Question

Discuss the five alternative ways used for supplying medicines and medical supplies to health services.

Answer 1

There are five alternative ways for medicine and medical supplies to health services ( government and nongovernmental)------Central medical stores system,autonomous supply agencies system , direct delivery system,primary distributor system, primarily private supply system.

1) CENTRAL MEDICAL STORES(C.M.S)-- It is a public sector (conventional)supply.totally controlled by government unit.Important requirements like contracting suppliers,storage , delivery done by Fully central medical store and monitoring medicine quality is done by national drug regulatory authorities, central medical stores. Like every things it has some advantages and disadvantages . Advantages are like it is the conventional, easy and throughout the entire system government controls over it. Disadvantages are like high cost is needed for storage ,delivery, transport ,operating and as it is governmental controlled so can be affected by political interference.

2) AUTONOMOUS SUPPLY  AGENCY --medicine and medical supplies procured and distributed by automous and semi autonomous agencies. It is  an alternative option to central medical stores system. Storage ,delivery , contracting the suppliers are done by automous agency.Other than this medicine monitoring is done by pharmaceutical procurement offices, national drug regulatory authorities, autonomous agencies . It has advantages like it is a centralized system , less affected by political interference, separate financing facilities is present. Also this system has disadvantages like--cost of establishment is toally upon autonomous supply agencies, if it is operated as monopoly competitive presssure is presented, can be presence of some limitations of central medical stores system.

3) DIRECT DELIVERY SYSTEM-- it is a decentralized system totally different from CMS system.The tenders of government pharmaceutical procurement offices establish the suppliers and price is fixed of each item. Medicine and medical supplies are delivered directly by suppliers and distributed directly to the districts and major facilities . Here storage and delivery are done by suppliers, monitoring medicine is done by government pharmaceutical procurement offices,national drug regulatory authorities. Many advantages are present like -- maintain fixed price benefits so less chance of black marketing, as  storage and delivery is not done by government so cost of storage and delivery eliminated, for being decentralized the order qualities are adjusted by local and seasonal demand. Beside the advantages there are also disadvantages -- can be problem seen in coordination and monitoring of government,suppliers,major facilities,this system can be infrastructured where plenty of private infrastructure exists ,if limited suppliers are present in a local area the it can reduce and the competition and increase the cost,it is nonbenificial or in efficient in remote areas .

4)PRIMARY DISTRIBUTOR SYSYEM-- It is also an non central medical store system.The government pharmaceutical procurement offices establish contracts and separate contracts is given to separate primary distributor. Means government can contract many with one or more primart distributors. Now this primary distributor takes the medicine and medical supplies from suppliers and then the primary distributors distribute to major facilities , districts. In this system , contracting the suppliers are done by government procurement offices but storage and delivery is done by primary distributors, also the monitoring is maintained by pharmaceutical procurement office, and primary distributors but the national drug regulatory authorities have no role. Advantages are like-- here as each contract is given to single primary distributor so there is no problem of coordination , primary distributors gives a competitive atmosphere for giving best service and best price. Disadvantages are like-- as primary distributors have a role of monitoring so the quality of medicine may be compromised, competition may or may not be present totally dependent upon on the primary distributors system is well developed or not.

5)PRIMARILY PRIVATE SUPPLY-- It gives the allowance to private pharmacies to provide supply to private sector patient but there should be a quality in providing services to medically needed peroson and poor people and also cost effectiveness. In this system storage and delivery ,procurement process ,distribution are done private enterprises. Supply monitoring is done by national drug regulatory authorities. Same as like other system it has advantages and disadvantages .advantages are-- demand is less,cost become less for government. Disadvantages are -- may not give the equity to medical needed person, poor person,quality of medicine may be compromised.