Evaluación del suministro de medicamentos en los servicios de atención primaria de salud de Rosario, Argentina, 2005

objective: to evaluate the public process for selecting and acquiring prescription drugs in the rosario municipality, argentina, during 2005, from the perspective of pharmaceuticals management. methods: a combination of management tools was used: a pareto analysis was used to prioritize the various drugs on the budget of the public health secretariat of the rosario municipality; therapeutic categories were reviewed to identify possible substitutions that would reduce spending on "unrestricted" prescription drugs (those not requiring proof of medical necessity); comparative analysis of drug prices was conducted and expenses were reconciled; and order fulfillment was reviewed as a means of rating suppliers. results: in 2005, a total of 371 medications were purchased: 12.4% of these medications (group a) absorbed 74.9% of the total budget; whereas 12.7% (group b) cost 14.9% and 74.9% (group c) used the remaining 10.2%. the largest proportion of the spending correlated with "unrestricted" prescriptions (group a: 82.1%; group b: 68%; group c: 58%), generally the first choice and most economical. the drugs in group a pertained to 21 therapeutic subgroups; savings opportunities were identified in five of them. the local price paid was 2.0 times more than the international reference price. four suppliers received 72.0% of the drug orders; however, three of them were responsible for the majority of fulfillment errors and the longest delays. conclusions: opportunities for cost-saving were identified, and as a consequence, for improving the general public's access to prescription medications. the prescription drug supply can be improved by putting in place a procedure for tracking delays and a process for evaluating and approving suppliers.