Central Hospital is a developed and leading Tertiary Care Private Hospital in central part of Sri Lanka. It functions with full multispecialty units for 24 hours a day and 365 days a year. It also delivers Out-patient Care, Inward care Units, Cardiac surgery unit, General surgery unit, Eye unit and Theatre and a newly developed Neurological Unit. It has three pharmaceutical supplying units for every individual department. Central Hospital is a busy hospital where all the specialist doctors from all over the Island come for channelling, surgeries, rehabilitation, counselling and inpatient consultation for all the referrals.
Due to the busiest environment in Central Hospital a massive purchasing and selling of medicines takes place every month. The purchasing of drugs, injections, gels, creams, and miscellaneous medical and non-medical items were purchased daily and weekly. Especially the injections for the theatre unit such as anaesthetic drugs and post-operative care unit drugs had been ordered in massive numbers. The pharmaceutical department is divided into three categories. One is the out-patient pharmacy, second is indoor pharmacy and the last main one which is pharmacy storage. The chain of request and supply occurs every day between department and stores. Every division has a pharmacist who requests for drugs from store and the store releases the same day to the units. The out-patient pharmaceutical unit and the indoor unit is subdivided under the pharmacy store.
Expiring or wastage of huge number of medicines in Central Hospital every month.
In Central Hospital every month there were about five hundred thousand rupees worth of drugs expired and thrown away. Though the hospital was busy, the proper identification and usage of medicines and the chain of purchasing and procurement was not developed. However, the day to day operations kept running and after few months the wastage of drugs started increasing. Every month end in the management meeting this issue was taken and discussed but a solution was not found to resolve this issue. Times later the wastage declined but it was declined by reducing the numbers of drugs purchased, but this did not help as they ran out of medicines quickly and there were times where patients were turned back without medicines for their treatment. Many pharmaceutical companies import drugs monthly in a particular quantity to supply their customers. When Central Hospital purchased in small quantity, other competitors bought drugs continuously in bulk amount. Once the supplier runs out of stock the hospital had to wait until they purchase their next stock. Wastage of medicines became an issue and challenge to reduce the expiry and wastage of drugs was not commenced by the management. The proper inventory management system was not introduced even after they lost plenty of money by expired medicines.
The fundamental reason and factors contributing to the expiry were medicine procured with short shelf life while purchasing without planning, plenty of same generic drugs appeared with different company names and the doctors do not prescribe the same group more than once, though the law says the doctors should prescribe the generic names only, but it is not practised yet (Nakyanzi et al, 2010). Wilcock (2005) support the argument of Nakyanzi et al (2010) by stating an incident in Uganda. Thirty percent of expired medicines were given to municipality due to short shelf life, medicines effected by abrupt cessation of use or the government medicine policy change, medicines with unpleasant taste, oncology drugs and some donated medicines. These contributing factors has to be analysed in order to reduce the wastage of medicines. For example, cancer patients tend to go to government funded hospitals as the medicine for cancers are highly expensive and some cannot claim through their insurance. Due to these