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Chapter 14 Inventory Control
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The Formulary System Formulary: itemized list of medications dispensed by institution Approved by P&T Committee Major factor in inventory control and cost management
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P&T Committee Comprised of: Physicians Pharmacists Nurses
Other health professionals Appointed to committee Decide which drugs to include in formulary
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Drug Inclusion Factors
Effectiveness Safety Abuse Potential Drug Interactions
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Drug Inclusion Factors (cont’d)
Therapeutic Duplication Medication Errors Cost
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Therapeutic Substitution
Way to reduce inventory costs Cost-effective drug is substituted for other drugs in the category Constitutes a formulary change Must be agreed upon by the P&T Committee Only allowable within the institution
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Product Buying Sources
Manufacturer direct Can be difficult for small pharmacies Wholesaler May require Prime Vendor Agreement
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Wholesalers Require a percentage of purchases be made from wholesaler
Provide discounts and services Offer prompt delivery Often have online listing of stock Generous return policies
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Manual Ordering Processes
Compile order “Want book” Collecting empty prescription bottles Place order by phone, fax, or modem
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Electronic Ordering Processes
Bar coding Hand-held machine scans bar codes of needed items Machine connects to phone line or modem Order transmitted Fully computerized system Monitors each transaction Re-orders as necessary
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Ordering Schedule II Drugs
Requires a DEA Form 222 Filled out in triplicate Hand-delivered to driver Authorized signature Every detail must be complete and accurate
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Steps in Receiving Process
Order arrives at pharmacy Check against shipping manifest Note or refuse damaged boxes Note products with special storage needs Sign driver’s manifest promptly
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Invoice Details Name Brand Dosage form Package Size Strength
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Invoice Details (cont’d)
Quantity Cost of item Any applicable discounts Terms of payment
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Checking the Invoice Check order against invoice for all factors
Check expiration date of each product Newly ordered item should have at least six months Re-order non-received items for next day
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Checking the Invoice (cont’d)
Create written record for items removed before proper check-in Date and initial checked invoice Send invoice on for payment Delayed payments can void discounts
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Placing Checked Order in Stock
Check for urgent prescriptions in order Should be processed first Place order items on appropriate shelf
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Precautions for Shelving
Triple-check label Manufacturer packaging often emphasizes logo instead of strength and dose Store similar looking products separately Liquids and injectables Sensitivity to light or temperature Visually check color and clarity
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Expiration Dating Check inventory regularly for expired medication
At least monthly Consult policy for when drugs are to be pulled Check all floor stock and satellite areas Check “opened on” date for liquids and injectables
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Expiration Dating (cont’d)
Dispose of expired medication properly Unopened bottles may be returned for credit Special conditions for control drug disposal Vary from state to state
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Investigational Drugs
Drugs that are part of research studies Very specific protocols for dispensing and returning Inventory management critical Strict records must be kept Details about drugs, study protocols, and patients are confidential
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Controlled Drugs Special inventory and storage requirements
Required biennial inventory of all controlled drugs Schedule II records must be kept separately
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Inventory Management Central to profitability of pharmacy
Inventory budget: Established by institution or pharmacy owners Depends on: Pharmacy size Daily ordering capacity Turnover rate
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Indicators of Inventory Management
Average inventories and turnover rates measure how well inventory is being managed Turnover rate Total annual cost of goods divided by average inventory Average inventory Sum of beginning and ending inventories divided by two
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Maintaining Inventory Levels
Remove expired drugs from shelf Promptly send back drug recalls Lower amount of infrequently used stock Periodically adjust minimum/maximum levels (for computerized inventory control)
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