RATIONAL USE OF DRUGS IN THE HEALTH CARE SYSTEM

Essential drugs are those that satisfy the Health care needs of the majority of the population. They should therefore be available at all times in adequate amounts and in the appropriate dosage forms. The Pharmaceuticals and Vaccine Technologies plays a pivotal role in any Health Care System. These technologies claim a major share of the health spending. The effect of this spending is greatly undermined because of the inappropriate drugs prescribed and utilized. The government has to pay unnecessarily high price for drugs because the Public facilities were hampered by shortages and wastages. The poor are the worst affected because they account for a major share of the disease burden and are least able to purchase and utilize the health services, such as drugs. Good value from pharmaceutical spending is most important in any health system.

Tamil Nadu, under the TNMSC has a list of Essential Drugs finalized on the basis of the model list by the WHO, and ensured that there is no shortage of funds and manpower for taking drugs from the TNMSC warehouses to the various health care delivery systems. The drugs are supplied only in strips and in blister packing. Drugs are also tested for quality. This is a first step towards Rational use of drugs.

The major achievement by the TNMSC is the preparation of the Essential Drug list, based on the needs of the primary health centers rendering primary level health care, district and taluk hospitals rendering secondary level health care and teaching hospitals serving as referral and tertiary level health care centers. TNMSC has selected drugs under generic names, in the disease pattern, safety, effectiveness, and cost and made arrangements for the proper storage of the drugs in modern warehouses.

The store keeping procedures have been revised. Training of the Pharmacists were undertaken and training materials are supplied to them regarding the storage and distribution of the drugs under the new system. The drugs are stored according to the first come and first out basis and according to their generic name. Accurate up to date stock information is kept on the computer and all the warehouses are directly linked telephonically with the TNMSC headquarters in Chennai.

The important aspect of drug distribution system is to ensure timely procurement and improvement of the management system into an efficient one. Having achieved drug availability at all levels and at all times, it is now essential that the drugs are prescribed rationally. For this is essential to have a standard treatment guidelines, diagnostic guidelines and drug information to monitor the proper use of drugs.

Promoting the rational use of drugs is the most difficult task. Rational use of drugs, the procurement and distribution of essential drugs etc. require resources, knowledge and skills among the prescribers and the dispensers. By providing objective information, continuing education and training in Epidemiology and Pharmacology, the essence of propagating the need for Essential Drugs and Rational use of drugs in the health care of the community can be achieved.