Advertisement

A simulation model to evaluate pharmaceutical supply chain costs in hospitals: the case of a Colombian hospital

  • Carlos FrancoEmail author
Research Article
  • 20 Downloads

Abstract

Background

Healthcare costs is one of the most studied issue in our days because of increasing demand and the aging of population. Final costs of medicines is one of the most important issue in patient treatment and determine its real value is an important task within hospitals. Simulation models and in this case system dynamics allows to build representations of reality considering the interaction of the whole variables that affect the system where first a causal loop diagram allows to represent and identify the interaction between variables for develop a stock flow diagram to determine the final results.

Objective

Develop a simulation model that allows decision makers in Hospitals and Governments to identify the variables that affect the final cost of medicines and to determine the legal reimbursement allowed by national agencies.

Methods

This paper presents a conceptual modeling framework using a causal loop diagram and a dynamic simulation model in the real case of a hospital in Colombia to explore how different internal charges for medicines affect the behavior of the final unit-dose cost of medicines, considering the complexity of the pharmaceutical system. We developed a simulation model to represent and characterize the pharmaceutical supply chain in a hospital and by using real data we validate the results of the model and conclude about the supply chain of medicines in Colombia using the legal regulations as a main factor of analysis.

Results and conclusions

We found that in some cases the maximum reimbursement value is less than the final cost of medicines within the hospital, which means that hospitals lose money on the administration of medicines to patients. The benefit of this model is that with the result the hospital can determine the real final monetary value of medicines, including the different processes starting from the reception of the medicines, ending with the administration to patients.

Keywords

Medicine costs System dynamics Health care systems Pharmaceutical supply chain Simulation 

Notes

Compliance with ethical standards

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

References

  1. 1.
    “World Bank,” 2015. [Online]. Available: www.worldbank.org/depweb/spanish/modules/social/pgr/. %5BÚltimo acceso: 1 Agosto 2015.
  2. 2.
    “World Health Organization,” 2015. [Online]. Available: www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/es/. %5BÚltimo acceso: 1 Agosto 2015.
  3. 3.
    Z. I. y V. M. V. Mantzana, M. Themistocleou, “Identifying healthcare actors involved in the adoption of information systems,” Eur J Inf Syst, 2007;16: 91–102.Google Scholar
  4. 4.
    Shah N. Pharmaceutical supply chains: key issues and strategies for optimisation. Comput Chem Eng. 2004;28(6–7):929–41.CrossRefGoogle Scholar
  5. 5.
    B. A.-L. Sara Martins, Pedro Amorim, Gonçalo Figueira, “An optimization-simulation approach to the network redesign problem of pharmaceutical wholesalers,” Comput Ind Eng , vol. In press, p. In press, 2017.Google Scholar
  6. 6.
    A. Nagurney, M. Yu, A. H. Masoumi, and L. S. Nagurney, “Pharmaceutical Supply Chains,” in Networks Against Time, Springer New York, 2013, pp. 89–116.Google Scholar
  7. 7.
    Ferrara I, Missios P. Pricing of drugs with heterogeneous health insurance coverage. J Health Econ. 2012;31(2):440–56.PubMedCrossRefGoogle Scholar
  8. 8.
    Kaiser U, Mendez SJ, Rønde T, Ullrich H. Regulation of pharmaceutical prices: evidence from a reference price reform in Denmark. J Health Econ. 2014;36(1):174–87.PubMedCrossRefGoogle Scholar
  9. 9.
    Brekke KR, Holmas TH, Straume OR. Reference pricing, competition, and pharmaceutical expenditures: theory and evidence from a natural experiment. J Public Econ. 2011;95(7):624–38.CrossRefGoogle Scholar
  10. 10.
    Brekke KR, Königbauer I, Straume OR. Reference pricing of pharmaceuticals. J Health Econ. 2007;26(3):613–42.PubMedCrossRefGoogle Scholar
  11. 11.
    Brekke KR, Grasdal AL, Holmås TH. Regulation and pricing of pharmaceuticals: reference pricing or price cap regulation? Eur Econ Rev. 2009;53(2):170–85.CrossRefGoogle Scholar
  12. 12.
    Miraldo M. Reference pricing and firms’ pricing strategies. J Health Econ. 2009;28(1):176–97.PubMedCrossRefGoogle Scholar
  13. 13.
    Lauenroth VD, Stargardt T. Pharmaceutical pricing in Germany: how is value determined within the scope of AMNOG? Value Health. 2017;20(7):927–35.PubMedCrossRefGoogle Scholar
  14. 14.
    Mohamed O, Kreling DH. The impact of a pricing policy change on retail prices of medicines in Egypt. Value Heal Reg Issues. 2016;10:14–8.CrossRefGoogle Scholar
  15. 15.
    Haji A, Assadi M. Fuzzy expert systems and challenge of new product pricing. Comput Ind Eng. 2009;56(2):616–30.CrossRefGoogle Scholar
  16. 16.
    Simpson D. New product forecasting: an applied approach by Kenneth B. Kahn. J Prod Innov Manag. 2007;24(4):406–7.CrossRefGoogle Scholar
  17. 17.
    Li M, Zhu Y, Xue C, Liu Y, Zhang L. The problem of unreasonably high pharmaceutical fees for patients in Chinese hospitals: a system dynamics simulation model. Comput Biol Med. 2014;47(1):58–65.PubMedCrossRefGoogle Scholar
  18. 18.
    Rauner MS, Schaffhauser-Linzatti M-M. Impact of the new Austrian inpatient payment strategy on hospital behavior: a system-dynamics model. Socio Econ Plan Sci. 2002;36(3):161–82.CrossRefGoogle Scholar
  19. 19.
    Chaerul M, Tanaka M, Shekdar AV. A system dynamics approach for hospital waste management. Waste Manag. 2008;28(2):442–9.PubMedCrossRefGoogle Scholar
  20. 20.
    K. Hassmiller Lich, N. D. Osgood, A. Mahamoud, and A. Mahmoud, “Using system dynamics tools to gain insight into intervention options related to the interaction between tobacco and tuberculosis.,” Glob Health Promot, vol. 17, no. 1 Suppl, pp. 7–20, 2010.Google Scholar
  21. 21.
    Rwashana AS, Williams DW, Neema S. System dynamics approach to immunization healthcare issues in developing countries: a case study of Uganda. Health Informatics J. 2009;15(2):95–107.PubMedCrossRefGoogle Scholar
  22. 22.
    Sirois S, Cloutier LM. Needed: system dynamics for the drug discovery process. Drug Discov Today. 2008;13(15):708–15.PubMedCrossRefGoogle Scholar
  23. 23.
    Kunc M, Kazakov R. Competitive dynamics in pharmaceutical markets: a case study in the chronic cardiac disease market. J Oper Res Soc. 2013;64:1790–9.CrossRefGoogle Scholar
  24. 24.
    Abdollahiasl A, et al. “A system dynamics model for national drug policy,” DARU. J Pharm Sci. 2014;4(1):1–13.Google Scholar
  25. 25.
    Forrester J. Industrial dynamics. Waltham: Pegasus Communications; 1961.Google Scholar
  26. 26.
    Ghosh A. Dynamic Systems for Everyone. Plymouth, Massachusetts. In: USA: springer international publishing; 2015.Google Scholar
  27. 27.
    J.-R. Borrell, “Drug Price regulation: recent trends and downstream neglected issues,” in Incentives for research, development, and innovation in pharmaceuticals, Madrid: Springer Healthcare Iberica, 2011, pp. 81–96.Google Scholar
  28. 28.
    Wittenborn AK, Rahmandad H, Rick J, Hosseinichimeh N. Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder. Psychol Med. 2016;46(3):551–62.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Escuela de AdministraciónUniversidad del RosarioBogotáColombia
  2. 2.Universidad de la SabanaChíaColombia

Personalised recommendations