title: [Organization of the drug supply chain in state health services: potential consequences of the public-private mix].
abstract: OBJECTIVE
  To assess the consequences of private outsourcing on the overall supply and filling of prescriptions in state health services.
  
  
  METHODS
  The research was conducted using quantitative and qualitative techniques in 13 states. The information was collected through interviews and direct observation. The interviews were carried on staff of state health services related to the drug supply chain and users of health services. The quantitative approach examined the percentage of stocked full recipes in a sample of users.
  
  
  RESULTS
  States that have opted for the fully outsourced model, and properly monitored this choice, have increased the supply of drugs to their users and guaranteed the supply in the care units in charge. Other states with the outsourced model have multiple problems: direct purchase of drugs not included in the basic drugs catalogue, failure of suppliers and shortage of supplies in the laboratories that provide the company. The main disadvantages identified in all models were: the subordination of the medical criteria to administrative criteria, insufficient planning based on local care needs, heterogeneous procedures, insufficient knowledge of regulations and lack of normativity.
  
  
  CONCLUSIONS
  The results indicate that the incorporation of private providers in the drug supply chain may not be the solution to bring down the shortage faced by health services, especially at the hospital level. The shift to outsourcing models has developed without incorporating evaluation mechanisms and the consequences that this transition can have on state health systems must be investigated more deeply.
authors.affiliation: Departamento de Atención a la Salud, División de Ciencias Biológicas y de la Salud, UAM, México. slopez@correo.xoc.uam.mx
authors.forename: Sergio
authors.initials: S
authors.lastname: López-Moreno
authors.forename: Rosa Haydeé
authors.initials: RH
authors.lastname: Martínez-Ojeda
authors.forename: Oliva
authors.initials: O
authors.lastname: López-Arellano
authors.forename: Edgar
authors.initials: E
authors.lastname: Jarillo-Soto
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Castro-Albarrán
mesh_terms: D006801:Humans; D008800:Mexico; D009313:National Health Programs; D010593:Pharmaceutical Services / Q000458:organization & administration*; D055553:Prescription Drugs / Q000600:supply & distribution*; D017149:Private Sector; D017150:Public Sector
chemical_list: D055553:Prescription Drugs