Monitoring and expiry management of drugs in Private sector

Monitoring the supply chain of anti TB drugs and appropriate management of drug expiry is important:

• to ensure an uninterrupted supply

• to avoid delays in treatment initiation

• to prevent drug stock imbalances.

Monitoring and Expiry Management of National TB Elimination Porgramme (NTEP) Drugs in the Private Sector

1) Personnel

• The monitoring and expiry management of NTEP drug stocks in the private sector is managed by the Patient Provider Support Agency (PPSA) contracted under the NTEP. 

• The PPSA identifies the stocking points for the private sector based on their TB notification rate as well as the patient reach.

• The PPSA will be responsible to ensure that sufficient stock is available at the private sector stocking unit and also to manage the transport of the drugs from the district to the empanelled chemists and other providers.

2) Assessment of stock requirement

• The supply of drugs to private sector stocking points should only be undertaken based on the number of regimen-wise new patients initiated on treatment as notified on Nikshay and calculated number of future patients for a particular period.

• Therefore, for smooth monitoring of private drug stocks, they must ensure that all the diagnosed TB patients in the private sector are notified on Nikshay.

• The dispensation of drugs to private sector patients is fulfilled through Ni-kshay which is integrated with Ni-kshay Aushadhi via backend APIs (Application Programming Interface).

3) Stock availability and expiry management

• Fixed Drug Combinations (FDCs) for DS TB treatment are stocked at the private sector health facilities and PPSA personnel should ensure the same.

• Drug inventory records such as the FDC prescriptions/voucher invoice from the private sector stocking points should be reviewed by the PPSA personnel and also cross-checked with Nikshay records.

• The drugs are to be supplied to the private sector stocking points for not more than twice a month.

• The private sector chemist also needs to maintain a separate Schedule H1 register that includes the patient's identity, prescribing doctor's contact information, drug name and dispensed quantity, and date.

• In any case of drugs being returned or drugs that are expiring, the same should be updated on Nikshay using the return dispensation module and should be transferred back to the parent store via the PPSA.

• In no case, more than 60 days of FDC should be issued to a single patient at once.

Resources

• Guidance Document on Partnerships, CTD, MoHFW, India, 2019.

• Guidelines for Programmatic Management of Drug-resistant TB (PMDT) in India, NTEP, CTD, MoHFW, India, 2021.

• Procurement, Supply Chain Management & Preventive Maintenance, Module 6, CTD, MoHFW, India.

Assessment