Gestion des Achats et de la Logistique des Médicaments et des Produits VIH/SIDA

Addis Ababa / Ethiopie24 Février 2005

Stockage, SIGL, Gestion de Stocket Distribution

LE CYCLE LOGISTIQUE

Service Clients

Prévisions &Acquisition

Sélection desProduits

Gestion de Stock• Stockage• Distribution

Système d’Informationde

Gestion Logistique (SIGL)

Suivi

Organisation & Personnel

Budget

Supervision

Evaluation

Contrôle Qualité

Contrôle Qualité

Contrôle Qualité

Contrôle Qualité

POLITIQUEPOLITIQUE

ADAPTABILITEADAPTABILITE

Points Principaux de la Journée

• Stockage• SIGL• Contrôle des Stocks

Tous font partis de la gestion de stock!

Points Essentiels

• Systèmes intégrés ou systèmes verticaux.

• Pleine disponibilité ou approvisionnementlimitée en produits.

But du Stockage

• Protèger la qualité du produit et son emballage tout au long de la chaîned’approvisionnement.

• Rendre le produit disponible pour la distribution.

Exemple : le Kaletra

• Stockées à 25ºC, les capsules de Kaletra sontstable et efficaces pendant 2 mois.

• Pour un stockage d’un jour à 45°C > les capsules deviennent molles, collantes et se délitent en les séparant.

• Recommandation d’Abbott : ne pas fournir plus de 30 jours d’approvisionnement en climatchaud.

Exemple : Determine

• Stockage entre 2ºC et 30ºC

• Le chase buffer expire au bout de 11-13 mois

• Le test expire au bout de 12-18 mois

2 décisions clé du SIGL

• Quelles données collecter

• Quel doit être le format du SIGL

3 données essentielles

• Stock disponible

• Taux de consommation

• Pertes et Ajustements

Revised 3/2003

ORIGINAL MINISTRY OF HEALTH

MONTHLY REPORT & REQUEST FOR LABORATORY REAGENTS Facility Name District: Province: Facility Type: Laboratory Other Report of Period Beginning 20 Ending 20

Table 1: Monthly Total Quantities Used by Each Type of Service

Reagent Name

Unit Pack

Clinical Diagnois

Blood

Screening

VCT

PMTCT

Other

Total Tests

Determine

Test

Unigold

Test

InstantScreen Other

Enzygnost

Test

Vironostika

Test

Other Test

Hep B SAH

Test

Murex Anti HCV

Test

Other

RPR

Test

Other Test Total #

Tests

Total # Clients

Table 2: Status of Testing Equipment, Storage Facility and Trained Personnel

Type of Machine, Equipment Date of Last Service

Number of trained staff

Condition/Comments

Managed by: GOK NGO Private

Revised 3/2003 TRIPLICATE

MINISTRY OF HEALTH MONTHLY REPORT & REQUEST FOR LABORATORY REAGENTS

Facility Name District: Province: Facility Type: Laboratory Other Report of Period Beginning 20 Ending 20

A B C D E F G H Earliest expiry date of stock

Reagent Name

Unit Pack

Begining Balance

Received This Period

Total Tests Used

Total Tests Issued

Adjustments (*)

Physical Count

Date

Qty

Qty Needed

Determine

Test

Unigold

Test

Instant Screen Test Other Test

Enzygnost

Test

Vironostika

Test

Other Test

Hep B SAH

Test

Murex Anti HCV

Test

Other Test

RPR

Test

Others Test

Test

Test

Comments: Submitted by:

Name Signature Designation: Date: * - In Column E put (E) for Expired, (W) for Withdrawn, (A) for Stock Adjustment or (O) for Other

Managed by: GOK NGO Private

MONTHLY FACILITY REPORT OF HIV TEST USAGE Ministry of Health / Ghana Health Services

Republic of Ghana

Facility Name: Report Period:

District: month/year

Region: Date Prepared day/month/year

For each test type, include tests used for initial screening, confirmatory tests, and tie-breaker tests (if applicable).

Note: Re-supply quantities are based on the number of tests used during the month/quarter. Under-reporting the number of tests used will result in insufficient re-supply and could lead to stock outs at the testing facility.

Client/Patient Testing Facility Use

Item Description (Test Type) Blood Safety

Voluntary Counseling and Testing

(VCT)

Prevention of Mother to

Child Transmission

(PMTCT)

Clinical Diagnosis

Sentinel Surveillance Lab Controls Quality

Testing Testing

Wastage

Total Number of Tests Used

during the Month

Stock on Hand at the End of the

Month

A B C D E F G H I = A + B + C + D + E + F + G

+ H J

Rapid Assay HIV Test Kits Determine HIV 1/2 (Abbot) Rapi-Test HIV 1/2 Long ELISA HIV Test Kits Vironostika Uniform II HIV 1/2 plus O (Organon)

Remarks:

Prepared by: Name/Signature: Designation: Date:

Reviewed by:

Name/Signature: Designation: Date:

MONTHLY REPORT FOR HIV TEST KITS AND CONSUMABLE LABORATORY SUPPLIES FOR HIV TESTING Ministry of Health / Ghana Health Services

Republic of Ghana

Region:

Report Period:

month/year

Maximum Stock Level: 3 Months

Date Prepared

day/month/year

Opening Balance

Total Qty. Received during the

Month

Total Monthly Issues

Losses/ Adjustments

(+ / -)

Closing Balance

Months of Stock on Hand

Total No. Days Out of Stock Serial

No. Item Description No.

Tests per Kit

Basic Unit

A B C D E = A + B – C +/- D F = E/C G

Rapid Assay HIV TEST KITS 1 Determine HIV 1/2 (Abbot) 100 1 test 2 Rapi-Test HIV 1/2 100 1 test 3 1 test

ELISA HIV Test Kits 4 Vironostika Uniform II HIV 1/2 plus O (Organon) 576 1 test 5 1 test

Consumable Laboratory Supplies for HIV Testing 6 Pipette Tips (Small) 5 - 40 microliter (venipuncture) 7 Pipette Tips (Big) 40 - 200 microliter (venipuncture) 8 Pasteur Pipettes graduated with bulb, Non-Sterile 9 Disposable Plastic [for venipuncture assay]

10 Vacutainers - 10ml 11 Vacutainer plain/serum Tubes 4 ml [plastic] 12 Vacutainer multi-sampler 21 Gauge needles

Remarks:

Prepared by: Name/Signature: Designation: Date:

Name/Signature:

Designation:

Date:

Reviewed by:

Name/Signature: Designation: Date:

MONTHLY LOGISTICS AND NEW PATIENTS REPORT – JCRC FREE DRUGS

Facility Name: Report Period: Maximum Stock Level 2 months

District: month/year

Delivery Zone: Date Prepared Minimum Stock Level 1month day/month/year

REPORT NEW PATIENTS

Opening Balance

Total Qty. Received during the

Month

Total Monthly Consumption

Losses/ Adjustments

( +/- )

Closing BalancesFacility Stores + Dispensing Area

E = A + B - C +/- D

Estimated number of NEW patients on this drug for next

month Serial No. Drug Product 1 Basic

Unit

A B C D E F

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS 1 Zidovudine (AZT, ZDV) 100mg Capsule 2 Zidovudine (AZT, ZDV) 300mg Tablet 3 Zidovudine (AZT, ZDV) 10mg/ml oral solution Btl 240ml 4 Lamivudine (3TC) 150mg Tablet 5 Lamivudine (3TC) 10mg/ml oral solution Btl 240ml 6 Stavudine (D4T) 20mg Capsule 7 Stavudine (D4T) 30mg Capsule 8 Stavudine (D4T) 40mg Capsule 9 Didanosine (DDI) 25mg Tablet 10 Didanosine (DDI) 100mg Tablet 11 Didanosine (DDI) 200mg Tablet

Republic of GhanaMinistry of Health/Ghana Health Services

MONTHLY LMIS REPORT FOR ANTIRETROVIRAL DRUGS

Facility: Central Medical Stores TEMA Month/Year: Maximum Stock Level: __10__ Months

Region : Greater Accra Region Minimum Stock Level: ___7__ Months

A B C1 C2 D E F G H I J

CMS CMS CMS ART Sites CMS CMS CMS CMS CMS MAXIMUM QUANTITYTOTAL Total Total MONTHS STOCK TO ORDER

TOTAL TOTAL TOTAL Losses/ CLOSING Quantity No. Days OF STOCK QUANTITY QUANTITY UNIT [Rounded upSerial Basic OPENING QUANTITY QUANTITY MONTHLY Adjustments BALANCE2 to Expire in Out of ON HAND3 (C2 x Maximum TO ORDER PACK to Pack Size)No. Unit BALANCE RECEIVED ISSUED1 ONSUMPTIO (+ / -) A+B-C1(+/-D) 3 Months Stock ( E / C2 ) Stock Level) ( G - E ) SIZE ( H / J )

FIXED DOSE COMBINATIONS1 Zidovudine 300mg/Lamivudine 150mg Tablet 60

NON-NUCLEOSIDE REVERSETRANSCRIPTASE INHIBITORS

2 Nevirapine (NVP) 50mg/5ml oral suspension (BI) 240ml Bottle 13 Nevirapine (NVP) 10mg/ml oral suspension (BI) 20ml Bottle 14 Nevirapine (NVP) 200mg Tablet 60

5 Efavirenz (EFV) 30mg/ml syrup ???ml Bottle 16 Efavirenz (EFV) 50mg Capsule 307 Efavirenz (EFV) 100mg Capsule 308 Efavirenz (EFV) 200mg Capsule 909 Efavirenz (EFV) 600mg Tablet 30

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS

10 Zidovudine (AZT) 10mg/ml syrup 200ml Bottle 111 Zidovudine (AZT) 100mg Capsule 10012 Zidovudine (AZT) 300mg Tablet 60

13 Lamivudine (3TC) 10mg/ml oral solution 240ml Bottle 114 Lamivudine (3TC) 150mg Tablet 60

15 Stavudine (d4T) 1mg/ml PFR for oral sol 200mg/Bottle 116 Stavudine (d4T) 15mg Capsule 6017 Stavudine (d4T) 20mg Capsule 6018 Stavudine (d4T) 30mg Capsule 6019 Stavudine (d4T) 40mg Capsule 60

20 Didanosine (ddI) 10mg/ml oral sol 2Gm PFR 4oz Bottle 121 Didanosine (ddl) 25mg Tablet 6022 Didanosine (ddl) 50mg Tablet 6023 Didanosine (ddl) 100mg Tablet 6024 Didanosine (ddI) 150mg Tablet 6025 Didanosine (ddI) 200mg Tablet 60

26 Abacavir (ABC) 20mg/ml oral sol 240ml Bottle 127 Abacavir (ABC) 300mg Tablet 60

NUCLEOTIDE REVERSETRANSCRIPTASE INHIBITOR

28 Tenofovir (TFD) 300mg Tablet 30

PROTEASE INHIBITORS29 Nelfinavir Mesylate (NFV) 50mg/g PFR 144g/Bottle 1

[50mg per 1.25ml scoop]30 Nelfinavir Mesylate (NFV) 250mg Tablet 270

31 Lopinavir+Ritonavir (LPV/r) 400mg/100mg/5ml 300ml Bottle 132 Lopinavir+Ritonavir (LPV/r) 133.3mg/33.3mg Capsule 180

1 The Total Quantity Issued from CMS during the month (Column C1) should equal the sum of the Total Quantity Received by all ART Facilities during the month. 2 The Closing Balance at CMS is calculated by subtracting the Total Quantity Issued (Column C1) during the month.3 The Months of Stock on Hand at CMS is calculated using the Total Monthly Consumption at all ART sites (Column C2).

Drug Product

DRAFT for reviewJSI/DELIVER Nov 2004

Monthly Summary Report of ART PatientsFacility: __________________________________ Month: ______________________

District: _________________________________ Year: __________

Region: __________________________________

Total No.Patients on

To From Regimen atregimen regimen end of Month

B C D E = (A+B+C)-D

A ADULT 1st Line RegimensA1 AZT 300mg/3TC 150mg + NVP 200mg

A2 AZT 300mg/3TC 150mg + EFV 600mg

A3 d4T(30) + 3TC 150mg + NVP 200mg

A4 d4T(40) + 3TC 150mg + NVP 200mg

A5 d4T(30) + 3TC 150mg + EFV 600mg

A6 d4T(40) + 3TC 150mg + EFV 600mg

B ADULT 2nd Line RegimensB1 TDF 300mg + ddI 250mg + NFV 250mg

B2 TDF 300mg + ddI 250mg + LPV/r 133.3mg/33.3mg

B3 ABC 300mg + ddI 150mg + NFV 250mg (< 60kg)

B4 ABC 300mg + ddI 200mg + NFV 250mg (> 60kg)

B5 ABC 300mg + ddI 150mg + LPV/r 133.3mg/33.3mg (< 60kg)

B6 ABC 300mg + ddI 200mg + LPV/r 133.3mg/33.3mg (> 60kg)

ADULT Other RegimensB7 AZT 300mg/3TC 150mg + NFV 250mg

B8 AZT 300mg/3TC 150mg + ABC 300mg

B9 AZT 300mg + ddI 150mg +NFV 250mg (< 60kg)

B10 AZT 300mg + ddI 200mg + NFV 250mg (> 60kg)

B11 d4T(30) + 3TC 150mg + NFV 250mg (< 60kg)

B12 d4T(40) + 3TC 150mg + NFV 250mg (> 60kg)

B13 d4T(30) + 3TC 150mg + LPV/r 133.3mg/33.3mg (< 60kg)

B14 d4T(40) + 3TC 150mg + LPV/r 133.3mg/33.3mg (> 60kg)

B15 d4T(30) + 3TC 150mg + ddI 150mg (< 60kg)

B16 d4T(40) + 3TC 150mg + ddI 200mg (> 60kg)

B17 d4T(30) + ddI 150mg + EFV 600mg (< 60kg)

B18 d4T(40) + ddI 200mg + EFV 600mg (> 60kg)

B19 ddI 150mg + 3TC 150mg + NFV 250mg (< 60kg)

B20 ddI 200mg + 3TC 150mg + NFV 250mg (> 60kg)

No of shiftsduring the month

Republic of Ghana Ministry of Health/Ghana Health Service

No. Patients No. of New

Treatment Regimen

Patientson Regimen end of Month

A

on Regimen

of Monthat Beginning

But du contrôle de stock

Maintenir un niveau de stock approprié de tous les produits, en évitant les pénurieset les sur-stockages.

Exemple simplifié de Chaîne d’Approvisionnement

PORT

Entrepôt Central

Entrepôt Régional

Hôpital de District

Centre de Santé Dispensaire

Agent de SantéCommunautaire

CLIENTSCLIENTS