Overview of Expiry management of supplies
ContentMeaning and Purpose of Expiry Management
To ensure timely consumption of supplies, the Pharmacist/storekeeper is expected to keep a track of the expiry dates of the drugs and other commodities held in stores. Expiry date reflects the period after which a drug or any other product is known to lose its strength, quality and purity and the time-period ranging from the manufacturing date to the expiry date is referred to as the Shelf-life. The processes involved in ensuring that the supplies are utilized within their shelf life without any wastage is known as the “Expiry Management”.
Supplies that get expired:
Under NTEP following supplies come with an expiry date and must be utilized within their shelf life
S.No.
Supply
Expiry date/shelf-life
1
Anti-TB drugs
2-5 years from the date of manufacturing
2
Xpert MTB/RIF Cartridges
2 years from the date of manufacturing
3
TrueNat MTB chips
2 years from the date of manufacturing
4
TrueNat MTB-RIF Chips
2 years from the date of manufacturing
Resources
Assessment
Answer 1
Answer 2
Answer 3
Answer 4
Correct answer
Correct explanation
Page id
Part of Pre-test
Part of Post-test
What does expiry management ensure?
Timely utilisation of drugs before losing its efficacy.
Reduction in wastage of drugs and lab consumables.
Redirecting drugs to different treatment centres for utilisation before expiry.
All of the above
4
Yes
Yes
Forecasting the expiry of supplies
ContentForecasting the expiry of supplies
In order to ensure the timely consumption of supplies it is important to develop mechanism to periodically monitor control over expiry position of the supplies held in stocks. Reviewing of reports generated by Nikshay Aushadhi can help forecasting the expiry of drugs and taking appropriate actions to ensure consumption of these supplies before their expiry dates. Some of these reports are listed below:
Drug expiry alert: This alert lists out all the drugs from the inventory of the store that are going to expire in the next three months.
Figure 1: Drug expiry alert
Source: Nikshay Aushadhi portal
Stock ledger report and Stock in hand reports: These reports give a list of drugs available at a particular store and details about their available stock and consumption status. These reports will highlight the stores that are overstocked based on their consumption pattern and might not be able to utilize the supplies within their expiry dates.
Figure 2: Stock in hand record
Source: Nikshay Aushadhi portal
Figure 3: Stock ledger report
Source: Nikshay Aushadhi portal
Once the stores having drugs with near expiry dates or those who are overstocked are identified the next step would be to calculate the consumption capacity of these stores based on their existing patient load and anticipated number of new patients to be added. This would help in forecasting drugs in stock that would be consumed before their expiry and those that will not.
Following format can be used for forecasting the consumption of the supplies before expiry:
Table 1: Format for forecasting consumption of supplies
Store
Drug
Expiry Date
Stock in Hand
Anticipated consumption by existing patients
Expected consumption by new patients
Total expected consumption
Excess quantity
Will the consumption happen within the expiry date? Yes/NO
Resources
Standard Operating Procedure Manual Procurement & Supply Chain Management, Ministry of Health and Family Welfare, Government of India 2018
Assessment
Answer 1
Answer 2
Answer 3
Answer 4
Correct answer
Correct explanation
Page id
Part of Pre-test
Part of Post-test
Drug expiry alert lists out drugs which have their expiry date in next:
6 months
3 months
1 month
15 days
2
Drug expiry alert lists out all the drugs from the inventory of the store that are going to expire in the next three months.
Follow-up actions to forecasting of expiry of supplies
ContentFollow-up actions to forecasting of expiry of supplies
Once the pharmacist has forecasted the supplies that may not be consumed within their expiry date, different scenarios may arise in order to manage these supplies efficiently. The scenarios are listed below:
Scenario 1: Supplies will not be consumed at a particular district but may be consumed in other districts of the same state
In this situation, the pharmacist should communicate the details of these supplies to the parent store and State TB Officer (STO). The STO upon receipt of the information will take following actions:
Issue to Sub-stores
After conducting requirement and utilization assessment of each district, STO will identify the needy district where the supplies can be transferred. Drug Transfer Advice (DTA) will be sent to both the stores by the STO.
Note: At least 5 months shelf life should remain before the drugs are diverted from one district to another district.
Other options
The STO can also explore the option of transferring such supplies to facilities outside of NTEP that can utilize these supplies. These facilities may include hospitals, dispensaries, or other facilities within the general health system.
Scenario 2: Supplies may not be consumed by any facility within the state
In this situation information about these supplies should be sent to the Central TB division and the STO with a request to divert these drugs to places where they can be utilized. CTD upon receipt of the information will take following actions:
Transfer to other states
On receipt of requests for diversion, CTD shall identify the States which can utilize these supplies within the given shelf-life. Drug Transfer Advice (DTA) will be sent by CTD to both the States for diversion of drugs.
Resources
Standard Operating Procedure Manual Procurement & Supply Chain Management, Ministry of Health and Family Welfare, Government of India 2018
Assessment
Answer 1
Answer 2
Answer 3
Answer 4
Correct answer
Correct explanation
Page id
Part of Pre-test
Part of Post-test
Minimum shelf-life of the drugs before inter district diversion should be
2 years
3 months
1 year
5 months
4
At least 5 months shelf life should remain before the drugs are diverted from one district to another district.
Disposal of expired supplies
ContentExpiry management of supplies is crucial to avoid financial losses and harm to patients.
If any drug expires due to reasons beyond control, the write-off of expired drugs should be as per the guidelines given in NTEP National Strategic Plan. As per NSP, the State is allowed to write off up to 2% of the cost of the annual supply of drugs on implementation of Drug Sensitivity Testing (DST) guided treatment and 2% cost of rapid molecular test cartridges. The expired stock should be disposed-off as per the Bio-medical Waste (Management and Handling) guidelines of Govt. of India.
Disposal of Expired/Discarded Medicines
Colour of the bag to be used: Yellow
Image
Figure 1: Disposal of expired supplies according to Bio-Medical Waste Management Rules 2016
Updating in Ni-kshay Aushadhi
To dispose of or remove the expired/rejected drugs from the online inventory, follow the steps below:
- Go to the ‘Write-Off/Disposal’ process in Stock Management,
- Click on the ‘Request’ button to generate the disposal request,
- Select the ‘Expired or Rejected’ category, and the system will show the respective drugs
- Select the drug with an expired batch and enter the quantity
- Click on the ‘Save’ button.
Figure 2: Write-off/disposal register in Nikshay Aushadhi Source: Nikshay Aushadhi portal
Figure 3: Entering details of expired drugs in the write-off/disposal register in Nikshay Aushadhi Source: Nikshay Aushadhi portal
Steps to follow
- After saving, select the request and click on the ‘Write-off’ button,
- Verify the drug details and select the type of write-off as ‘Burned/Buried’,
- Enter the ‘Remarks’, and click on the ‘Save’ button,
- System will generate the voucher, and the drug quantity will be deducted from the inventory.
Figure 3: Expired drug details in Nikshay Aushadhi Source: Nikshay Aushadhi portal
Condemnation of laboratory supplies
Figure 4: Process of condemnation of laboratory supplies which are non-functional, obsolete, non-reparable equipment in NTEP’s laboratories
Information is required in below mentioned format to condemn the lab equipment:
Figure 5: Form GFR 10 Source: General Financial Rules 2017, Ministry of Finance, Department of Expenditure, GoI
The request for the replacement of the equipment condemned has to be submitted to State TB Officer (STO)/Central TB Division (CTD) in the below-mentioned format:
Figure 6: Annexure 4 for details of equipment for condemnation Source: Guidelines for the condemnation and replacement of Tuberculosis (TB) laboratory equipment under the Revised National Tuberculosis Control Programme (RNTCP) 2019
Resources
1. Guidelines for Management of Healthcare Waste as per Biomedical Waste Management Rules, 2016
Assessment:
Question Answer 1 Answer 2 Answer 3 Answer 4 Correct answer Correct explanation Page id Part of Pre-test Part of Post-test Disposal of expired supplies is done in which colour bag? Yellow Red White Blue 1 Discarded or expired medicine in yellow coloured non-chlorinated plastic bags
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