2025斯里兰卡制药供应链评估报告

MARCH 2025 PHARMACEUTICAL SUPPLY CHAINASSESSMENT FOR SRI LANKA MARCH 2025 Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) © 2025 Asian Development Bank6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, PhilippinesTel +63 2 8632 4444; Fax +63 2 8636 2444www.adb.org Some rights reserved. Published in 2025. ISBN 978-92-9277-233-8 (print); 978-92-9277-234-5 (PDF); 978-92-9277-235-2 (ebook)Publication Stock No. TCS250093-2DOI: http://dx.doi.org/10.22617/TCS250093-2 The views expressed in this publication are those of the authors and do not necessarily reflect the views and policiesof the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for anyconsequence of their use. The mention of specific companies or products of manufacturers does not imply that theyare endorsed or recommended by ADB in preference to others of a similar nature that are not mentioned. By making any designation of or reference to a particular territory or geographic area in this document, ADB does notintend to make any judgments as to the legal or other status of any territory or area. This publication is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO)https://creativecommons.org/licenses/by/3.0/igo/. By using the content of this publication, you agree to be boundby the terms of this license. For attribution, translations, adaptations, and permissions, please read the provisionsand terms of use at https://www.adb.org/terms-use#openaccess. This CC license does not apply to non-ADB copyright materials in this publication. If the material is attributedto another source, please contact the copyright owner or publisher of that source for permission to reproduce it.ADB cannot be held liable for any claims that arise as a result of your use of the material. Please contact pubsmarketing@adb.org if you have questions or comments with respect to content, or if you wishto obtain copyright permission for your intended use that does not fall within these terms, or for permission to usethe ADB logo. Corrigenda to ADB publications may be found at http://www.adb.org/publications/corrigenda. ACKNOWLEDGMENTSvii ABBREVIATIONS REPORT BACKGROUNDxvii Chapter 1:INTRODUCTION1 Chapter 2:OBJECTIVES5 Chapter 3:CONCEPTUAL FRAMEWORK6 Chapter 4:METHODOLOGY9 4.1Data Collection94.2Data Analysis114.3Presentation and Review of Findings11 Chapter 5:FINDINGS 12 5.1Systems for Ensuring Quality, Safety, and Efficacy125.2Appropriate Use of Medical Products165.3Access185.4Pharmaceutical Supply Chain Management255.5Enabler Factors375.6Market Ecosystem425.7Summary: Performance Against Selected Key Indicators43 Chapter 6:DISCUSSION 46 6.1Governance and Rational Product Selection476.2Forecasting and Strategic Procurement496.3Warehousing and Distribution516.4Use of Data for Decision-Making56 7.1Pathway 1: Governance, Rational Prescribing, and Product Selection597.2Pathway 2: Strategic Procurement607.3Pathway 3: Optimized Distribution617.4Pathway 4: Data Visibility627.5Pathway 5: Quality Assurance and Improved Medicine Regulatory System637.6Pathway 6: Capacity Building657.7Pathway 7: Regional Medicines Access66 APPENDIXES 67 1Methodology and Questionnaire Resource Pack672Good Storage Practices of Pharmaceutical Stores Assessed92 SELECTED REFERENCES 94 TABLES 1Selected Performance Indicators for the Pharmaceutical Supply Chain7Assessment Framework2Sample Sizes for Facilities Assessment93Quality Decisions by the National Medicines Regulatory Authority, 2021–2023134Pharmacovigilance Reports Received and Analyzed by the National Medicines15Regulatory Authority5Last Update Dates of Some Sample National Treatment Guidelines176Value of Health Commodity Loss Due to Expiry, November 2022–October 2023207Percentage of Product Value Lost (excluding COVID-19 items) Due to Expiry,20November 2022–October 20238Number of Health Facilities in Sri Lanka, 2020219Percentage of Estimate Over Consumption of Tracer Products, 2019–20222710Prices of Items Locally Procured by Hospitals3011Procurement Performance and Prices for the Orders to Be Delivered,31November 2022–October 202312Good Storage Practices Maintained3213On-Time and In-Full Delivery to Health Facilities3314Pharmaceutical Waste Disposal Practice3515Current Procurement Policies and Practices3816Number of Days Taken for Decision-Making on Registration3917Number of Days Taken for Decision-Making on Registration, 20243918Pharmacist Positions for Institutions Owned by the Ministry of Health4019Pharmaceutical Supply Management Positions at Subnational Level4120Local Manufacturing of Essential Medicines4221Performance Against Selected Key Indicators4322Different Models of Pharmaceutical Supply Chain46 FIGURES 1Flow of Commodities and Flow of Estimates22Pharmaceutical Supply Chain Assessment Framework63Current System for Ensuring Qua