Drug and Therapeutics
Committee
Session 7B. Identifying Problems with
Medicine Use: Aggregate Methods
1
Objectives
 Discuss the use of aggregate data including defined
daily dose in analyzing the consumption of medicines
• Perform ABC analysis and explain how it can be used to
identify medicine use problems, reduce cost, and
improve efficiency in the pharmaceutical supply system
• Discuss how VEN system for setting priorities will assist
the DTC in medicine selection, purchasing, and
inventory management
Outline—Part B
 Introduction
 Aggregate data
 DDD
 VEN
ABC Analysis
 Activities 3–5
 Summary
Methods to Investigate Medicine Use
 Indicator study methods
 Use data collected at the individual level—patient, health facility
 Data insufficient to make judgments about appropriateness of a
medicine for a specific diagnosis
 Aggregate data methods
 Use routine data (e.g., stock records) not collected at the
individual patient level
 Gives overview of medicine use and can highlight problem areas
 In-depth investigation of medicine use
 Prescription audit, patient record review
 Drug use evaluation (DUE) (discussed in session 11)
 Qualitative methods to understand causes of a medicine use
problem (discussed in session 8)
Aggregate Data (1)
 Medicine use aggregate data sources
 Procurement records
 Warehouse medicine records
 Pharmacy stock and dispensing records
 Adverse drug reaction (ADR) and medication
error reports
 Patient medical records
Aggregate Data (2)
 Data that can be retrieved
 Medicine consumption
 Medicine availability
 Medicine cost data
 Frequency of use
 Per capita use of specific product
 Prevalence of ADRs
 Prevalence of medication errors
Defined Daily Dose (1)

The DDD methodology converts and standardizes
readily available product quantity data, such as
packages, tablets, injection vials, bottles, into crude
estimates of clinical exposure to medicines, such as
the number of daily doses

A methodology that allows comparison of
consumption of pharmaceutical products across
hospitals, regions, and countries

Combines different medicine strengths and doses to
provide one unit of consumption for each medicine
for comparison of use
Defined Daily Dose (2)
 Defined globally by the WHO Collaborating
Center for Drug Statistics Methodology, Oslo,
Norway http://www.whocc.no/atcddd/
 Typically expressed as follows
 DDD per 1,000 inhabitant per day for total
medicine consumption
 DDD per 100 beds per day (100 bed-days),
for hospital use
Defined Daily Dose Example 1: Captopril
District hospital and clinics use of captopril with 2,700,000 population
– 22,500,000 tablets yearly of captopril 25 mg
– 3,000,000 tablets yearly of captopril 50 mg
Quantity of medicine used in 1 year multiplied by strength of the product
= (22,500,000 × 25 mg) + (3,000,000 × 50 mg) = 712,500,000 mg
Divide total quantity by assigned DDD for that medicine (captopril = 50 mg ) =
712,500,000 / 50 mg = 14,250,000 DDDs
Divide total quantity by 2,700,000 population and multiply by 1,000 (this is the
population denominator for this method)
= (14,250,000 / 2,700,000 ) x 1,000 inhabitants
= 5,278 DDD / 1,000 inhabitants / year
5,278 / 365 = 14.5 DDD / 1,000 inhabitants / day
Defined Daily Dose Example 2:
Carbamazepine Use in South Africa, 2001

Annual consumption
= 100 million x 200 mg tablets
= 20,000,000,000 mg = 20,000,000 g

Assigned DDD for carbamazepine = 1 g

No. DDDs consumed
= 20,000,000/1
= 20,000,000 per year
= 20,000,000/365
= 54,795 per day for population of 48,000,000
= 54,795 / 48,000,000
= 0.0011 per person per day
= 1.1 DDD per 1,000 population per day
VEN Analysis
 Method to prioritize for medicine purchase and
stock
 V–Vital
 Potentially lifesaving
 Crucial to providing basic health services
 E–Essential
 Effective against less severe but significant
illness, but not vital
 N–Nonessential
 For minor illnesses
 High cost and low therapeutic advantage
Conducting a VEN Analysis
 Step 1. Classify all medicine on the list as V, E, or N.
 Step 2. Analyze the “N” items. Where possible,
reduce quantities to purchase or eliminate them.
 Step 3. Identify and limit therapeutic duplications.
 Step 4. Reconsider proposed purchase quantities.
 Step 5. Find additional funds if needed or possible.
VEN Applications for DTC
 Identifies high-priority medicines for procurement
 Identifies low-priority medicines that the DTC
should analyze carefully for deletion from the
formulary
VEN Analysis, Activity, and Discussion
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Description
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
CLOXACILLIN SODIUM FOR INJECTION500MG
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
DIAZEPAM TABLETS 5MG ;1000'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
LITHIUM CARBONATE TABLETS 250MG; 1000'S
LOPERAMIDE 2MG TABLETS;6'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
PARACETAMOL TABLETS 500MG;500'S
PERINDOPRIL TABLET 4MG;28'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
VITAMIN B6 TABLETS 25MG;500'S
WATER FOR INJECTION PLASTIC;10ML
VEN
ABC Analysis
 Method for determining and comparing
pharmaceutical costs within the formulary system
 “Separating the vital few from the trivial many”—
Pareto principle
 Tool for identifying many medicine use problems
 Utilizes computer and appropriate software to run
analysis
ABC Analysis: A, B, and C Medicines (1)
Category
Percentage of
Budget
Percentage of
Medicines Ordered
A medicines
70–80%
10–20%
B medicines
15–20%
10–20%
C medicines
5–10%
60–80%
ABC Analysis: A, B, and C Medicines (2)
 A medicines—High percentage of funds spent
on large-volume or high-cost items
 Greatest potential for savings
 Greatest potential for identifying expensive
medicines that are overused
 B medicines—Moderate cost and moderate
number of items; important items
 C medicines—Small amount of funds spent on
the majority of the inventory
Applications of ABC Analysis for a DTC
 Measures the degree to which actual consumption reflects public
health needs and morbidity
 Reduces inventory levels and costs by arranging for more
frequent purchase or delivery of smaller quantities of class A
items
 Seeks major cost reductions by finding lower prices on class A
items
 Reduces inventory of items that have limited use in the system,
but costs the system large amounts of money
 Provides information for choosing the most cost-effective
alternatives and finding opportunities for therapeutic substitution
 Gathers information for pharmacoeconomic analysis
Steps in Performing ABC Analysis

Step 1. List all items purchased and enter the unit cost.

Step 2. Enter consumption quantities for each item.

Step 3. Calculate the value of consumption for each
item.

Step 4. Sort the list in descending order by total value.

Step 5. Calculate the percentage of total value
represented by each item.

Step 6. Calculate the cumulative percentage of total
value for each item.

Step 7. Choose cutoff points for A, B, and C.
ABC Step 1. List items and unit costs.
TOTAL = 666,643
20
13
18
2
25
3
23
15
10
12
6
22
4
5
26
14
1
9
21
19
7
17
11
24
8
16
Description
PERINDOPRIL TABLET 4MG;28'S
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
VITAMIN B6 TABLETS 25MG;500'S
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
LOPERAMIDE 2MG TABLETS;6'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
CLOXACILLIN SODIUM FOR INJECTION500MG
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
WATER FOR INJECTION PLASTIC;10ML
LITHIUM CARBONATE TABLETS 250MG; 1000'S
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
PARACETAMOL TABLETS 500MG;500'S
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
DIAZEPAM TABLETS 5MG ;1000'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
NO.ITEMS =
Pack
Price
R 20.08
R 61.65
R 2.38
R 115.27
R 11.30
R 36.31
R 10.18
R 1.22
R 1.97
R 33.74
R 2.81
R 42.46
R 19.73
R 10.75
R 0.53
R 224.64
R 2.68
R 83.56
R 7.24
R 16.61
R 1.91
R 5.66
R 11.18
R 5.31
R 9.90
R 0.68
26
Qty
Issued
3000
800
20000
400
4000
1200
4000
30000
18000
1000
12000
700
1500
2500
50000
65
5000
160
1400
600
3000
1000
500
600
15
50
Value
60,226
49,320
47,520
46,109
45,200
43,572
40,705
36,462
35,381
33,739
33,696
29,724
29,596
26,865
26,729
14,602
13,388
13,370
10,130
9,968
5,724
5,659
5,589
3,188
148
34
% of
Value
ABC Steps 2 and 3. Calculate consumption quantities
and values—sort list by descending values.
TOTAL = 666,643
20
13
18
2
25
3
23
15
10
12
6
22
4
5
26
14
1
9
21
19
7
17
11
24
8
16
Description
PERINDOPRIL TABLET 4MG;28'S
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
VITAMIN B6 TABLETS 25MG;500'S
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
LOPERAMIDE 2MG TABLETS;6'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
CLOXACILLIN SODIUM FOR INJECTION500MG
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
WATER FOR INJECTION PLASTIC;10ML
LITHIUM CARBONATE TABLETS 250MG; 1000'S
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
PARACETAMOL TABLETS 500MG;500'S
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
DIAZEPAM TABLETS 5MG ;1000'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
NO.ITEMS =
Pack
Price
R 20.08
R 61.65
R 2.38
R 115.27
R 11.30
R 36.31
R 10.18
R 1.22
R 1.97
R 33.74
R 2.81
R 42.46
R 19.73
R 10.75
R 0.53
R 224.64
R 2.68
R 83.56
R 7.24
R 16.61
R 1.91
R 5.66
R 11.18
R 5.31
R 9.90
R 0.68
26
Qty
Issued
3000
800
20000
400
4000
1200
4000
30000
18000
1000
12000
700
1500
2500
50000
65
5000
160
1400
600
3000
1000
500
600
15
50
Value
60,226
49,320
47,520
46,109
45,200
43,572
40,705
36,462
35,381
33,739
33,696
29,724
29,596
26,865
26,729
14,602
13,388
13,370
10,130
9,968
5,724
5,659
5,589
3,188
148
34
% of
Value
ABC Step 4. Calculate the percentage of
total value represented by each item.
TOTAL = 666,643
20
13
18
2
25
3
23
15
10
12
6
22
4
5
26
14
1
9
21
19
7
17
11
24
8
16
Description
PERINDOPRIL TABLET 4MG;28'S
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
VITAMIN B6 TABLETS 25MG;500'S
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
LOPERAMIDE 2MG TABLETS;6'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
CLOXACILLIN SODIUM FOR INJECTION500MG
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
WATER FOR INJECTION PLASTIC;10ML
LITHIUM CARBONATE TABLETS 250MG; 1000'S
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
PARACETAMOL TABLETS 500MG;500'S
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
DIAZEPAM TABLETS 5MG ;1000'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
NO.ITEMS =
Pack
Price
R 20.08
R 61.65
R 2.38
R 115.27
R 11.30
R 36.31
R 10.18
R 1.22
R 1.97
R 33.74
R 2.81
R 42.46
R 19.73
R 10.75
R 0.53
R 224.64
R 2.68
R 83.56
R 7.24
R 16.61
R 1.91
R 5.66
R 11.18
R 5.31
R 9.90
R 0.68
26
Qty
Issued
3000
800
20000
400
4000
1200
4000
30000
18000
1000
12000
700
1500
2500
50000
65
5000
160
1400
600
3000
1000
500
600
15
50
Value
60,226
49,320
47,520
46,109
45,200
43,572
40,705
36,462
35,381
33,739
33,696
29,724
29,596
26,865
26,729
14,602
13,388
13,370
10,130
9,968
5,724
5,659
5,589
3,188
148
34
% of
Value
9.03%
7.40%
7.13%
6.92%
6.78%
6.54%
6.11%
5.47%
5.31%
5.06%
5.05%
4.46%
4.44%
4.03%
4.01%
2.19%
2.01%
2.01%
1.52%
1.50%
0.86%
0.85%
0.84%
0.48%
0.02%
0.01%
Value
Cum%
ABC Step 5. Rank items in descending order.
TOTAL = 666,643
20
13
18
2
25
3
23
15
10
12
6
22
4
5
26
14
1
9
21
19
7
17
11
24
8
16
Description
PERINDOPRIL TABLET 4MG;28'S
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
VITAMIN B6 TABLETS 25MG;500'S
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
LOPERAMIDE 2MG TABLETS;6'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
CLOXACILLIN SODIUM FOR INJECTION500MG
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
WATER FOR INJECTION PLASTIC;10ML
LITHIUM CARBONATE TABLETS 250MG; 1000'S
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
PARACETAMOL TABLETS 500MG;500'S
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
DIAZEPAM TABLETS 5MG ;1000'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
26
Pack
Qty
Price Issued
R 20.08
3000
R 61.65
800
R 2.38 20000
R 115.27
400
R 11.30
4000
R 36.31
1200
R 10.18
4000
R 1.22 30000
R 1.97 18000
R 33.74
1000
R 2.81 12000
R 42.46
700
R 19.73
1500
R 10.75
2500
R 0.53 50000
R 224.64
65
R 2.68
5000
R 83.56
160
R 7.24
1400
R 16.61
600
R 1.91
3000
R 5.66
1000
R 11.18
500
R 5.31
600
R 9.90
15
R 0.68
50
NO.ITEMS =
Value
60,226
49,320
47,520
46,109
45,200
43,572
40,705
36,462
35,381
33,739
33,696
29,724
29,596
26,865
26,729
14,602
13,388
13,370
10,130
9,968
5,724
5,659
5,589
3,188
148
34
% of
Value
9.03%
7.40%
7.13%
6.92%
6.78%
6.54%
6.11%
5.47%
5.31%
5.06%
5.05%
4.46%
4.44%
4.03%
4.01%
2.19%
2.01%
2.01%
1.52%
1.50%
0.86%
0.85%
0.84%
0.48%
0.02%
0.01%
Value No. Items
Cum% Cum%
9.03%
16.43%
23.56%
30.48%
37.26%
43.79%
49.90%
55.37%
60.68%
65.74%
70.79%
75.25%
79.69%
83.72%
87.73%
89.92%
91.93%
93.93%
95.45%
96.95%
97.81%
98.66%
99.49%
99.97%
99.99%
100.00%
ABC Step 6. Calculate the cumulative percentage
of total value for each item.
TOTAL = 666,643
20
13
18
2
25
3
23
15
10
12
6
22
4
5
26
14
1
9
21
19
7
17
11
24
8
16
Description
PERINDOPRIL TABLET 4MG;28'S
ISONIAZID AND THIACETAZONE TABLETS 133MG AND 50MG;1000'S
PARACETAMOL AND CODEINE TABLETS500MG;8MG;20'S
AMPHOTERICIN B FOR INJECTIONINTRAVENOUS;50MG
VITAMIN B6 TABLETS 25MG;500'S
BECLOMETHASONE DIPROPIONATE INHALER;50MCG/DOSE;200 DOSES
THIOPENTONE SODIUM INJECTION 0.5G/20ML;W/OUT DILUENT;MIXER VIAL;20ML
LOPERAMIDE 2MG TABLETS;6'S
GENTAMICIN SULPHATE INJECTION80MG/2ML;2ML
INSULIN INJECTION:HUMAN;SOLUBLE 30%;ISOPHANE 70%;100IU/ML;10ML
CLOXACILLIN SODIUM FOR INJECTION500MG
TEST STRIPS AND COLOR CHART,GLUCOSE IN BLOOD ACCUTREND;50'S
CARBAMAZEPINE 200MG TABLET;PATIENT READY PACK;84'S
CHLORHEXIDINE GLUCONATE DETERGENT SOLUTION4%;SURGICAL SCRUB;500ML
WATER FOR INJECTION PLASTIC;10ML
LITHIUM CARBONATE TABLETS 250MG; 1000'S
AMOXYCILLIN CAPSULES PATIENT READY PACK;250MG;15'S
ETHAMBUTOL,RIFAMPICIN,ISONIAZID AND PYRAZINAMIDE TABLETS:225/120/60/300MG;100'S
RESERPINE TABLETS PATIENT READY PACKS;0,25MG;14'S
PARACETAMOL TABLETS 500MG;500'S
CO-TRIMOXAZOLE 480mg TABLETS PATIENT READY PACK;20'S
NUR-ISTERATE:NORETHISTERONE ENANTATE INJECTION LONG-ACTING;200MG/ML;1ML
IBUPROFEN SUSPENSION:PAEDIATRIC;100MG/5ML;100ML
VACCINE POLIOMYELITIS;ORAL TRIVALENT;10 DOSE
DIAZEPAM TABLETS 5MG ;1000'S
MERCUROCHROME SOLUTION; 1%; DROPPER BOTTLE; 20ML
26
Pack
Qty
Price Issued
R 20.08
3000
R 61.65
800
R 2.38 20000
R 115.27
400
R 11.30
4000
R 36.31
1200
R 10.18
4000
R 1.22 30000
R 1.97 18000
R 33.74
1000
R 2.81 12000
R 42.46
700
R 19.73
1500
R 10.75
2500
R 0.53 50000
R 224.64
65
R 2.68
5000
R 83.56
160
R 7.24
1400
R 16.61
600
R 1.91
3000
R 5.66
1000
R 11.18
500
R 5.31
600
R 9.90
15
R 0.68
50
NO.ITEMS =
Value
60,226
49,320
47,520
46,109
45,200
43,572
40,705
36,462
35,381
33,739
33,696
29,724
29,596
26,865
26,729
14,602
13,388
13,370
10,130
9,968
5,724
5,659
5,589
3,188
148
34
% of
Value
9.03%
7.40%
7.13%
6.92%
6.78%
6.54%
6.11%
5.47%
5.31%
5.06%
5.05%
4.46%
4.44%
4.03%
4.01%
2.19%
2.01%
2.01%
1.52%
1.50%
0.86%
0.85%
0.84%
0.48%
0.02%
0.01%
Value No. Items
Cum% Cum%
9.03%
16.43%
23.56%
30.48%
37.26%
43.79%
49.90%
55.37%
60.68%
65.74%
70.79%
75.25%
79.69%
83.72%
87.73%
89.92%
91.93%
93.93%
95.45%
96.95%
97.81%
98.66%
99.49%
99.97%
99.99%
100.00%
Cumulative Items Value (%)
ABC Step 7. Choose cut-off points
for ABC analysis chart.
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Cumulative No. of Items (%)
Activities 3, 4, and 5
 Activity 3. VEN Analysis—Performing a VEN
analysis
 Activity 4. Performing an ABC analysis—
Identifying high-cost medicines using an ABC
analysis
 Activity 5. Performing an ABC/VEN analysis
using participants’ data
Summary

A major function of a DTC is to identify medicine use
problems and to implement corrective measures

Aggregate methods are a useful way to gain an
overview of medicine use problems using routine
data not collected at the individual patient level.

Examples of a aggregate data methods include—
 DDD
 VEN analysis
 ABC analysis