Monitoring a primary wholesaler depot program

Techniques for monitoring a primary wholesaler depot program used by a university hospital pharmacy department are described. One year after the program began, data from the past four months, obtained from monthly management reports provided by the wholesaler, were reviewed. Attention was focused on the drugs and drug categories that represented the bulk of purchases (in dollar value). Summary purchase orders showed that approximately half the drugs were purchased at the most favorable prices (usually contract bid prices). Most drugs not purchased at the most favorable bid prices were accounted for by sole-source items, inadequate computer documentation by the wholesaler, and atypical orders. A study of ordering patterns revealed that 16 of the top 40 drugs ordered (by volume and dollar expenditures) were ordered less than once per month; the inventory management goal was to order a two-week supply. The wholesaler could not completely fill orders for 18% of the contract drugs, often because of back orders from manufacturers. Although the computerized management reports used in this study did not allow evaluation of all aspects of the primary wholesaler depot program, they provided a convenient mechanism for concurrent assessment of the program's effectiveness. The program appeared to be advantageous to the pharmacy department, and most problems encountered were easily remedied. Several performance measures for institutions considering depot programs are recommended.