Analisis Praktek Distribusi Obat oleh Apotek di Wilayah Kabupaten Jember

EKO A. BUDI DARMAWAN, Prof. Dr. apt. Satibi, M.Si.; Dr. apt. Nanang Munif Yasin, M.Pharm.

2022 | Tesis | Magister Manajemen Farmasi

Dengan keterbatasan cakupan pengawasan pemerintah dan sebaran fasilitas pelayanan kefarmasian, praktek distribusi obat oleh apotek tumbuh subur di wilayah Kabupaten Jember. Penelitian ini dilakukan dengan tujuan untuk mengetahui aspek-aspek pengadaan dan penyerahan obat di apotek yang menjalankan praktek distribusi obat, unsur-unsur penting proses bisnis dari praktek distribusi obat oleh apotek, serta mengetahui faktor-faktor yang mempengaruhi terjadinya praktek distribusi obat oleh apotek. Penelitian ini menggunakan rancangan penelitian kualitatif dengan pendekatan case study. Sampel penelitian adalah apotek-apotek yang ditentukan berdasarkan hasil Focused Group Discussion (FGD) bersama Loka Pengawas Obat dan Makanan (POM) di Kabupaten Jember, Dinas Kesehatan Kabupaten Jember dan Ikatan Apoteker Indonesia (IAI) Pengurus Cabang Jember (purposive sampling). Cara pengumpulan data dilakukan dengan observasi apotek dan wawancara mendalam kepada PSA dan APA masing-masing apotek yang diobservasi. Variabel penelitian meliputi pengelolaan obat (pengadaan dan penyerahan obat), unsur-unsur penting proses bisnis praktek distribusi obat serta faktor-faktor yang mempengaruhi praktek distribusi obat (sikap, motivasi, persepsi, dukungan sosial, pengetahuan dan pemahaman peraturan perundang-undangan, otonomi, situasi untuk bertindak). Dari hasil observasi terhadap 9 (sembilan) subyek apotek dan wawancara terhadap 13 (tigabelas) responden, didapatkan hasil bahwa subyek melakukan pengadaan dalam jumlah besar dan tanpa pembatasan jumlah dari PBF, sedangkan pada penyalurannya seluruh subyek melakukan penyerahan obat kepada tenaga kesehatan (dokter, perawat, bidan) ataupun sarana pelayanan kefarmasian lain (apotek, Puskesmas, klinik, rumah sakit). Dalam menjalankan proses bisnisnya, subyek melakukan pengadaan dalam jumlah besar untuk mendapatkan potongan harga. Subyek juga melakukan evaluasi untuk terhadap pesanan pelanggan walaupun jika stok tersedia sebagian subyek tetap akan melayani pesanan sesuai jumlah permintaan. Penyerahan obat selain diambil langsung di apotek juga dapat dilakukan dengan pengiriman oleh pegawai apotek maupun jasa ekspedisi. Responden penelitian menyetujui bahwa aspek sikap, motivasi, persepsi, dukungan sosial, pemahaman informasi dan peraturan perundangan, otonomi dan situasi untuk bertindak mempengaruhi praktek distribusi obat oleh apotek dengan berbagai alasan yang melatarbelakanginya. Fenomena praktek distribusi obat oleh apotek ini menjadi catatan bagi Pemerintah untuk dapat ditangani dengan mengedepankan analisis risiko dan ketersediaan obat di masyarakat. Peran semua institusi juga diharapkan agar tindakan pengendaliannya tidak hanya bersifat penegakan hukum saja tapi juga dengan sinergi tenaga-tenaga kesehatan dan instansi-instansi pemerintah untuk memberdayakan potensi apotek.

With limited government supervision and the distribution of pharmaceutical service facilities, the practice of drug distribution by pharmacies thrives in the Jember Regency area. This study was conducted with the aim of knowing the aspects of drug procurement and delivery in pharmacies that carry out drug distribution practices, the important elements of the business process of drug distribution practices by pharmacies, as well as knowing the factors that influence the occurrence of drug distribution practices by pharmacies. This study uses a qualitative research design with a case study approach. The research sample was pharmacies that were determined based on the results of a Focused Group Discussion (FGD) with the Food and Drug Supervisory Workshop (POM) in Jember Regency, the Jember District Health Office and the Indonesian Pharmacists Association (IAI) Jember Branch Management (purposive sampling). The method of data collection was done by observing pharmacies and in-depth interviews with PSA and APA of each of the observed pharmacies. Research variables include drug management (procurement and delivery of drugs), important elements of the business process of drug distribution practices as well as factors that influence drug distribution practices (attitudes, motivations, perceptions, social support, knowledge and understanding of laws and regulations, autonomy, situation to act). From the results of observations of 9 (nine) pharmacy subjects and interviews with 13 (thirteen) respondents, it was found that the subjects procured in large quantities and without restrictions on the number of PBFs, while in distribution, all subjects delivered drugs to health workers (doctors, nurses). , midwife) or other pharmaceutical service facilities (pharmacies, health centers, clinics, hospitals). In carrying out their business processes, subjects procure in large quantities to get discounted prices. Subjects also evaluate customer orders even if stock is available some of the subjects will still serve orders according to the number of requests. The delivery of drugs, apart from being taken directly at the pharmacy, can also be done by delivery by pharmacy employees or shipping services. Research respondents agreed that aspects of attitude, motivation, perception, social support, understanding of information and laws and regulations, autonomy and situations to act affect the practice of drug distribution by pharmacies with various reasons behind it. The phenomenon of drug distribution practice by pharmacies is a record for the Government to be handled by prioritizing risk analysis and drug availability in the community. The role of all institutions is also expected so that the control measures are not only law enforcement but also with the synergy of health workers and government agencies to empower the potential of pharmacies.

Kata Kunci : distribusi obat, apotek, pengadaan, penyaluran, sales, tenaga kesehatan