Last Mile Delivery of Cold Chain Medicines – Challenges and Recommendations

Abstract

Cold chain medicines are those that require special temperature-controlled cold storage to maintain their quality and efficacy. Cold chain management is important to ensure that the right quality is maintained throughout the supply chain. There lies a variety of reasons why cold chain management continues to be the challenge in India like lack of the consolidated list of cold chain medicines, lack of standard refrigeration guidelines for retail pharmacies, non-uniformity in storage temperature instructions on the label, patient education and lack of awareness. The study aims to identify the challenges faced in the last mile delivery of such medicines in India and suggest practical recommendations for improvement that confirms the international best practices. More than 100 interviews were conducted with healthcare professionals like doctors, pharmacists, retail pharmacy experts, logistic partners, distributors and ex-regulators to understand the storage conditions and the possible solutions, especially at retail and customer level. An exhaustive list of cold chain medicines was framed with the databases of Indian hospitals, local drug distributors and drug retailers. Given the complexity of cold chain system in India, the guidelines for maintaining and managing the cold chain should be clearly available and then be mandatorily followed, in order to avoid the deleterious effects on such medicines due to storage and handling issues as elaborated in this study.