TY - JOUR AU - Vagnoni, Emidia AU - Cavicchi, Caterina AU - Scanavacca, Paola AU - Dell’Orco, Stefania AU - Mazzuca, Fausta AU - Campi, Anna AU - Bianchi, Stefano T1 - An analysis of the cost of drugs’ delivery processes:
policy implications PY - 2017 Y1 - 2017-07-01 DO - 10.1721/2784.28071 JO - Giornale Italiano di Farmacia Clinica JA - GIFAC VL - 31 IS - 3 SP - 121 EP - 130 PB - Il Pensiero Scientifico Editore SN - 1120-3749 Y2 - 2026/06/24 UR - http://dx.doi.org/10.1721/2784.28071 N2 - Summary. Background. Given the significance of pharmaceutical expenditure, countries have searched for pharmaceutical policies that enable efficiency. In Italy, two different processes for drugs’ distribution to outpatients were defined, involving both hospital and local health authorities’ pharmacies and community pharmacies: direct distribution and dispensation on behalf of hospital pharmacies undertaken by community pharmacies. The study evaluates the distribution processes and discusses which presents a greater advantage from the perspective of the national healthcare system. Methods. An investigation of the two processes of drug distribution was conducted in pharmaceutical departments in two different regions of Italy. A qualitative comparative case study approach was used to conduct organizational analysis of the distribution processes and a cost efficient analysis. Costs were investigated using an activity based costing approach with regard to year 2013. The average cost per distributed pack was defined for both distribution processes at each of the two pharmaceutical departments. Thus, the most efficient process was detected from the perspective of the national healthcare service. Results. Our results revealed that direct distribution was more efficient in both of the two analyzed departments. Analysis of the cost of the direct distribution process showed that both departments brought to similar amounts, whereas the number of distributed packages had a significant effect on the average cost per distributed package. Discussion. Analysis of the process of dispensation by community pharmacies revealed a significant difference in costs of the process to the two departments: the terms of remuneration criteria defined in regional agreements appears to be the main driver of the different costs of the process. Conclusions. The case studies enabled us to state that the direct distribution process of drugs’ distribution by community pharmacies on behalf of hospital and local health authorities was the most efficient. As a consequence, pharmaceutical policies based on the direct distribution process would probably improve efficiency from the perspective of the national healthcare service. Furthermore, replicating our study in other regional contexts could highlight best practices and promote efficiency in the way healthcare organizations manage the two distribution processes. ER -