.7certification of products by, 19.14on childhood illnesses management, 31.6on classification of diseases, 28.6on community participation, 31.3on consumer use of medicines, 28.13on counterfeit medicines, 19.9defined daily doses and, 40.24on diagnosing HIV, 47.6on diagnostic supplies, 47.11on disposable syringes, 47.7–47.8on DOTS strategy, 33.11on drug bulletins, 34.14drug donation guidelines of, 15.5–15.6, 15.8emergency health kits of, 26.3equipment specifications of, 47.15–47.17on essential medicines concept, 1.2, 1.7, 2.3, 2.8essential medicines lists of. See Model List of Essential

MedicinesGlobal Initiative on Health Technologies of, 47.3–47.4Good Governance for Medicines of. See Good

Governance for Medicineson good manufacturing practices, 19.13history of, 2.3–2.4

I.42 InDEx

on human resources crisis, 51.4–51.9Intergovernmental Working Group on Public Health,

Innovation and Intellectual Property of, 3.17on medical products and the Internet, 34.3medicine information of, 34.14on medicine promotion, 34.8medicine selection criteria of, 16.5on medicine use communications, 33.21on medicine use in health facilities, 28.7–28.9medicine use indicators of, 28.7–28.9on mortality rates, 1.3–1.4on national medicine policies, 4.3organizational roles of, 2.8pharmaceutical management indicators of, 36.16–36.17on pharmaceutical production capacities, 7.4pharmaceutical situation indicators of, 36.15pharmacopoeia of, 19.4on pharmacovigilance, 35.2Pharmacy Education Taskforce Action Plan, 51.7prequalification of medicines by, 19.12on prequalification of suppliers, 21.4–21.5, 21.12price monitoring method of, 9.14–9.15Programme for International Drug Monitoring, 35.10on quantifying pharmaceutical requirements, 20.8,

20.18on rational medicine use, 4.16, 27.2on rational prescribing, 29.6on social health insurance, 1.13software by, 50.6on storage facility planning, 42.7

on traditional medicine, 5.2training programs of, 52.13TRIPS and. See TRIPS (Trade-Related Aspects of

Intellectual Property Rights)World Health Report, 31.3World Intellectual Property Organization (WIPO), 3.14,

3.17World Trade Organization (WTO)

on fraud, 43.12on generic medicines, 9.8on intellectual property, 3.4–3.11, 3.17on patents, 39.10pharmaceutical prices and, 9.19TRIPS Agreement. See TRIPS (Trade-Related Aspects of

Intellectual Property Rights)

Yemen, 4.17

Zambiacompulsory license in, 3.8HIV/AIDS treatment in, 47.14medication safety form in, 35.13pharmacovigilance in, 35.13transport management in, 25.4

Zimbabwedispensing prescribers in, 27.8supervisory visits in, 48.8transport management in, 25.15

zoning stock, 44.9–44.10