Pharmacy Products Research Articles

Deciphering the Raman spectrum of royal jelly. Fabrication of Ag‐polymer embedded royal jelly nanoparticles manifesting SERS effect

AbstractRoyal jelly (RJ) is secretion from the hypopharyngeal glands of worker bees, which serves as food for the queen bee and enabling larvae growth. Having biological properties already proven, RJ has considerable commercial appeal and is used in many sectors (pharmacy, food industries, and cosmetic products) nowadays. However, due to its chemical complexity on one hand and the easy adulteration and sensitivity of the biological molecules present, a limited information of the Raman spectrum of RJ is available, although it has been methodically investigated by midinfrared spectroscopy. The present paper aims to systematize the previous petite Raman spectroscopy knowledge and to holistically grasp band assignments in the whole region in Raman spectrum by fabrication of Ag nanoparticles (AgNPs) with surface adsorbed RJ. In order to obtain representative Raman spectrum in which the bands of the major components in the RJ (proteins and sugars) could be forced to appear here, AgNP‐RJ particles are fabricated. The method enabled to enhance the weak Raman signal, decreased the fluorescence, and improved signal‐to‐noise ratio. The obtained AgNPs with RJ were synthesized by careful selection of three stabilizing water‐soluble agents (citrate, poly (ethylene glycol), and polyvinylpyrrolidone) and produced SERS effect that increased the Raman bands signal and allowed, for the first time, to interpret the whole Raman spectrum of RJ.

PNS112 MANAGEMENT OF SPECIALTY DRUGS, SPECIALTY PHARMACIES, AND BIOSIMILARS IN THE UNITED STATES

A better understanding of health plan management of specialty pharmacy (SP), SP products and biosimilars. Online survey of health plan exec on: roles+plan information, specialty pharmacies and specialty pharmaceuticals, expected biosimilar coverage/restrictions/copays. Results were compared with prior surveys (changes >2% reported). Survey completed by 85 respondents. 42.9% were senior officers, 13.1% regional, 8.3% payor specific, 1.2% therapeutic area specific. 36.9% worked for health plans, 13.1% PBMs, 9.5% IDNs, 2.4% PPOs/IPAs, 1.2% Government. Plans were National=29.9%, Regional=24.7% or Local=22.1% and cover multiple member types: commercial (58.6%=FFS, 77.8%=HMO/PPO), Medicaid (Traditional=27.8%, HMO/PPO=72.3%), Medicare (71%, PDP-only=51%), Employer/Self-funded=79% and IDN (43.6%, 340B Qualified=43.8%). 45.6% reported the plan's PBM as their SP provider and providers were restricted by 58%↓23% with plans restricting products: 58% to those under contract, 11.6% for those available through multiple SPs, 10.1% allow any SP handling a product, and 4.4% carving out their SPs. Compared with last year, providers shifted approximately 6% from independents to internally provided and currently 45.6% are PBM-owned, 38.2% health plan-owned, 25% independent and 13.2% hospital/IDN-owned. SP products continue to move from fixed to %copays with more plans determining by group+benefit design. Plans covered clinician-administered products under the medical benefit (36.8%↓7.3%), 2.9% under the pharmacy benefit the remainder used price+plan design. Biosimilar use expected for all reference product indications 58.8%↓5.7%, 31.4%↓13.5% will restrict to approved indications, and 9.8% will use indication as the basis for copay. 10%↓15% expect the biosimilar to be the only product available, copays are expected to be discounted off the innovator 58%↓10.1%, and 32%↓4.9% to vary based on approval timing. Biosimilar education provided through: different copays=64.7%, prescriber+patient mailings (76.5%↓4.2%+58.8%), prescriber+patient calls (51%↓10.6%+27.5%↑4.1%). Expected biosimilars savings: 66%↑20.9% expect 20% 5 years from now. Costs associated with specialty pharmacies and specialty pharmacy products have shifted and are expected to grow with some relief coming from biosimilars.

Tapping Into Multiple Data "Springs" to Strengthen Policy Streams: A Guide to the Types of Data Needed to Formulate Local Retail Tobacco Control Policy.

In 2015, the tobacco industry spent $8.24 billion to market tobacco products in convenience stores, supermarkets, pharmacies, and other retail or point-of-sale settings. Community tobacco control partnerships have numerous evidence-based policies (eg, tobacco retailer licensing and compliance, tobacco-free–school buffer zones, eliminating price discounts) to counter point-of-sale tobacco marketing. However, deciding which point-of-sale policies to implement — and when and in what order to implement them — is challenging. The objective of this article was to describe tools and other resources that local-level tobacco use prevention and control leaders can use to assemble the data they need to formulate point-of-sale tobacco policies that fit the needs of their communities, have potential for public health impact, and are feasible in the local policy environment. We were guided by Kingdon’s theory of policy change, which contends that windows of policy opportunity open when 3 streams align: a clear problem, a solution to the problem, and the political will to work for change. Community partnerships can draw on 7 data “springs” to activate Kingdon’s streams: 1) epidemiologic and surveillance data, 2) macro retail environment data, 3) micro retail environment data, 4) the current policy context, 5) local legal feasibility of policy options, 6) the potential for public health impact, and 7) political will.

Scientific and methodological approaches for forming the management strategy for the assortment of medicinal cosmetic products in pharmacies

Aim. To substantiate scientific and methodological approaches for forming the management strategy for the assortment of medicinal cosmetic products taking into account the characteristics of this pharmaceutical product group and determining the key indicators of activities for each type of pharmacy.Materials and methods. The works of domestic and foreign authors in the field of optimization of the pharmacy assortment and formation of the effective assortment policy of drugs, the legislative and regulatory framework in the field of the pharmaceutical activity regulation in Ukraine were considered. The expert evaluation method, criteria of maximum reasonableness and non-parametric Mann-Whitney test, generalized additive spline models, etc., were used.Results. It has been found that all pharmacies depending on their location are divided into walkthrough ones located in supermarkets, those located in residential areas and transit. Medicinal cosmetic product consumers who visit these pharmacies differ in their behavior model. It has been proven that in order to form an optimal of medicinal cosmetic product assortment it is necessary to take into account not only the specificity of the consumer behavior, but also the strategic priorities in activities of pharmacies of various types. The methodological recommendations for optimizing the medicinal cosmetic product assortment in pharmacies of various types has been proposed, and the algorithm for forming the management strategy for the assortment of medicinal cosmetic products based on the use of category management principles has been developed.Conclusions. The presence of medicinal cosmetic products in the assortment of different types of pharmacies has a positive effect on the financial and economic indicators of their activities. To include them in the assortment it is necessary to develop the assortment management strategy specifically for each type of pharmacy. Formation of such a strategy should be based, firstly, on the key indicators of activities, which most adequately reflect the strategic benchmarks of development of pharmacies of a definite type; secondly, on methodical recommendations regarding formation of the optimal assortment portfolio of medicinal cosmetic products using modern economic and mathematical methods.

Interaction between a bio-tolerable amino-acid based amphiphile (N-dodecanoylsarcosinate, SDDS) and modified cationic polymers, hydroxyethylcelluloses (JR 400, and LM 200) in isopropanol-water medium

Interaction between the eco-friendly amino-acid based anionic amphiphile (N-dodecanoylsarcosinate, SDDS) and the cationic polymers, hydroxyethylcelluloses (JR400 and LM200) in isopropanol-water (IP/W) medium has been studied employing different techniques. Formation of SDDS micelles, and their binding interaction with the polymers by way of charge and hydrophobic interactions have been investigated, and physicochemical corroboration of the results has been looked into. Interfacial and bulk behaviors of SDDS in the mixed IP/W medium have been examined; the information on the micelle type, shape and counter-ion binding as well as the related thermodynamic parameters have been estimated. The solvent property (Gordon Parameter), and the shape of the micelles (in terms of the Israelachvili’s “packing parameter”(P)) have been also estimated in the mixed solvent system. The critical aggregation concentration of the polymer induced micelles (CAC), their complete binding (CS) to the polymers forming necklace-bead like configurations, and finally forming the extended free micelles of the surfactant (CMCe) in the IP/W medium have been evaluated. The formation of coacervate phase in the system, and its dissolution during the interaction process has been noted, and supported from the turbidity measurements. The overall thermodynamics of the interaction process have been estimated from isothermal titration calorimetry (ITC) measurements. A comparison of parities among the results of different methods (tensiometry, conductometry, turbidimetry and calorimetry) has been made. Possible utility values of the interacted products in pharmacy, medicine, nano- science, etc. have been indicated.

A proposed method of identifying significant effects in unreplicated factorial experiments

In many areas of research/ production, a lot of factors are combined to obtain a desired product. To be able to analyze which factors (or combinations of factors and at what level) are significant, the experiment has to be replicated. For economic or practical reasons, it may not be feasible to perform the experiment more than once therefore unreplicated factorial designs are often employed. This is especially true in the field of Medicine, Pharmacy and Industrial production units. The traditional method of analysis of variance (ANOVA) cannot be employed in unreplicated factorial designs, therefore many methods have been proposed in literature. In this paper, a new method of analyzing unreplicated factorial designs is proposed and was compared with some of the existing methods. The four existing methods considered were: Lenth, Berk and Picard, Juan and Pena, and Dong. The comparison was performed using Monte Carlo simulation method. The criteria used in evaluating the performances of the methods are Power and Individual Error Rate (IER). Using these criteria of evaluation, the results showed that on overall performance, Dong method is the best among the four existing methods considered and was closely followed by Berk and Picard, Lenth, then Juan and Pena methods in that order. It was also found that not only is the proposed method simpler to compute, it competed favourably with Dong and even performed better than all the others when IER is used for assessment.

Development of curative and preventive antiseptic markers technology. Application in mycosis and skin damage complex therapy

Today, the problem of the treatment of fungal diseases is particular importance in the health care system; it shares in Ukraine and abroad is about 25-30 %. Aim. To develop a scientifically based technology of preparation the composition “Propolis-PHNS” in pharmacy and industrial conditions, which is a part of the prophylactic medicines of “Propolis-Derma” for using in the complex therapy of mycosis and skin damage. Materials and methods. Analysis, empirical, physical, physical-chemical, pharmaco-technological, statistical methods. Results . The analysis of marketing researches of medicines according to ATC classification shows that the pharmaceutical market of anti-mycotic drugs is represented by synthetic drugs mainly, which shows that creation of therapeutic and prophylactic agents on the basis of substances of natural origin is an actual. It is established that the most promising and accordingly effective in this aspect are medicines with complex action in the form of therapeutic and prophylactic antiseptic vials-pencils (markers). Based on the results of physical and physical-chemical studies of API and their mixtures as a concentrate solution, the technology for obtaining a new pharmaceutical composition “Propolis-PHNS” in the form of therapeutic and prophylactic markers have been theoretically substantiated and experimentally developed. Conclusions . Results of the experimental research have been used in the development of block design of the technological process of preparation for treatment and prophylactic medicine “Propolis-PHNS” in the conditions of pharmacy and industrial production and development the normative documentation in accordance with the requirements of the State Pharmacopoeia of Ukraine in the form of a technological instruction and a project of technological regulation for the medicinal-prophylactic medicine.

Gas chromatographic-mass spectrometric analysis of sunscreens and their effects on mice liver and kidney enzyme function.

BackgroundSunscreens are one of the most widely used products among cosmetics and personal care products. Recent studies have shown that some of sunscreen formulations may contain toxic, carcinogenic, or even nonallowed chemicals that may affect skin, cells, and hormones.Materials and methodsThis study aimed to develop and validate a method that allows the determination of sunscreen ingredients by gas chromatography–mass spectrometry (GC–MS). Analysis of original sunscreen products (n=5) from a licensed pharmacy and counterfeit sunscreen products (n=5) from local markets in Jordan was performed using GC–MS. pH stability of the sunscreen samples were also monitored under different storage temperatures. Topical application of sunscreens on mice skin was conducted to study their effects on liver and kidney enzymes’ function.ResultsIn terms of pH stability, there is a significant change in pH at different degrees of temperature between the products. Diethyl phthalate (DEP) was detected in two counterfeit products and was not mentioned on the ingredients’ label. DEP was reported for its percutaneous absorption and systemic uptake in the literature. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly increased with a P<0.005 in some groups treated with original sunscreens under sun radiation. Creatinine showed a significant decrease in some groups treated with original and counterfeit sunscreens, while blood urea nitrogen (BUN) showed no differences.ConclusionThis study presents a method that allows the scanning and profiling of sunscreen ingredients as well as investigates their stability, permeation, and toxicity. Profiling of sunscreen product, changing in pH stability, and analyzing kidney and liver enzymes’ level would be of a great impact on products’ safety and consumers’ health.

TECHNOLOGY OF MEDICINES AND GALENICAL PREPARATIONS: THE CASE OF PRESCRIPTION FORMULASFROM “ANTIDOTARIUM” NICOLAI BY NICHOLAS OF SALERNO

Introduction. This study deals with the problem of similarity of the principles and approaches of drug technologies in the medieval manuscript “Antidotarium Nicolai” by Nicholas of Salerno with modern pharmaceutical technologies.The aim of study is a textual investigation of “Antidotarium Nicolai”, a detailed research of the content of the manuscript, recipes and technologies for making medicines.Materials and methods. In order to achieve this goal, eighty-five recipes of “Antidotarium Nicolai” have been identified, systematized and analyzed in a documentary translation from medieval French. An interdisciplinary study of the content of the manuscript was carried out with the help of factor analysis of the historical source and modern scientific literature.Results and discussion. Having described the content and aspects of the prescriptions of “Antidotarium Nicolai”, the authors note the similarity of the technologies of drugs and galenical preparations with modern pharmaceutical technology, in particular, with the technology of pharmacy production. In “Antidotarium Nicolai” it is stated that preparations based on herbal medicinal raw materials may be second-line therapy agents for completing treatment after the application of basic pharmacological preparations.Conclusion. The results of this work reveal the potential for the use of herbal medicines in the conditions of modern evidence-based medicine, in particular, in the organization of long-term treatment and secondary prevention of chronic diseases in patients who need to maintain their ability to work, and provide them with a sufficiently high level of quality of life. A detailed translation of the full text of the manuscript, the analysis of its content in accordance with the requirements of rational pharmacotherapy and phytotherapy, further favors to identify the prospects for the development of new drugs, multi-component in their chemical composition with a wide range of therapeutic effects.

An Untapped Resource in the Spotlight of Medicinal Biotechnology: The Genus Scutellaria.

This review is intended to draw the attention of pharmaceutical and biotechnological communities to the untapped potential of the Scutellaria genus. Skullcaps, as they are more widely known, are found in one of the oldest materia medica in the world, that of ancient Chinese pharmacology, and their numerous wide range of medicinal bioactivities have been studied both in vivo and in vitro. For thousands of years, chemical compounds from the Scutellaria species have been safely used as antitumor, antibacterial, antiviral, anti-inflammatory, antioxidant or hepatoprotective factors. As these effects are well known, reflected in the presence of Scutellaria plants in national pharmacopoeias, it is clear that the plant has yet enormous unexploited potential. The European pharmacological market has turned to the resources of Scutellaria only in the last two decades, and although the construction and clinical processing of a new drug is a long process, the general impression is that very few medical products in pharmacies have been inspired by the phytochemistry of skullcaps. This paper presents the current state of knowledge on the wealth of Scutellaria chemical compounds with treatment applications, its tissue culture and biotechnological achievements, especially in the context of the production of secondary metabolites.

Abstract 605: Investigating the potential impact of dose-banding for systemic anticancer therapy (SACT) in the pediatric setting based on pharmacokinetic evidence

Abstract Background: In order to make systemic anticancer therapy (SACT) preparation more practicable, dose-banding approaches are currently being introduced in many clinical centers. This involves the individual dose for a particular patient being calculated according to a single body surface area (BSA) value per band, usually the mid-point of the band in which the actual BSA of the patient lies. Advantages of such an approach include a rationalization of chemotherapy provision, with the preparation of drugs with sufficient long-term stability feasible well in advance of treatment, reduced potential for medication errors and improved capacity planning of pharmacy production. The current study aimed to determine the potential impact of utilizing recently developed National Health Service in England (NHSE) dose-banding tables in a pediatric setting, according to pharmacokinetic criteria determined from previously-published clinical trials for a range of commonly used anticancer drugs. Methods: Using pharmacokinetic parameters obtained from 385 drug administrations in 352 children aged from 1 month to 18 years, treated with 5 drugs (dactinomycin, busulfan, carboplatin, cyclophosphamide, etoposide), individual exposures (area under the curve; AUC) obtained using doses rounded according to the published NHSE tables (or banded using the same method) were calculated and compared to those obtained by standard dose calculation methods. The patients included in the study were treated for a wide range of tumors including neuroblastoma, B cell non-Hodgkin's lymphoma, Wilms tumor, rhabdomyosarcoma and Ewing's sarcoma. Results: For all five drugs, the relative variation between the NHSE dose and the recommended dose (standard individually calculated dose) was between -6% and +5% as expected. Indeed, more marked differences were observed between the actual dose administered and the recommended dose for these retrospective datasets, particularly for carboplatin and dactinomycin. In terms of AUC, there was no statistically significant difference in precision between exposures obtained by the recommended dose and those obtained with dose-banding (absolute value of relative difference 15-34%). Conclusion: Based on pharmacokinetic data from 352 children, the results generated from the current study support the implementation of NHSE dose-banding tables, at least for the five drugs investigated here. Indeed, inter-patient variability in drug clearance and exposure would appear to far outweigh the impact of relatively small drug dose changes associated with dose-banding. Further evaluation of the effect of using dose-banding for other drugs would be needed to confirm these results and extend them to additional anticancer drugs. Citation Format: Melanie White-Koning, Caroline Osborne, Angelo Paci, Alan V. Boddy, Etienne Chatelut, Gareth J. Veal. Investigating the potential impact of dose-banding for systemic anticancer therapy (SACT) in the pediatric setting based on pharmacokinetic evidence [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 605.

Galenics and their promotion in pharmacies

In the present article galenical formulations are defined and some of their characteristics are analyzed in order to present their significance even in our days and age. Prescription forms, symbols and abbreviations as well as general information that are widely accepted by international scientific community are provided. General information about them are also provided. Medical specialties that propose the use of galenics as well as limitations concerning their use are mentioned. Furthermore, their use from special patient populations is discussed. The procedure that must be followed to produce galenics as well as the expiration and discard dates, the listing of ingredients on the package and its costing are necessary elements for their consuming, reproduction or replacement. Despite the skepticism with which galenics are dealt with by organizations that are relevant with quality control of medications, their uses not only in dermatological conditions and cosmetology but also in pediatrics, gynecology and trauma are well known from the past. Moreover, ways of promotion for cosmetic pharmaceutical products and researches on consumers’ preferences are cited. Our aim is to present the timeless value and usefulness of galenics in aesthetics and dermatology, and to highlight the contribution of proper promotion of these products in pharmacies

Long-term stability of ganciclovir in polypropylene containers at room temperature.

Purpose Ganciclovir is increasingly provided by hospital pharmacy production unit in a ready-to-use form, in order to improve the safety of healthcare workers and the efficiency of the organisation. The objective of this study was to develop a stability-indicating method to assay ganciclovir and determine the stability of ganciclovir in syringes (5 mg/mL) and infusion bags (0.25 and 5 mg/mL) at two different temperatures. Method Ganciclovir solutions (0.25 mg/mL and 5 mg/mL) in 0.9% sodium chloride were prepared in 50 mL polypropylene syringes or 100 mL polypropylene infusion bags and stored at 2-8℃ and 23-27℃. The chemical stability was measured using a stability-indicating Ultra High Performance Liquid Chromatography coupled to mass spectrometry method. Physical stability was assessed by visual inspection. Results No significant loss of ganciclovir under any of the tested conditions was observed in this study. All solutions remained clear through the study period. Conclusion All tested formulations remained stable for at least 185 days independently of container type, temperature or concentration studied.

The cost and cost-effectiveness of childhood cancer treatment in El Salvador, Central America: A report from the Childhood Cancer 2030 Network.

Although previous studies have examined the cost of treating individual childhood cancers in low-income and middle-income countries, to the authors' knowledge none has examined the overall cost and cost-effectiveness of operating a childhood cancer treatment center. Herein, the authors examined the cost and sources of financing of a pediatric cancer unit in Hospital Nacional de Ninos Benjamin Bloom in El Salvador, and make estimates of cost-effectiveness. Administrative data regarding costs and volumes of inputs were obtained for 2016 for the pediatric cancer unit. Similar cost and volume data were obtained for shared medical services provided centrally (eg, blood bank). Costs of central nonmedical support services (eg, utilities) were obtained from hospital data and attributed by inpatient share. Administrative data also were used for sources of financing. Cost-effectiveness was estimated based on the number of new patients diagnosed annually and survival rates. The pediatric cancer unit cost $5.2 million to operate in 2016 (treating 90 outpatients per day and experiencing 1385 inpatient stays per year). Approximately three-quarters of the cost (74.7%) was attributed to 4 items: personnel (21.6%), pathological diagnosis (11.5%), pharmacy (chemotherapy, supportive care medications, and nutrition; 31.8%), and blood products (9.8%). Funding sources included government (52.5%), charitable foundations (44.2%), and a social security contribution scheme (3.4%). Based on 181 new patients per year and a 5-year survival rate of 48.5%, the cost per disability-adjusted life-year averted was $1624, which is under the threshold considered to be very cost effective. Treating childhood cancer in a specialized unit in low-income and middle-income countries can be done cost-effectively. Strong support from charitable foundations aids with affordability. Cancer 2018;124:391-7. © 2017 American Cancer Society.

Ending tobacco sales in pharmacies: A qualitative study

ObjectiveThe states of California and Massachusetts are leading the effort to prohibit the sale of tobacco products in pharmacies in the United States. The process of adopting these tobacco-free pharmacy laws remains understudied. This study qualitatively explores the process of adopting and enforcing tobacco-free pharmacy laws. MethodsResearchers performed qualitative semistructured telephone interviews with 23 key informants who were involved in the effort to adopt and implement tobacco-free pharmacy laws in California and Massachusetts. A content analysis was used to study the process of adopting tobacco-free pharmacy laws as well as barriers and facilitators during the process. Two researchers independently coded the interview transcripts and written responses to identify key categories and themes that emerged from the interviews. ResultsThe qualitative study results suggest that the process of adopting the tobacco-free pharmacy laws was fairly smooth, with a few barriers. Local youth groups and independent pharmacies played an important role in raising public awareness and attracting media attention. The results also highlighted the need to regulate the sale of e-cigarettes as a part of tobacco-free pharmacy laws. ConclusionAs the number of cities that have adopted tobacco-free pharmacy laws grows, banning tobacco sales in pharmacies is becoming less controversial and more normative to both pharmacy retailers and the public. Our findings inform the ongoing discussion about tobacco-free pharmacy laws and are useful for decision-makers from communities that are considering such laws.

O24 Functionality of selected seaweed extracts on selected pharmaceutical applications

Cosmetic and pharmaceutical industry is looking more and more for natural marine compounds with key identified bioactivities. The Laboratoires Gilbert are a major French industrial player developing natural origin products in cosmetic and pharmacy markets. ALGAIA is a French company providing R&D services and natural extracts from macro- and micro-algae. The present study is based on a private close collaboration between the Laboratoires Gilbert and ALGAIA. The main approach has been to extract, characterise and test bioactivities of novel seaweed extracts towards cosmetic and pharmaceutical applications. In the overall work, 1 green species, 2 red species and 3 brown seaweed species have been used as starting material for creating more than 50 different extracts. After characterization, these extracts have been screened for different bioactivities, each one implemented with different techniques. In the present work, some of the outcomes related to the brown seaweed species studied will be presented and discussed. The focus will be made between the main composition of the selected extracts including polysaccharides and phenolic compounds and their anti-inflammatory and wound healing activities in particular. The composition between the three species is by nature different but also the compounds extracted vary also by their yields and size, depending on the extraction process used. As a consequence, in our study, the results on each bioactivity tested show different levels and scope of action dependent upon the extract that has been tested. Those results will be presented and discussed in order to propose hypotheses of actions and constitute a strong base for sustainable development of innovative pharmaceutical products based on active seaweed extracts.

A Benders decomposition-based heuristic for a production and outbound distribution scheduling problem with strict delivery constraints

The problem addressed in this paper is from a chemotherapy production and delivery environment, where production and delivery are strongly connected problems. Independent jobs have to be prepared by pharmacy technicians working in parallel. These jobs represent pouches of injectable chemotherapy preparations. The production process corresponds to a classic parallel machine scheduling problem. Then, the jobs must be delivered to the patients by a given due date. Only one person ensures all the deliveries, making several trips between the pharmacy production unit and the patient locations. We model this step as a multi-trip traveling salesman problem, where only one salesman can make more than one trip. The objective to minimize is the maximum tardiness of delivery. In addition to the constraints that link the two problems, some constraints related to the chemical stability of chemotherapy drugs have to be taken into account: The time between the production starting time and the date the treatment is administered to the patient (here, the delivery time) cannot exceed the stability duration, as the drug may otherwise become dangerous or ineffective for the patient. Due to these constraints, the problem is more difficult to solve. The proposed resolution method in this paper is a Benders decomposition-based heuristic that makes it possible to find feasible solutions and lower bounds. The advantage of the Benders decomposition approach is that this method exploits the structure of the problem, which can be easily decomposed into two stages. Computational experiments are conducted, and a comparison with a direct exact resolution shows the efficiency of this approach.

Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity

Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work.

Etude D’un Espace Marchand Specialise Dans La Vente De Medicaments De La Rue: L’exemple Du Marche De Roxy A Adjame (Abidjan, Cote d’Ivoire)

This study which has been held on the Roxy market of Adjamé took place from November 2013 to October 2014. It is a transversal study with descriptive and analytical aim whose objective is to proceed to the description of the organization of the circuit of the informal sale of drugs in Abidjan. This article describes the socio-demographic characteristics of street drugs vendors before examining drug pricing methods. Documentary research, direct observation and interviews with vendors were the main techniques used to gatherg information. Our investigations show that the sale of drugs at Roxy is done at 95% by Ivorian women in majority and for the most part illiterate. Pricing is highly dependent on the place of supply of drugs: drugs with a marketing authorization are more expensive on the illicit market than drugs which do not have marketing authorization. In the category of drug products with a marketing authorization: syrups, out-of-stock drugs products in pharmacy and drug the delivery of which asks for time of wait of at least a day in pharmacy is more expensive on the illicit market.

Aplikasi Algoritma Hybrid dalam Penentuan Rute Pendistribusian Produk (Studi Kasus: PT. Enseval Putera Megatrading)

PT. Enseval Putera Megatrading is a company which operates in general business and distribution of pharmacy products, general needs, cosmetics, foods and hospital equipment. In their current practice, routing in products deliveries, which is limited by time windows, has not considered the utilization of vehicles' maximum loading capacities. Distribution route from a hybrid algorithm using heuristic clustering and Mixed-Integer Linear Programming approach can accommodate such problem with time windows and vehicles' capacities utilization. Based on the comparison between company’s current route and the route from the hybrid algorithm, it can be seen that the hybrid algorithm is able to decrease total distance and total cost of transportation. This new route concerns on vehicles allocation and time windows limit. This new route can minimize the total cost of transportation that company has to pay.