Why Hospital Pharmacists Have Failed to Manage Antimalarial Drugs Stock-Outs in Pakistan? A Qualitative Insight

Purpose. This study aimed to explore the perceptions of hospital pharmacists towards drug management and reasons underlying stock-outs of antimalarial drugs in Pakistan. Methods. A qualitative study was designed to explore the perceptions of hospital pharmacists regarding drug management and irrational use of antimalarial drugs in two major cities of Pakistan, namely, Islamabad (national capital) and Rawalpindi (twin city). Semistructured interviews were conducted with 16 hospital pharmacists using indepth interview guides at a place and time convenient for the respondents. Interviews, which were audiotaped and transcribed verbatim, were evaluated by thematic content analysis and by other authors’ analysis. Results. Most of the respondents were of the view that financial constraints, inappropriate drug management, and inadequate funding were the factors contributing toward the problem of antimalarial drug stock-outs in healthcare facilities of Pakistan. The pharmacists anticipated that prescribing by nonproprietary names, training of health professionals, accepted role of hospital pharmacist in drug management, implementation of essential drug list and standard treatment guidelines for malaria in the healthcare system can minimize the problem of drug stock outs in healthcare system of Pakistan. Conclusion. The current study showed that all the respondents in the two cities agreed that hospital pharmacist has failed to play an effective role in efficient management of anti-malarial drugs stock-outs. 1. Introduction Efficient drug management is the key strategy in reducing costs of drugs and ensuring their availability in the healthcare facilities [1]. High incidence of drug stock outs is diverse and imitates perpetual problems including inadequate resources and weak healthcare systems to delineate procurement needs and manage stock flows [2]. The selection of most cost-effective essential drugs to treat commonly encountered diseases, appropriate quantification, preselection of potential suppliers, procurement and monitoring of the performance of suppliers and the procurement system can be achieved by adopting efficient procedures. Failure in any of these areas leads to lack of access to appropriate drugs and waste of resources. Lack of properly trained staff in good procurement practices at key positions can also doom any procurement system to failure. Low incentives, inadequate posts, and lack of career development tend to confine potentials to attract and retain qualified staff in the healthcare facilities [3]. Medicines procurement is an effective way