Household Drug Stockpiling and Panic Buying of Drugs During the COVID-19 Pandemic: A Study From Jordan

The coronavirus disease that emerged in 2019 (COVID-19) has affected health, societies and economies. Policies that have been imposed by different countries to slow the spread of the disease, including national lockdowns, curfews, border closures and enforcement of social distancing measures have disturbed the drug supply chain and resulted in drug shortages. Uncertainty concerning the pandemic has also led to the panic buying of drugs and the stockpiling of drugs in households, which has amplified the problem. In this cross-sectional study, a self-developed questionnaire was distributed online in order to a) assess the practice of household drug stockpiling prior to the national lockdown in Jordan, b) investigate the factors affecting it and c) measure peoples’ knowledge about the consequences of this behaviour. Results from this study show that drug purchasing was reported by 44.3% of the participants and was most common among participants from non-medical backgrounds (336, 75.7%) or those who have chronic diseases (261, 58.8%) and taking chronic supplements (282, 63.5%) regardless of their age, gender, living area or the possession of health insurance. Analgesics and antipyretics were the most frequently purchased drugs (225, 70.5%) and anticipation of their need was the most common reason for purchasing drugs (231, 52.0%). Buyers were also less aware, when compared to non-buyers, that panic buying and drug stockpiling may lead to drug shortages (204, 45.9% vs 325, 58.1%) and that this behaviour can pose a health hazard, especially to children (221, 47.5% vs 342, 61.2%). Our study shows that panic buying of drugs and household drug stockpiling were common in Jordan during the COVID-19 pandemic and this was related to participants’ medical knowledge and educational backgrounds. Therefore, educating the general population regarding rational drug use is urgently needed. This is also a compelling case for the development of national guidelines for drug management that target the general population and healthcare personnel, especially pharmacists, to avoid drug shortages during crises.

Requirements Identification for a Blockchain-Based Traceability Model for Animal-Based Medicines

In this paper, the traceability of heparin medicine will be studied. Currently, the registration of traceability data is conducted in a decentralized manner. With blockchain implementation, the traceability systems that use this data could become semi-automated, increasing the quality, security, and confidence of the information generated in the supply chain. This paper presents the essential requirements and activities wherein information must be collected within the heparin drug supply chain, focusing on the animal raw materials production link and its requirements. Blockchain technology is proposed to increase traceability and reliability in relation to the current situation. It also fulfills all the requirements identified if used as part of a traceability system. These requirements are: the existence of a consensus mechanism; anonymity; protocol, efficiency, and consumption; immutability; ownership and management; and approval time. We conclude the paper by presenting the mapping of requirements and entities and critical activities for adopting blockchain technology to support the traceability of raw materials from animals used in heparin production.

Evaluation and Classification Risks of Implementing Blockchain in the Drug Supply Chain with a New Hybrid Sorting Method

In blockchain technology, all registered information, from the place of production of the product to its point of sale, is recorded as permanent and unchangeable, and no intermediary has the ability to change the data of other members and even the data registered by them without public consensus. In this way, users can trust the accuracy of the data. Blockchain systems have a wide range of applications in the medical and health sectors, from creating an integrated system for recording and tracking patients’ medical records to creating transparency in the drug supply chain and medical supplies. However, implementing blockchain technology in the supply chain has limitations and sometimes has risks. In this study, BWM methods and VIKORSort have been used to classify the risks of implementing blockchain in the drug supply chain. The results show that cyberattacks, double spending, and immutability are very dangerous risks for implementation of blockchain technology in the drug supply chain. Therefore, the risks of blockchain technology implementation in the drug supply chain have been classified based on a literature review and opinions of the experts. The risks of blockchain technology implementation in the supply chain were determined from the literature review.

Supply Chain and Delivery of Antimicrobial Drugs in Smallholder Livestock Production Systems in Uganda

This study assessed the veterinary drug supply chain in Uganda, the constraints faced by the actors, and how the challenges influence the use of antimicrobial (AMs) by livestock farmers. We carried out stakeholder consultation workshops, key informant interviews and a knowledge, practices, and awareness survey with actors of the veterinary drug supply chain. We also profiled drugs stored in 23 urban and peri-urban drug shops in Lira and Mukono districts to record the commonly sold drugs. The veterinary drug supply chain is made of several actors including wholesalers, retailers, Animal Health Service Providers (AHSP) and farmers. Nearly ninety per cent of drug retailers and veterinary practitioners did not receive specialized training in veterinary medicine, and most of veterinary practitioners have been in the drug business market for more than 10 years. Antibiotics and anti-helminthics were the most stocked drugs by retailers, with antibiotics ranking highest in terms of contribution to annual financial profits, accounting for 33%. The choice of a drug by veterinary practitioners was mainly informed by past success with efficacy of the drug, and financial capacity of the client (the farmer) to meet the treatment cost. Many veterinary practitioners were not conversant with veterinary drug policies of the country, with Mukono having a higher number (72%) compared to Lira (37%). Veterinary practitioners from Lira district compared to Mukono and those mainly serving small scale farmers relative to large scale smallholders were more knowledgeable about antibiotics and AMR. Several supply chain constraints were identified as potential drivers of misuse of antibiotics that could contribute to AMR. These included low level of education of supply chain actors, particularly drug retailers, poor handling of drugs at purchase and administration practices, low enforcement of policies and regulations, and lack of awareness of stakeholders about policies that regulate drug use. Thus, future interventions to reduce misuse of AM drugs in livestock production systems in Uganda such as capacity building, should also target veterinary input suppliers, and deliberately involve a strong policy advocacy component.

Ubiquitous Internet of Medical Things on Interoperable Ssn Ontology Platforms for E-Health Monitoring of Connected Objects

Ubiquitous Internet of medical things (U-IoMT) technology is designed to predict the efficiency and quality of health care facilities by using various connected objects to support patient monitoring systems. U- IoMT is connected to devices such as RFID tags and several physical sensor devices (WSN) that collect real-time information. This technology is used to comprehend complex security-related tasks. The ubiquitous platform can be used to access smart health care information through mobile and electronic devices, allowing for faster diagnosis and higher service quality. In this study, we use ontology to describe the semantic representation of medical objects and their data in U-IoMT backup in this analysis. The healthcare system aims to examine patient prescriptions and drug supply chain management records. Emergency healthcare services are connected to smartphone-wearable devices of patients for monitoring purposes to reduce emergency cases and to maintain e-patient records. The mobile health application aims to maintain the health status of a patient wherever the patient is located. The semantic sensor networks (SSN) architecture uses peer-to-peer communication to achieve semantic interoperability, which is described as interoperable IoMT platforms. A framework of SSN and the context-awareness layer was additionally created for visualization of patient remote health monitoring, drug management, patient moment analysis, and patient tracking were monitored using various devices, e-health was used to demonstrate the chronic diseases.

A comprehensive review on global contributions and recognition of pharmacy professionals amidst COVID-19 pandemic: moving from present to future

Background COVID-19, a respiratory tract infection caused by SARS-CoV-2, is a burning question worldwide as it gives rise to a pandemic situation. No specific medications are still recommended for COVID-19; however, healthcare support is crucial for ameliorating the disease condition. Pharmacists are the frontline fighters who are responsible for providing healthcare support to the COVID-19 infected patients around the world. This review endeavored to briefly rationalize the contributions of several pharmacy professionals in diverse fields along with their collaborative efforts and dedication regarding their limitations during the COVID-19 situation and view the prospects of pharmaceutical care services in the post-pandemic period. Main body of the abstract Online databases were utilized to search for scholarly articles and organizational websites, to sum up the information about the contemporary and expanded role of pharmacists. Key articles were retrieved from Google Scholar, PubMed, and Science Direct databases using terms: “COVID-19,” “novel coronavirus,” “community,” “industrial,” “hospital,” “clinical,” “recognition,” “obstacles,” “collaboration,” “SARS-CoV-2,” “healthcare,” and “outbreak” in combination with “pharmacist.” The articles were included from the inception of the pandemic to January 25, 2021. The current review found pharmacist’s global contributions and involvements with other professionals to provide healthcare services amidst COVID-19. This included testing of suspects, providing medical information, psycho-social support, debunking myths, mitigating drug shortage events, telemedicine, e-prescription, infection control, and controlling the drug supply chain. In many countries, pharmacists’ activities were much appreciated but in some countries, they were not properly acknowledged for their contributions amidst COVID-19 outbreak. They played additional roles such as participating in the antimicrobial stewardship team, improving value-added services, conducting clinical data analysis to suppress the outspread of the SARS-CoV-2. Short conclusion During the COVID-19 pandemic while the whole world is fighting against an invisible virus, the pharmacists are the earnest hero to serve their responsibilities along with additional activities. They need to be prepared and collaborate with other healthcare professionals further to meet the challenges of post-pandemic circumstances.

Non-Sterile to Sterile Compounding: An Unconventional Response During the COVID-19 Pandemic

The drug supply chain has suffered many interruptions over the past decade. The COVID-19 pandemic exacerbated an already fragile infrastructure for supplying critical medications to hospitals and health-systems. The purpose of this paper is to provide insight to the history, thought-processes, and response to critical medication shortages during the COVID-19 pandemic, with a focus on hydromorphone infusions and the action steps taken to engage in non-sterile to sterile (NSTS) compounding. Over a period of 6 weeks, we compounded 1,613 NSTS hydromorphone infusion bags. All lots were cleared for sterility, particulate, potency, and endotoxin testing by an outside FDA registered laboratory. We did not have any safety reports filed specific to the NSTS compounded hydromorphone infusion bags. Over a period of 15 weeks, 715 infusions were consumed. The drug supply chain suffers frequent interruptions and critical shortages, particularly in times of a natural disaster or a global pandemic. Non-sterile to sterile compounding is often associated with risks of inaccuracies, impurities, and contamination. There are instances in which non-sterile to sterile compounding is appropriate and should be considered in times of drug shortages to support the care of hospitalized patients.

Expedited development and review pathways for novel oncology drugs.

e13578 Background: Following approval of the Food and Drug Administration (FDA) Safety and Innovation Act in 2012, the FDA launched a 3-year plan to promote innovation, increase stakeholder involvement, secure the drug supply chain, and fund these endeavors by collecting user fees. The FDA created its fourth expedited pathway, Breakthrough Therapy Designation (BTD) to focus on the development and approval of therapies to treat serious and life-threatening conditions that lack adequate therapies. Our 2017 study (ASCO abstract #e18270) identified a trend of increased use of these approaches with oncology drugs, particularly the BTD, which was a nascent pathway at the time. We aimed to reexamine FDA pathway and approval trends in oncology interventions. Methods: We analyzed publicly available data on novel drug approvals by the FDA’s Center for Drug Evaluation and Research (CDER) from 2012-2020 and the 4 expedited pathways (BTD, Accelerated Approval, Fast Track Designation [FTD], and Priority Review). Results: Between 2012 and 2020, CDER approved 380 new chemical entities, including 101 oncology drugs. Due to data limitations, 3 novel oncology biologics (approved by the Center for Biologics Evaluation and Research) and 4 diagnostics were excluded from the analyses. Oncology drugs comprised a mean 27% (range 14-34%) of all approvals from 2012-2020, including 25% from 2012–2016 and 28% from 2017-2020. Of all approved oncology drugs from 2012-2020, 94% (range 82-100%) utilized at least one expedited pathway. Oncology approvals were more likely than non-oncology approvals to have used one or more expedited pathways. Use of these pathways for oncology approvals increased from 2012-2016 to 2017-2020: ≥2 (65% vs 78%) and ≥3 (35% vs 50%) pathways. BTD usage for oncology drugs increased from 35% in 2012-2016 to 57% in 2017-2020, though for 2012-2016, the time interval between awarding the (new) designation and the remainder of development activities must be considered. Presumably because BTD grants additional benefits over FTD, generally the use of FTD for oncology drugs has declined over time. The use of Priority Review and Accelerated Approval has remained the same. Despite the pandemic, for oncology and non-oncology drugs alike, approvals using pathways remained consistent between 2019 and 2020. Conclusions: Efficient FDA review plays an important role in oncology drug development. Since its inception in 2012, BTD has been adopted and expeditiously used, comprising more than half of all novel oncology drug approvals from 2017-2020. Our data show a gradual increase in approvals of drugs granted BTD, which, given the duration of drug development, likely reflects the time between the acceptance of the BTD request and remainder of the pre-submission development activities. As BTD was expressly developed to increase stakeholder interaction and prioritize innovation, the speed-to-adoption and use of this pathway among oncology interventions is promising.