Analysis of the Supply Chain in Managing Second-line Anti-TB Drugs at State Drug Stores: An Observational Study

Abstract

Abstract: Introduction: MDR-TB is a global health threat requiring uninterrupted access to second-line TB drugs for successful treatment. Inefficiencies in the supply chain can disrupt access, prompting this investigation into stockout factors at an SDS in Maharashtra, India. Objectives: Study investigates the drug supply chain at the State Drug Store (SDS). Measure the stock situation for second-line anti-TB drugs at the SDS. By analyzing stakeholder perspectives, the study will explore factors contributing to gaps invloved. Materials and Methods: A cross-sectional study was conducted from October 2023 to January 2024 in one of three State Drug Stores (SDS) located in Maharashtra, India. Maharashtra has 3 SDS and to ensure anonymity, the SDS involved in the study are labeled as SDS1. Five-year retrospective data of the TB drug supply chain from the Central TB Division website (quantitative) and primary data rom stakeholders (interviews, document review, TB program survey) were analyzed using Power Query (quantitative) and thematic analysis (qualitative) to identify trends, challenges, and stakeholder perspectives. Results: The key findings of the study are stockouts of medicines, expiry of drugs and delay in disposal of expired drugs, insufficient fund allotment for local purchases, and inadequate quantities received from the Central TB Division (CTD). Conclusion: State Drugs State in total has been maintained well and it is crucial to recognize the ongoing efforts of the SDS to navigate these difficulties and ensure patient access to vital medications. Moving forward, implementing the proposed solutions like demanding funds from higher authorities to start local purchases can strengthen the SDS's ability to provide uninterrupted access to essential medications.