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Stocking Norms of Drugs and Supplies
Learning Objectivesstocking norms
The National TB Elimination Programme (NTEP) strives to ensure an uninterrupted supply of drugs, and stocking norms have been developed by the Central TB Division (CTD) to help achieve this goal.
The drug stocks equivalent to 10 months of consumption, shall be maintained with implementing states.
The table shows the quantity of reserve stocks at each level at the start of the quarter (considering the receipt from one higher level).
| Level | Stock for Utilisation (Months) | Reserve Buffer Stock (Months) | Drug Requirements |
| State Drug Store (SDS) | 0 | 3 | (Quarterly consumption / 3) X 10 – (existing stock in SDS including stocks at all districts at end of the quarter) |
| District Drug Store (DDS) | 0 | 3 | (Quarterly consumption / 3) x 7 – (Existing stock in District TB Centre (DTC), TB Unit (TU) and Peripheral Health Institution (PHI) drugstores at end of the quarter) |
| TU Drug Store | 0 | 2 | (Quarterly consumption / 3) x 4 – (existing stock in TU including PHI drug stores at end of the quarter) |
| PHI | 1 | 1 | (Monthly consumption x 2) – (existing stock in PHI at end of the month) |
Based on the state stock availability and consumption, the stock is supplied from SDS to the district drug store to its TUs and then to the PHIs. This stocking pattern may be denoted as the 3-3-2-2 (SDS-District-TU-PHI) inventory-stocking norm, aggregating 10 months of inventory at the state level.
- At the start of the quarter, PHIs are supplied with a stock of 2 months (as shown in the table above)
- Every month, they are supplied with stock from the TU based on consumption, which helps to maintain 1 month reserve stock for utilization at the PHI
- This reserve stock helps the PHI to provide drugs if more patients are put on treatment in a particular month and to provide cover for delays in supplies from TU
- Thus, no patient is sent back due to a lack of drugs
- For the TU level to ensure that the PHIs have 1-month utilization stock plus 1-month reserves, it needs to have a reserve stock of 2 months at the beginning of the quarter
- In this way, the continuous supply of drugs is maintained
Paediatric Stocking Norms
Paediatric drug stocks equivalent to 10 months' consumption will also be kept, but paediatric boxes are not expected to be kept at PHI levels. The stocking of paediatric boxes has been limited to the TU level only.
The paediatric stocking pattern may be denoted as the 3-3-4 (SDS-District-TU) inventory stocking norm, aggregating 10 months of inventory at the state level.
| Level | Stock for utilisation | Reserve stock | Drug requirements |
|---|---|---|---|
| SDS | 0 Months | 3 months | (Quarterly consumption/3) X 12 – (existing stock in SDS including stokes at all districts at the end of the quarter) |
| DTC drug store | 0 Months | 3 months | (Quarterly consumption/3) X 9 – (existing stock in DTC drug store including TU & HF drugs stores at the end of the quarter) |
| TU drug store | 0 Months | 2 months | (Quarterly consumption/3) X 6 – (existing stock in TU including HF drugs stores at the end of the quarter) |
| Health facility | 0 Months | 2 months | Reserve stoke in HF at the end of the month |
| Treatment supporter | 2 months | 0 Months | Two-monthly PWB under utilisation |
Figure: Stocking Norms for Second-line Anti-TB Drugs for Adults; to be Followed at Each Level
Abbr: TU: TB Unit; DTC: District TB Centre; SDS: State Drug Store; PWB: Patient-wise Box; HF: Health Facility.
|
Level |
Stock for utilization |
Reserve stock in months of full TPT courses |
Drug requirements |
|
Treatment supporter |
One full TPT course per beneficiary |
0 month |
Full TPT course under utilization |
|
HF drug store |
0 month |
2 month |
Reserve stock in HF at end of the month (2 x total TPT beneficiaries on Full TPT course for HF) |
|
TU drug store |
0 month |
2 months |
(Quarterly consumption/ 3) x 5 – (existing stock in TU including HF drug stores at end of the quarter) |
|
DTC drug store |
0 month |
3 months |
(Quarterly consumption/ 3) x 8 – (existing stock in DTC drug store including TU & HF drug stores at end of the quarter) |
|
SDS |
0 month |
3 months |
(Quarterly consumption/ 3) x 11 – (existing stock in SDS including stocks at all districts at end of the quarter) |
Figure: Stocking norms for full TPT courses at various stocking points
Resources:
- NTEP Training Modules 5-9 for Programme Managers & Medical Officers, 2020.
- Standard Operating Procedures Manual for State Drug Stores, NTEP, 2012.
Assessment
| Question | Answer 1 | Answer 2 | Answer 3 | Answer 4 | Correct answer | Correct explanation | Page id | Part of Pre-test | Part of Post-test |
| How much stock of first-line anti-TB drugs should be available at a PHI at any given moment? | 1 | 2 | 3 | 4 | 2 | 2 months' stock of drugs must be available at the PHI level | | ||
| Which of the following stocking norms are implemented by the NTEP? | 2-2-3-4 (SDS-District-TU-PHI) inventory-stocking norm | 2-3-4 (SDS-TU-PHI) inventory stocking norm | 3-3-4 (SDS-District-TU) inventory stocking norm | None of the above | 3 |
The paediatric stocking pattern may be denoted as the 3-3-4 (SDS-District-TU) inventory stocking norm, aggregating 10 months of inventory at the state level.
|
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