Background Efficient management of hospital inventories, particularly pharmaceuticals, is essential for ensuring timely patient care and optimizing resource allocation.Buffer stock is the backup stock, which is kept for providing a supply of drugs when the main stock is consumedand new stock is in the process of procurement.The buffer stock is sometimes kept in excess, which causes unnecessary overutilization of the financial resources. Therefore, the author's team aimed to optimize the inventory control of the buffer stock.This study addressed these challenges by integrating always better control (ABC) and vital, essential, and desirable (VED) analysis to categorize drugs based on consumption patterns and clinical importance to minimize buffer stock and ensure optimum resource allocation. To overcome these challenges, there is a need to integrate financial and clinical factors into inventory management decisions. Methods This study was done at the pharmacy of an apex hospital situated in a rural region of western India. The study aimed at the categorization of drugs that require strict inventory management control. The drugs and consumables used in the month of April 2024 in the hospital pharmacy were considered for the study& inventory control methods were applied. Results The study discovered that a subgroup of drugs accounted for a significant portion of the pharmacy's budget, with 12.18% categorized as high-value (Category A), 22.07% as moderate-value (Category B), and 65.74% as low-value (Category C) items. ABC analysis showed that Category A drugs consumed 70.1% of the average daily expenditure (ADE) of the pharmacy, while Category B and Category C drugs contributed 19.9% and 9.98% of the ADE, respectively. VED analysis classified drugs into vital (11.34%), essential (58.26%), and desirable (30.39%) categories. The ABC-VED matrix further categorized drugs into subgroups, with class I items constituting 20.62% of the inventory and accounting for 73.82% of the ADE. Class II items comprised 56.69% of the inventory, consuming 22.91% of the ADE, while class III items constituted 22.68% of the inventory and consumed 3.28% of the ADE. Conclusion ABC and VED analysis integration provides a comprehensive framework for optimizing drug inventory management in healthcare facilities. By considering both financial and clinical factors, this approach enables tailored management strategies, minimizing buffer stock, eliminating stockouts, and enhancing patient care. The rural hospital's location is responsible for maintaining the buffer stock level and the reorder level quantity. This study highlighted the role of inventory control techniques in healthcare facilities, particularly in pharmacies, to ensure the availability of essential medications while optimizing resource utilization. By integrating segmentation techniques such as ABC and VED analysis, this study provided valuable insights into categorizing drugs based on their consumption patterns, criticality, andimportance in the clinical area.