This document discusses various methods for quantifying medicine needs, including the patient morbidity-standard treatment method and the adjusted consumption method. It compares the advantages and disadvantages of each. Critical issues in quantification are also outlined, such as preparing an action plan, estimating quantities while considering factors like lead time and losses. The ideal inventory model and calculations for safety stock, consumption, and budgeting are demonstrated. Effective medicines supply management requires selection, quantification, procurement, distribution, and use.

1. Quantification
of
medicines needs
Dr. Thida Hla
Deputy Director (Medical Care)
Department of Health
Project Manager
Myanmar Essential Medicines Project

2. Why we need to quantify
the medicines need?
• Armament in health services
• Available of good quality, safe and
less expensive medicines all the
time
• Part of a sequence of inter-
dependent steps in the medicines
supply management system

3. Effective Medicines Supply
Management
• Main components are
Selection
Quantification
Procurement
Distribution
Use

4. Quantification
• Imbalance in quantification could
lead to
– High inventory
– Stock outs
• Stock outs lead to
– Local purchases
– Poor image of the facility

5. Methods of quantification
1. The patient morbidity-standard
treatment method
(morbidity method)
2. The adjusted consumption method
(consumption method)

6. Comparisons of Two Methods
Method Advantages Disadvantages
Consu-
mption
-Morbidity
data
not required
-Requires less
detailed
calculations
-Difficult to
review prescribing
habits
-Difficult to get
consumption data
for new facilities

7. Comparisons of Two Methods
Method Advantages Disadvantages
Consu-
mption
-Good for
hospitals
(because
Treatment is
more complex)
-Does not
encourage
good morbidity
recording

8. Comparisons of Two Methods
(cont’d)
Method Advantages Disadvantages
Consu-
mption
-Reliable if
consumption is
well recorded
and stable
-Unreliable if
there have been
long stock-outs

9. Comparisons of Two Methods
Method Advantages Disadvantages
Morbi-
dity
-Consumption
data not
required
-Good for new
services
-More detailed
calculation
required
-Morbidity/STG
required

10. Comparisons of Two Methods
Method Advantages Disadvantages
Morbi-
dity
-Based on
rational
prescribing
-Motivate
morbidity
recording
-Results may
differ from
actual supply
-Estimate only the
quantities needed
to dispense to

11. Critical issues in
Quantification
• Preparing an action plan for
quantification
• Using centralized or decentralized
quantification
• Using normal or computerized
methods for quantification
• Estimating the time required
• Developing the medicines list
(Selection)

12. • Filling the supply pipeline
• Considering the impact of lead time
• Adjusting for losses due to wastage
and theft and for programme
growth
• Cross checking estimates produced
by quantification
• Estimating total procurement cost
• Adjusting and reconciling final
quantities

13. • Use the final estimates to order
drugs from suppliers and to issue
them to health facilities
• Evaluate the effectiveness of the
quantification and require estimates
in successive periods
• Were all aspects evaluated?
• Have causes of the main problem
been identified?

14. • Have appropriate solutions been
found to the problem?
• Are the estimates sufficiently
accurate?

15. The patient morbidity –
Standard treatment
method
• This method starts from two sets
of data:
The number of episodes of each
health problem treated by the
type or types of facilities
Standard treatment schedules
agreed for each health problem

16. Quantity
of drug
specified
for a
standard
course of
treatment
No. of
treatment
episodes of
the health
problem
Total
quantity of
a drug
required
for a given
health
problem
X =
This calculation is repeated for each
health problem and its corresponding
drugs

17. Ideal inventory model
Q+S
I
S
safety
stock
Average
inventory
Q Working
stock
Order
placed
Drugs
received
Order
placed
Drugs
received
Lead
time
Lead
time
Time in months
Stockonhand

18. The stock in hand consists of two
components, the working stock and the
safety stock
• Working stock varies from zero to the
order quantity (Q) and represents the
stock which is used to satisfy demand
between deliveries
• Safety stock (S) exists to protect
against stockouts, which would otherwise
occur when deliveries are delayed, or
when demand is unexpectedly high

19. • Calculate the quantity of each drug
required in the next procurement period
• Adjust for expected changes in
consumption pattern
• Adjust for losses
• Compile decentralized quantifications (if
applicable)
• Estimate costs for each drug and total
costs
• Compare total costs with budget and
make adjustments

20. Calculate the consumption
of each drug
Opening
Stock
Drugs
Received
Closing
stock
Consumption += -

21. Adjust for avoidable
wastage and losses
• Drugs destroyed by damp, time expired,
batch seized for poor quality,
unaccounted
• Should not exceed 5-10% in a well run
pharmacy or store
Avoidable
wastage-
Recorded
consumption=
Consumption
adjusted for
avoidable
wastage

22. Estimating the safety stock
• Safety stock is the quantity of stock
used on average during the average
lead time from the current supplier.
For calculation:
SS = LT X CA
Where SS=Safety stock
LT=Lead Time
CA=Average Consumption

23. VEN analysis for
Budget constraint
V- Vital (Fixed item & amt)
E- Essential (Fixed item)
N- Non-Essential

24. Discussion Points
- Source of Morbidity data
(HMIS, DUNS, OPD register,
Morbidity report)
- Standard Treatment Guidelines
(MEDP Guidelines, Treatment
guidelines from vertical projects)