Optimizing medicines use to improve patient outcomes

Guidelines on pharmaceutical donations; The case of KNH

The need for guidelines

• Medicine donations though well intended can cause problems

• Major disasters elicit emotional appeal for medical supplies without regard to the need.

• WHO in collaboration with other stakeholders issued guidelines in 1996 which were reviewed in 1999.The aim was to reduce problems associated with donations

• Guidelines are applicable to both emergency and long term donations.

Problems with donations

• may not be relevant to the emergency, disease patterns or level of care

• may not be known to the local health professionals

• may not comply with policies and treatment guidelines

• arrive unsorted and labeled in foreign language with unknown brand names

• quality may not comply with standards in the donor country

Problems with donations

• may be medicines or free samples returned to pharmacies with short expiry

• may have high declared value based on market value in donor country leading to high import taxes

• arrive with short shelf life leading to expiry and need for disposal

• create extra workload in sorting, documenting and distribution

Examples of donations to KNH

• 1998 Bomb blast (lessons learnt) • Sachang’wan fire tragedy of 2009(after KNH

guidelines)• Sinai fire tragedy of 2011

Core principles for donations

• Maximum benefit • Respect for the wishes and authority of the

recipient • No double standards in quality• Effective communication between donor and

recipient

Implementation of policy on pharmaceutical donations

• Decide who is responsible for defining the needs and who will prioritize them

• Decide who coordinates all medicine donations

• Which documents are needed when a donation is planned and who should receive them

• Which procedure should be used when donation do not follow guidelines

Implementation of policy on pharmaceutical donations

• What are the criteria for accepting or rejecting donations and who makes the final decision

• Decide who coordinates reception, storage, and distribution of donated medicine

• How are donations valued and entered into the budget/ expenditure records

• How will inappropriate donations be disposed of

Challenges

• Pharmaceutical donation guidelines developed and disseminated yet dumping and inappropriate donations still occur

• Donations delivered directly to the clinics/wards

• No record or proper documentation of donations

• interference of clinical activities by medical representatives

Conclusion

• Adhering to pharmaceutical donation

guidelines will optimize use of donated medicines for improved patient outcomes