1. Managerial and Regulatory Strategies to Improve Drug Use

2. Managerial and Regulatory Strategies to Improve Drug Use: Objectives
Recognize the range of managerial and regulatory strategies
Identify strategies best suited to program need
Successfully develop and implement strategies
Managerial and Regulatory Strategies

3. Managerial Strategies
Managerial Strategies structure information, information flow, and the decision process to achieve more cost-effective use of pharmaceutical resources.
Managerial and Regulatory Strategies

4. Managerial Strategies: Structure Decisions
Selection and Procurement
Essential Drug Lists
National Formulary
Morbidity-Based Quantification
Drug Procurement Review and
Feedback to Decision-Makers
Distribution
Distribution Review Process
Kit Supply Systems
Managerial and Regulatory Strategies

5. Managerial Strategies: Structure Decisions
Prescribing and Dispensing
Standard Diagnostic and
Treatment Guidelines
Structured Drug Order Forms
Automatic Stop Orders
Course-of-Therapy Packaging
Effective Labeling
Audits plus "Feedback" to Providers
Required Consultations or Justifications
Financing
Pricing Drugs According to Health Impact
Patient Cost-Sharing (e.g., $0.20 per prescription)
Managerial and Regulatory Strategies

6. Audit and Feedback in Uganda
Managerial and Regulatory Strategies

7. Regulatory Strategies
Regulatory Strategies limit access to drugs or constrain choices in order to save money or prevent improper use of drugs
Managerial and Regulatory Strategies

8. Regulatory Strategies: Restrict Decisions
Market Controls
Banning unsafe or Ineffective Drugs
Limits on Product Selection
Registration Based on Medical Need
Distribution Controls
Prescribing and Dispensing Controls
Level-of-Use Prescribing Restrictions
Restricting Who Can Prescribe or Dispense
Limits on Number of Different Drugs per
Patient (e.g., "3-drug rule")
Limits on Quantities of Each Drug (e.g., "3-Day Rule)
Managerial and Regulatory Strategies

9. Monthly Proportions of Study Patients in Nursing Homes: Effect of Caps
Managerial and Regulatory Strategies

10. Choosing Managerial and Regulatory Strategies
Expected Magnitude of Impact
Likelihood for Success
Potential for Unintended Effects
Political and Cultural Feasibility
Technical Feasibility
Cost (economic feasibility)
Potential for Donor Support
Managerial and Regulatory Strategies

11. Activity One
Managerial Strategies to Change Generic Drug Use in a Teaching Hospital
Managerial and Regulatory Strategies

12. Regulatory Strategies in
Activity Two
Regulatory Strategies in
Use in Your Countries
Managerial and Regulatory Strategies