Abstract
BackgroundAccessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”.MethodWe conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements.ResultsInterviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors’ prescriptions, which were heavily influenced by pharmaceutical companies’ marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none.ConclusionsProcurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and regulation of national and international policies is recommended for enhancing medicine accessibility, as well as improving preparedness for health emergencies during natural disasters and health epidemics.
Highlights
A hospital pharmacy is an integrated part of healthcare in health institutions and is responsible for all medicine-related and management health processes to optimize outcomes and enhance the safety and quality of health services provided to patients [1]
Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal
The Basel Statements are 75 statements grouped under six key elements of hospital pharmacy practice, and are considered valuable guidelines for standardizing hospital pharmacy practice around the globe
Summary
A hospital pharmacy is an integrated part of healthcare in health institutions and is responsible for all medicine-related and management health processes to optimize outcomes and enhance the safety and quality of health services provided to patients [1]. In order to enhance hospital pharmacy practice globally, standardised guidelines based on essential elements of hospital pharmacy practice need to be followed [2, 3]. With the objective of developing global consensus statements for advancement of hospital pharmacy practice, the Hospital Pharmacy Section of International Pharmaceutical Federation (FIP) developed the first set of international consensus statements, named the Basel Statements, in 2008 [4]. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. We aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”
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