Hospital pharmacy: how to prevent stock-outs and expired drugs

To prevent stock-outs and expired drugs in a hospital pharmacy, manage stock from actual consumption, set a safety stock and a reorder point for each product, and issue the batches that expire first. These simple rules depend on reliable data: receipts, issues and expiry dates recorded without delay.

Key takeaways

• Stock-outs and expiries often share one cause: orders placed by instinct rather than from consumption.
• Calculate the average monthly consumption of each product and set a reorder point.
• Apply the “first expired, first out” rule to shelving as well as dispensing.
• Focus monitoring on priority products using VEN and ABC classifications.
• Review every month the batches approaching their expiry date.

Stock-outs and expiries in a hospital pharmacy: two symptoms of one problem

A stock-out disrupts care and sends families to buy from a community pharmacy. An expiry destroys cash, whether counted in naira or cedis, and triggers a disposal procedure. Both appear when orders are placed by guesswork, with no link to actual consumption.

• Stock cards updated late, or not at all.
• Unrecorded issues: loans between wards, night emergencies.
• Orders placed without accounting for delivery lead time.
• Donations or bulk purchases accepted without a plan to use them.
• Expiry dates not checked on receipt.

Example: in a 30-bed clinic in Abuja, the pharmacist orders the same quantities every month. A widely prescribed antibiotic runs out at the end of the month, while a rarely used infusion fluid piles up and expires. The problem is not the budget but the lack of calculation.

Calculating the right stock levels

Stock management relies on three parameters per product: average monthly consumption (AMC), delivery lead time and safety stock. Together, they give the reorder point, the stock level that triggers a new order.

Worked example: a product is issued at an average of 200 units a month, the supplier delivers in half a month and safety stock is set at 100 units. The reorder point is 200 × 0.5 + 100 = 200 units: as soon as stock falls to that level, the order goes out.

Applying FEFO and monitoring expiry dates

The FEFO rule (first expired, first out) means issuing first the batch with the nearest expiry date. It applies to shelving as well as dispensing.

1. Check the expiry date on receipt and refuse short-dated batches, according to a rule agreed with suppliers.
2. Shelve by expiry date, with the nearest at the front.
3. Produce a monthly list of batches expiring in the coming months.
4. Redistribute these batches to the wards that use them most, or negotiate an exchange with the supplier when the contract allows.
5. Isolate and record expired products, then follow the applicable disposal procedure.

Example: when a new batch of sterile gloves arrives, the storekeeper places it behind the existing batch, which expires sooner. A single swap on the shelf is enough to create an avoidable expiry.

Setting priorities with VEN and ABC classifications

Not every product needs the same level of monitoring. The VEN classification separates vital, essential and non-essential products, while ABC analysis ranks products by their weight in spending. Combined, they show where to focus attention.

Use your country’s national essential medicines list (Ghana and Nigeria each publish one), based on the WHO Model List, and your drugs and therapeutics committee if you have one. Example: in a district hospital in Ghana, products classed as vital have a higher safety stock and a weekly check, while costly non-essential products are ordered in small quantities.

Organising roles and tracking a few indicators

Stock management is a team effort. The pharmacist sets the parameters, the storekeeper records movements, wards report their needs and management approves large orders. Example: a clinic sets the rule “no issue without a record”, including at night, with an emergency cupboard checked every morning.

• Number of stock-outs in the month, with vital products shown separately.
• Value of expired or destroyed products.
• Number of products below their reorder point.
• Discrepancies found during stock counts.

These indicators only make sense if recorded stock matches physical stock, hence the importance of a regular inventory of medicines and supplies. Batch traceability from supplier to patient completes the system.

What MediFlow brings to the pharmacy

MediFlow’s stock room, already available, records receipts and issues, tracks batches and their expiry dates, and raises stock alerts. The pharmacist thus has a reliable basis for calculating consumption and spotting products close to a stock-out or to expiry.

The pharmacy module, in development, will extend this tracking to the patient: dispensing, prescriptions from smart medical follow-up and per-patient tracking, on the same platform.

Frequently asked questions

How do we calculate safety stock for a medicine?

There is no universal value. Safety stock depends on how critical the product is, how steady its consumption is and how reliable the supplier is. A simple method is to express it as a period of consumption, for example a few weeks of AMC, then adjust it after each stock-out or overstock.

What should we do with medicines close to expiry?

Spot them early with a monthly list, then redistribute them to the wards that use them or negotiate an exchange with the supplier if the contract allows. Once expired, they are isolated, recorded and destroyed according to the applicable procedure. They must never be dispensed.

How often should reorder points be reviewed?

At least once a year, and at every major change: new supplier, new ward, marked seasonal variation. Vital products deserve a more frequent review, for example every quarter. Also review a product’s settings after any stock-out.

Want to see how MediFlow fits your facility? Request a free demo.