Estimating Drug Requirements - A Practical Manual: PART II: THE MORBIDITY METHOD: MODULE 7: The patient morbidity/standard treatment method: calculation procedures: 5. TASK 15: CALCULATING AVERAGE DRUG REQUIREMENTS PER 1,000 TREATMENT EPISODES OR PER 1,000 PATIENT CONTACTS

Estimating Drug Requirements - A Practical Manual
(1995; 158 pages) [French] [Spanish]

Table of Contents

PREFACE
PART I: INTRODUCTION
	MODULE 1: Objectives and use of the manual
		1. INTRODUCTION
		2. THE TWO METHODS OF QUANTIFICATION
			2.1 The patient morbidity-standard treatment method
			2.2 The adjusted consumption method
		3. TARGET GROUP OF THE MANUAL
		4. OBJECTIVES OF THE MANUAL
		5. USING THE MANUAL
			5.1 Use for self tuition
			5.2 Use for courses
	MODULE 2: Assessing the need for better quantification
		1. SYMPTOMS OF POOR QUANTIFICATION
			1.1 Chronic and widespread shortages
			1.2 Surpluses
			1.3 Inequity of supply
			1.4 Inadequate cost-effectiveness
			1.5 Irrational adjustments to budgetary constraints
			1.6 Irrational and ineffective prescribing
			1.7 Suppression or distortion of demand
	MODULE 3: Preparing an action plan
		1. INTRODUCTION
		2. TASKS IN PREPARING AN ACTION PLAN
			2.A THE PREPARATORY PHASE
				TASK 1: Name the person responsible
				TASK 2: Form a working group for coordination
				TASK 3: Agree specific objectives
				TASK 4: Choose the quantification methods
				TASK 5: List tasks, estimate budget and obtain resources
				TASK 6: Programme tasks
				TASK 7: List health problems to be treated at facilities covered
				TASK 8: Select appropriate drugs for each health problem, in order to draw up essential drug list(s) for the facilities covered, and add packaging and price data
				TASK 9: Train staff in quantification methods
			2.B THE QUANTIFICATION PHASE
				TASKS 10-15: Data collection, quantification, costing, reconciliation to budget, calculation of final quantities per 1,000 cases
				TASK 16: Feed back results to managers for placing orders and allocating drugs to individual facilities
				TASK 17: Provide training in prescribing and stock management
				TASK 18: Evaluate the quantification process and make any necessary improvements
	MODULE 4: DRAWING UP AND REVIEWING ESSENTIAL DRUG LISTS BY TYPE OF FACILITY
		1. INTRODUCTION
		2. TASK 7-8: DECIDING LEVELS OF CARE AND ESSENTIAL DRUG LISTS BY TYPE OF FACILITY
		3. ADD PACK SIZE AND PRICE PER PACK
PART II: THE MORBIDITY METHOD
	MODULE 5: Data requirements: standard drug treatment schedules for quantifying requirements, based on average doses
		1. INTRODUCTION
		2. TASK 10: STANDARD DRUG TREATMENT SCHEDULES FOR QUANTIFYING DRUG REQUIREMENTS, BASED ON AVERAGE DOSES (AVERAGE DRUG TREATMENT SCHEDULES)
		3. GUIDELINES FOR DRAWING UP AVERAGE DRUG TREATMENT SCHEDULES
		4. ILLUSTRATIVE AVERAGE DRUG TREATMENT SCHEDULES FOR THE MIDDLE (HEALTH CENTRE) LEVEL OF CARE
	MODULE 6: Data requirement: morbidity data
		1. THE DATA REQUIRED - TREATMENT EPISODES
		2. TASK 11: DATA COLLECTION
			2.1 Estimates from centrally assembled patient morbidity data
			2.2 Estimate from morbidity data from a sample of health facilities
			2.3 Prospective sample survey
	MODULE 7: The patient morbidity/standard treatment method: calculation procedures
		1. INTRODUCTION
		2. TASK 12: CALCULATING QUANTITIES REQUIRED OF EACH DRUG
		3. TASK 13: ESTIMATING THE COST OF THE DRUG QUANTITIES REQUIRED
		4. TASK 14: RECONCILING DRUG QUANTITIES TO BUDGET
		5. TASK 15: CALCULATING AVERAGE DRUG REQUIREMENTS PER 1,000 TREATMENT EPISODES OR PER 1,000 PATIENT CONTACTS
PART III: THE CONSUMPTION METHOD
	MODULE 8: The adjusted consumption method: calculation procedure
		1. INTRODUCTION
		2. METHOD OF CALCULATION
		3. TASK 10: SELECT THE “STANDARD” FACILITIES WHOSE CONSUMPTION IS TO SERVE AS THE NORM FOR THE DRUG QUANTITIES TO BE SUPPLIED TO ALL FACILITIES OF THE SAME TYPE
		4. TASK 11: ESTIMATE THE NUMBER OF PATIENT CONTACTS AT ALL FACILITIES OF THE TYPE(S) CONCERNED
		5. TASK 12: CALCULATE THE AVERAGE DRUG USE PER 1,000 PATIENT CONTACTS AND THE QUANTITY REQUIRED OF EACH DRUG
ANNEXES
	Annex 1: Model record form for the community health worker
	Annex 2: Calculation sheet for drug quantities by health problem
	Annex 3: Calculation sheet for total quantities of each drug, number of order packs and cost
	Annex 4: Calculation sheet for total drug quantities and cost after reconciliation to budget, and quantities per 1000 treatment episodes
	Annex 5: Calculation sheet for recording drug quantities (consumption method)

5. TASK 15: CALCULATING AVERAGE DRUG REQUIREMENTS PER 1,000 TREATMENT EPISODES OR PER 1,000 PATIENT CONTACTS

The purpose of this calculation is to enable drugs to be allocated to individual facilities according to their number of treatment episodes or patient contacts. The formula is:

EXAMPLE:

The quantity of each drug per 1,000 treatment episodes is calculated in Table 7.9, column 10.

We know that the drug quantities in column 9 are intended to cover a total of 544,320 treatment episodes (from Table 6.6). Starting with acetylsalicylic acid, the first drug in the list, the total order quantity, 700,000 tablets/544,320 treatment episodes = 1,287 tablets per 1,000 treatment episodes.

For the second drug, aluminium hydroxide, the total order quantity, 84,000 tablets/544,320 treatment episodes = 154 tablets per 1,000 treatment episodes, and so on for each drug.

On the basis of these results a community health worker with a thousand treatment episodes annually would be allocated 1,287 acetylsalicylic acid tablets, 154 aluminium hydroxide tablets, and so on; a CHW with two thousand treatment episodes would receive twice these amounts, and so on proportionately to the number of treatment episodes. In practice, actual deliveries would be made in order packs or, if necessary, fractions of order packs re-packed for distribution.

The same calculation can be done per 1,000 patient contacts if contacts rather than treatment episodes are recorded routinely.