Drug Distribution System in Iran: A Multi Method Study of Defects and Solutions

Abstract

Background and Objectives: The drug distribution network is one of the most important pillars of the Iranian pharmaceutical system which plays a vital role in rapid and easy access to drugs. The purpose of this article is to evaluate drug distribution system in Iran and also to provide the suggestions for improvement. Material and Methods: In terms of purpose, the present study is among the applied researches and in terms of data collection method, it is a multi-method study that has used a quantitative and qualitative approach. Data collection tools were structured questionnaire and semi-structured interviews and also data evaluation was performed by thematic analysis. The study population includes pharmaceutical industry activists. To select the sample among industry players, snowball sampling method was used. Initially, existing drug distribution system was documented, current potentialities and flows in the network were identified and they were drawn by Bizagi Modeler. Then, distribution network evaluation indicators were extracted from relevant literature. Also, status of these indicators was evaluated by using a questionnaire. By using factor relationship technique (FARE), the priorities of these indicators were determined. Finally, existing bottlenecks were diagnosed by thematic analysis. Ultimately, guidelines to tackle such bottlenecks were provided. Results: In this study, 11 complications were identified for the drug distribution network. Drug unavailability or shortage, supply of near-expiration drugs, supply of counterfeit drugs, improper sale of over-the-counter drugs, black market activity and drug trafficking, sharp price fluctuations, insufficient interaction with consumption pharmacist, high distribution costs, low distribution network performance in emergency deliveries, long time to search and find drugs (in case of certain drugs) and low quality of response and consumer complaints seem to be some of the complications identified in this study. Conclusion: Investments on measuring patients' needs correctly, supporting drug retailing competitive brands development, improving drug distribution system information comprehensive system throughout the country within needs measurement loops, network inventory, production and importation, improving the utilization of modern tools and technologies such as internet–based sales, seller-free shops, establishing electronic files for patients and similar ones, utilizing direct sale methods and fostering the roles of potentialities such as insurance in planning, decision making and monitoring drug distribution system countrywide are some of the solutions obtained from this research that are used to improve the drug distribution system in the country.