FABAD J. Pharm. Sci., 28, 141-148, 2003 RESEARCH ARTICLES
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A SSttuud dyy oonn C Cuussttoom meerr SSaattiissffaaccttiioonn iinn PPhhaarrm maacceeuuttiiccaall D Diissttrriibbuuttiioonn C Chhaannnneellss
Erdem MAHANO⁄LU*°, Gülbin ÖZÇEL‹KAY*
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A SSttuuddyy oonn CCuussttoommeerr SSaattiissffaaccttiioonn iinn PPhhaarrmmaacceeuuttiiccaall D
Diissttrriibbuuttiioonn CChhaannnneellss
SSuummmmaarryy :: As is well known, distribution channels have a big role in transportation of the products to the customers. Com- panies/firms can develop rapidly if the distribution channels work effectively. With effective and good working distribution channels not only the customer satisfaction but also improve- ment in the economy in the country can be achieved.
In this study “Customer Satisfaction in Pharmaceutical Dist- ribution Channels” is explained in accordance with the litera- ture and the survey applied.
The purpose of this study was to determine and analyze custo- mer satisfaction in pharmaceutical distribution channels.
In this study, a 20-itemed questionnaire was applied among 190 pharmacists in Ankara.
In the evaluation part of this study, SPSS (version 7.5) statisti- cal package program was used.
At the end of the study, the following results were obtained:
1- 80.5% of the pharmacists who completed the survey stated that they can easily find all medicines they demand, 66.3%
could find it on time, and 49.5% could obtain the products conveniently.
2- Within the medicinal distribution channels 76.8% of the 190 pharmacists had no problems regarding payment. Those who did have problems stated that they mostly concerned conditions of payment as required from the pharmaceutical distribution chan- nels to be inflexible and untimely. Sometimes the difference in the maturity of a bill that is required, is also a problem.
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Keeyy wwoorrddss:: Pharmacy, Pharmacist, Medicine, Pharmaceutical Distribution Channels, Customer Satisfaction Recived : 28.01.2004
Revised : 31.03.2004 Accepted : 06.04.2004
‹‹llaaçç DDaa¤¤››tt››mm KKaannaallllaarr››nnddaa MMüüflfltteerrii MMeemmnnuunniiyyeettii Ü
Üzzeerriinnddee BBiirr ÇÇaall››flflmmaa Ö
Özzeett:: : Üretilen mallar›n tüketicilere ulaflt›r›lmas›nda ve da¤›t›l- mas›nda da¤›t›m kanallar›n›n rolü büyüktür. Da¤›t›m faaliyet- leri etkin ve rasyonel bir flekilde gerçeklefltirilebilirse, iflletmelerin büyümesi ve geliflmesi de o ölçüde h›zl› olacakt›r. Böylece müfl- teri memnuniyeti sa¤land›¤› gibi, ülke ekonomisinin büyümesi ve geliflmesi de bu durumdan olumlu olarak etkilenecektir.
Bu çal›flmada ilaç da¤›t›m kanallar›ndaki müflteri memnuniye- ti literatür ve uygulanan anket do¤rultusunda aç›klanmaya ça- l›fl›lm›flt›r.
Bu çal›flman›n amac›, ilaç da¤›t›mlar›ndaki müflteri memnuni- yetini etkileyen faktörlerin belirlenmesi ve incelenmesidir.
Çal›flma s›ras›nda Ankara ilinde bulunan 190 eczane eczac›s›- na 20 sorudan oluflan bir anket uygulanm›flt›r.
Araflt›rmada verilerin de¤erlendirilmesinde SPSS (ver. 7.5) ista- tistiksel paket program› kullan›lm›flt›r.
Çal›flma sonucunda afla¤›daki sonuçlara ulafl›lm›flt›r.
1-Anket sorular›n› cevaplayan 190 eczac›dan %80.5’i istedik- leri çeflitlikteki ilaçlar› kolayl›kla bulabilmekte; %66.3’ü her is- tedi¤i ilac› zaman›nda bulabilmekte; %49.5’i ise her istedi¤i ilac› uygun flartlarda bulabilmektedir.
2- ‹laç da¤›t›m kanallar› ile 190 eczac›dan %76.8’i ödeme ko- nusunda bir sorun yaflamamaktad›r. Problem yaflayan eczac›- lar›n ilaç da¤›t›m kanallar› ile yaflad›klar› sorunlar›n; esnek ol- mayan ödeme koflullar›, zamans›z istenen ödemeler ve vade fark› istenmesi oldu¤u görülmektedir.
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Annaahhttaarr kkeelliimmeelleerr:: Eczane, Eczac›, ‹laç, ‹laç Da¤›t›m Kanal- lar›, Müflteri Memnuniyeti
IINNTTRROODDUUCCTTIIOONN
Pharmaceutical distribution channels include the institutions which sell a variety of goods which can be sold to veterinarians and pharmacies according to laws, i.e. medicine, active materials, chemicals, and health and pharmacy equipment.
The distribution channel is a system in which manu- facturers, retailers and consumers establish mutual relations. In the pharmaceutical sector, the medicine distribution channels distribute the goods. As the distributed goods, medicine, directly affect human life, it must reach the patient, that is, from the man- ufacturer to the producer, without spoiling, on time
* Ankara University, Faculty of Pharmacy, Department of Pharmacy Management, 06100, Tando¤an, Ankara, TURKEY.
° Corresponding author e-mail:
and in an appropriate manner. The medicine distri- bution channels facilitate the connection of the ma- nufacturer and final consumer.
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Phhaarrmmaacceeuuttiiccaall DDiissttrriibbuuttiioonn CChhaannnneellss iinn TTuurrkkiisshh P
Phhaarrmmaacceeuuttiiccaall SSeeccttoorr
The pharmaceutical distribution channels in the me- dicine sector are as shown in Figure 1 below1.
FFiigguurree 11.. Pharmaceutical distribution channels
The medicine is brought from the manufacturer to the pharmaceutical warehouses, from there to phar- macies and then to the patient, which is the most commonly used route of distribution. According to Figure 1, the routes of distribution from the point of manufacturing to delivery to the consumer can be listed as follows1:
1- Manufacturer and Importer → Pharmaceutical Warehouse → Pharmacy → Patient
2- Manufacturer and Importer → Hospital → Patient
3- Manufacturer and Importer → Pharmaceutical Warehouse → Others → Patient
4- Manufacturer and Importer → Pharmacy → Patient
In Turkey, 72% of the medicine on the market is distributed from the manufacturer to the patient through the 1st route. In other words, 72% of the medicine in the market is distributed from the man- ufacturer and importer firms to pharmacies and from there to patients through pharmaceutical warehouses. The remaining 28% consists of the medicines which are sold by the manufacturer to the hospitals owned by the Social Security Organization (SSK), training hospitals and other
hospitals. 17.5% of the total medicine market consists of Social Security Organization’s medicine expendi- tures and 8.5% constitutes the medicine expenses of the National Defense Ministry and universities.
Thus, the cost of the medicine not distributed to patients through the pharmacy is 26% of the total value. Considering that only 2% of the medicine is marketed to pharmacies by the manufacturer directly, the remaining share of 72% indicates the amount of medicine forwarded by pharmaceutical warehouses to pharmacies. In other words, 74% of medicines reach to consumers through pharmacies. The amount of medicine produced by pharmacies is negligible1.
As of 2001, the number of pharmaceutical ware- houses registered by the Turkish Ministry of Health is 438, but the number of those which display acti- vity is below 1002.
A wide range of medicine, including those which do and do not require a physician’s prescription, are sold in pharmacies in our country. The situation might be different in certain countries in Europe and in the U.S. According to a research done in more than 110,000 pharmacies in the strongest countries in Europe in terms of economy, 84% of prescribed medicines are sold in pharmacies, 95% of which are obtained from pharmaceutical warehouses. 58% of medicines not requiring a physician’s prescription are sold in pharmacies and 65% of this rate is sold in pharmaceutical warehouses. If the method of marketing medicines not requiring the physician’s prescription outside pharmacies comes on the agenda in our country, this way of distribution might gain importance1.
FFuunnccttiioonnss ooff PPhhaarrmmaacceeuuttiiccaall DDiissttrriibbuuttiioonn CChhaannnneellss
Medicine distribution channels are the most impor- tant component of the chain between the patient and the drug manufacturer. The medicine distribution channel forwards the medicines and health pro- ducts, which are sold by manufacturers and impor- ters, to pharmacies economically and effectively3.
Most of the medicine sold in pharmacies through- out the world is distributed through distribution channels. In Europe, medicines are distributed through the Groupement International de la Repartition Pharmaceeutique Europenne (GIRP), established in Paris in 1960. The GIRP consists of 450 medicine wholesalers and extends its services to 18 European countries. This function was regulated by the Euro- pean Directions in March 1992 and by the "Regula- tions on Pharmaceutical Warehouses and Products in Pharmaceutical Warehouses" in Turkey in October 1999. An efficient processing of an order can be ensured by a simple, reliable, fast and economic service4.
SSttrruuccttuurriinngg ooff PPhhaarrmmaacceeuuttiiccaall DDiissttrriibbuuttiioonn CChhaann-- nneellss iinn tthhee WWoorrlldd
The structures of pharmacies, physicians’ tendency towards filling a prescription and the range of prod- ucts depend on the social health systems which dif- fer among the countries in the world. These differ- ences of structure can be categorized as follows5:
1- International Companies 2- National Companies
3- Regional Companies in Countries 4- Cooperatives
1- International Companies carry out wholesale deals and sales by retail. They have professional management and strong financial resources.
They serve as partially open companies with a good rate of profitability.
2- National Companies carry out wholesale deals and sales by retail as well. They extend their ser- vice only to the market in the country and the market of the region. They establish a manage- ment generally consisting of the company owner and professionals. Their financial structure is self-sufficient. Their profitability can be consider- ed below that of international companies.
3- Regional Companies in Countries extend their service to a limited region within the country.
They are managed generally by the company owners and professional managers. Their finan-
cial resources are limited with lower profitabi- lity.
4- Cooperatives extend their service throughout the country and region. They are managed by pro- fessional managers with pharmacists. They carry out wholesale deals. They have low financial ca- pacity; profit is considered secondary.
SSttrruuccttuurree ooff PPhhaarrmmaacceeuuttiiccaall DDiissttrriibbuuttiioonn CChhaannnneellss iinn TTuurrkkeeyy
The pharmaceutical distribution channels in Turkey include the four types of structuring mentioned above.
Hedef Alliance Group is an example of an inter- national company, Selçuk Group of national compa- nies; S›hhat, Galenos and Nevzat Pharmaceutical Warehouses for regional companies in the country;
and ISTKOOP, EDAK and BURSA KOOP for cooper- atives5.
The limitations of activities of pharmaceutical ware- houses in Turkey were determined by the "Law on Poisonous and Effective Chemicals Used in Pharmacies and Art and Agricultural Works" num- bered 984, which became effective in 19276.
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Reellaattiioonn BBeettwweeeenn DDiissttrriibbuuttiioonn CChhaannnneellss aanndd C
Cuussttoommeerr SSaattiissffaaccttiioonn
In a gradually increasing competitive atmosphere, management must develop the marketable character- istics of the goods and services they produce. There- fore, current management is inclined towards the to- tal quality and is making efforts to achieve success this way. Total quality management is a model tar- geted at guaranteeing the perfection of all functions, including the function of knowing and perceiving the customer, that is, the marketing activities. In a management in which this model is adopted, the physical distribution systems also target customer satisfaction7.
The foreign and domestic customers’ needs and ex- pectations should be met and problems overcome and customer satisfaction should be targeted to en-
sure the competitive advantage. The customer is the key to the management’s success. Customers who are pleased with the things they hear, see and feel will return. Customers will be pleased to the extent their expectations and needs are met. The expecta- tions are based on the customers’ experiences with the management and products of its rivals. Custo- mer satisfaction can be achieved by ensuring the availability of the right product with the right price in a convenient manner. Customers are interested in the product’s function, practicality, performance, re- liability, price and availability. Management must ensure these elements in order to be successful8.
The aim of this study was to determine and analyze the factors which affect customer satisfaction in pharmaceutical distribution.
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MAATTEERRIIAALLSS AANNDD MMEETTHHOODDSS
We distributed a questionnaire consisting of 20 questions to pharmacists from 190 pharmacies in the province of Ankara.
The total field under survey consisted of 1,600 phar- macies which show activity in 10 regions in the pro- vince of Ankara. The sample size of the survey, i.e.
213 pharmacies, was determined by applying the formula below to the entire field. However, for vari- ous reasons, only 190 questionnaire forms were eval- uated; these were chosen by simple random meth- ods.
N: Number of persons in the field (1,600)
n: Number of persons to be included in the sample p: Expected proportion of the possibility of the fre- quency of researched incident’s occurrence
q: Expected proportion of the possibility of the fre- quency of researched incident’s lack of occurrence t: Theoretical values found from the t table on a cer- tain degree of freedom and the level of determined error
n = N t2 pq d2 (N - 1) + t2 pq
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d: Desired ± deviation according to the frequency of the incident’s occurrence
P: 0. 50
q: 0. 50 (1- 0.50= 0. 50)10 pq: 0.25
t= 1. 96 for α= 0.05 and df= ∞ d= 0. 05
The statistical package program SPSS (version 7.5) was used for the evaluation of data in this research.
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REESSUULLTTSS
The results of our study are illustrated in the follow- ing 12 Tables.
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Taabbllee 11.. Pharmacists’ ability to find the drug they demand from pharmaceutical distributor channels
N
Nuummbbeerr %%
Sometimes 12 6.3
Usually 107 56. 3
Always 71 37.4
T
Toottaall 119900 110000
T
Taabbllee 22.. Pharmacists’ ability to connect easily with pharmaceutical distribution channels
N
Nuummbbeerr %%
Sometimes 3 1.6
Usually 47 24.7
Always 140 73.7
T
Toottaall 119900 110000
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Taabbllee 33.. Pharmacists’ ability to find the medicine on time from pharmaceutical distribution channels
N
Nuummbbeerr %%
Rarely 3 1.6
Sometimes 14 7.4
Usually 90 47.4
Always 83 43.6
T
Toottaall 119900 110000
T
Taabbllee 44.. Pharmacists’ supply source N
Nuummbbeerr %% Pharmaceutical Warehouse 187 98.4
Drug Company 3 1.6
T
Toottaall 119900 110000
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Taabbllee 55.. Frequency of exchange problems N
Nuummbbeerr %%
Never 111 58.4
Rarely 25 13.2
Sometimes 31 16.3
Usually 13 6.8
Always 10 5.3
T
Toottaall 119900 110000
T
Taabbllee 66.. Pharmacists’ experiencing a payment problem with pharmaceutical distribution channel
N
Nuummbbeerr %%
Yes 44 23.2
No 146 76.8
T
Toottaall 119900 110000
T
Taabbllee 77.. Pharmacists’ reasons for their pharmaceu- tical distribution channel preference
N
Nuummbbeerr %% I can find every drug easily 153 80.5 I can find every drug on time 126 66.3 I can find every drug in
appropriate condition 94 49.5
I like the way they connect
with me 90 47.4
Very near to my pharmacy
(Convenient location) 3 1.6
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Taabbllee 88.. Pharmacists’ ability to echange the medi- cines which are near expiration
N
Nuummbbeerr %%
Never 163 85.8
Rarely 15 7.9
Sometimes 6 3.2
Usually 2 1.1
Always 4 2.1
T
Toottaall 119900 110000
T
Taabbllee 99.. Frequency of pharmacists’ coming across with the surcharge.
N
Nuummbbeerr %%
Never 115 60.5
Rarely 41 21.6
Sometimes 20 10.5
Usually 8 4.2
Always 6 3.2
T
Toottaall 119900 110000
T
Taabbllee 1100.. Pharmacists’ satisfaction with the packag- ing of the medicines they provide from the pharmaceutical distribution channels
N
Nuummbbeerr %%
Never 2 1.1
Rarely 6 3.2
Sometimes 27 14.2
Usually 86 45.2
Always 69 36.3
T
Toottaall 119900 110000
T
Taabbllee 1111.. Pharmacists who continue to use same pharmaceutical distribution channel as from the beginning
N
Nuummbbeerr %%
Yes 147 77.4
No 43 22.6
T
Toottaall 119900 110000
T
Taabbllee 1122.. Pharmacists’ expectations from pharmaceu- tical distribution channels.
N
Nuummbbeerr %% I need to get every kind of
drug I demand on time 190 100
I need to have a good relationship
with the salesman 164 86.3
I need to have a good relationship with all staff in the drug
distribution channels 124 65.3 I need appropriate payment
condition 109 57.4
I need an appropriate
campaign 109 57.4
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DIISSCCUUSSSSIIOONN
In this study on customer satisfaction with the phar- maceutical distribution channels, the evaluations concerning the tables which reflect the responses of the 190 pharmacists who participated in the survey and the classification of questions in the questionn- aire are mentioned below.
Of the pharmacists who participated in the survey, 56.3% stated that they often find the medicines which they demand from the pharmaceutical distri- bution channels, 37.4% find them every time and 6.3% sometimes ((TTaabbllee 11)). All the pharmacists who participated in the survey answered this question.
Pharmacists’ inability to find a required medicine every time stems from the pharmaceu-tical firm’s marketing strategies. It is sometimes obligatory to make a quota agreement between the pharmaceuti- cal firms and warehouses and cooperatives which are the other members of the distribu-tion channel.
If the bargaining process is delayed and unresolved, the firms do not put the medicine in their stock on the market. Thus, the pharmacists cannot present the medicine to the patient in those periods. This also occurs prior to the twice yearly periods of cost incre- ases on medications. After the amount and date of the increase on the medicine is announced, pharma- cists have difficulties in finding the medicine via dist- ribution channels until the medicine with the newly fixed price is brought to the firms’ stocks.
73.7% of pharmacists who participated in this sur- vey stated that they can reach the medicine distribu- tion channels every time, 24.7% can reach them oft- en and 1.6% sometimes ((TTaabbllee 22)).. All pharmacists answered this question. It is pleasing that the parti- cipating pharmacists can reach the medicine distri- bution channels easily. The reason for their occa- sional inability to do so might derive from the fact that the number of pharmacies in Ankara’s center is significantly higher than the corresponding number of pharmaceutical warehouses and cooperatives in the area.
43.6% of pharmacists stated they can always find the medicine they demand on time, 47.6% often, 1.6%
rarely and 7.4% sometimes ((TTaabbllee 33)).. Most of the pharmacists who participated in the study could oft- en find the medicine needed on time. Because of the intensive competition among the pharmaceutical warehouses, the mentality focusing on the pharma- cist and on better service is becoming widespread.
Pharmaceutical warehouses today can provide me- dicine three times to pharmacists in the city center and once to those in rural areas with a distance of a maximum of 150 kilometers. In such a situation, the probability of the pharmacists’ ability to find the medicine they demand increases unless a technical problem occurs.
98.4% of pharmacists bought their medicines from pharmaceutical warehouses or cooperatives and 1.6% from the pharmaceutical firm ((TTaabbllee 44)).. All the pharmacists answered this question. Normally, according to the legal aspects of distributing the me- dicine from its production to the pharmacy, phar- macists buy the drug from pharmaceutical ware- houses and/or cooperatives, which was the previ- ous distribution channel. The reason for 1.6% of the participant pharmacists’ buying the drug from the pharmaceutical firm derives from the fact that firms sometimes prepare special campaign conditions re- garding medicines with high cost of stock, termed "a firm campaign". The pharmacists who want to bene- fit from the campaign order and buy the medicine from the firm directly. However, this situation is so rare that this is almost irrelevant to the evaluation.
In general, the firm prepares an invoice for the phar- macist’s order by changing the conditions of its goods sold in the pharmaceutical warehouse. In other words, the medicine is bought from the pharmaceu- tical warehouse but with certain conditions which are changed according to the firm’s campaign.
16.3% of pharmacists who participated in the survey had problems with the "exchange" sometimes, 13.2%
rarely, 6.8% often and 5.3% every time. 58.4% of pharmacists who participated in the survey never encountered problems with "exchange" in distribu-
tion channels. All the pharmacists who participated in the questionnaire answered this question ((TTaabbllee 55)).. The reasons for 58.4% of participant pharmacists’
never having had a problem can be listed as follows:
relations between the pharmaceutical warehouse and pharmacy are good, they have been satisfied with good business relations for a long period of time and generally want to exchange the medicine shortly after they purchase it from the pharmaceuti- cal warehouse. Pharmaceutical warehouses can ea- sily solve the issues of return and exchange within the same month of the medicine’s sale.
76.8% of pharmacists who participated in the ques- tionnaire never had problems with the drug distri- bution channels concerning payment, but 23.2% of them did ((TTaabbllee 66)).. Most problems derived from the date of cheques which are drawn for payment. Phar- maceutical distribution channels tend to not be flex- ible concerning the payment to the extent required by the market. As the pharmacists have difficulties in collecting money for the medicine they sell and the service s/he extends, certain disagreements oc- cur regarding the days of payment, which are deter- mined by the distribution channels.
80.5% of pharmacists who participated in the survey stated that they preferred the distribution channels because they could easily find all the medicine they demand, 66.3% stated that they could find the medi- cine they demand on time, 49.5% stated that they could easily find the medicine they demand in appropriate conditions and terms, 47.4% stated that they liked their service and 1.6% stated that they liked them because they were near to their pharmacies. All the pharmacists who participated in the survey answe- red this question ((TTaabbllee 77)).. As can be seen from the study results, the pharmacists mostly prefer the pharmaceutical distribution channels which have a larger variety of medicine. Other factors cites inclu- ded finding any kind of medicine whenever they demand, in appropriate conditions and on time, which is always important. Today, the increased number of drug distribution channels and the com- petitive atmosphere facilitate the drugs’ being for-
warded to pharmacies; thus, nearness to the phar- macy does not play an important role in the phar- macist’s preference.
2.1% of pharmacists who participated in the ques- tionnaire stated that they can always exchange the medicine which has expired or is nearly expired, 7.9% rarely could, 3.2% sometimes, 1.1% often and 85.8% never ((TTaabbllee 88)).. All the pharmacists answered this question. In principle, the drug distribution channels do not and should not sell medicines which are nearly expired. If they do sell them, the pharmacists are informed on this issue and they pre- sent the conditions of sale. The problems that the pharmacists have with the exchange are as follows:
pharmaceutical firms do not accept regular exchange and the pharmaceutical warehouses do not want to be occupied with the issue of the surcharge made by pharmacists.
3.2% of pharmacists who participated in the survey always experience a surcharge, 21.6% rarely, 10.5%
sometimes and 4.2% often. 60.5% of the participating pharmacists had never come across the surcharge ((TTaabbllee 99)).. All the pharmacists answered this questi- on. In the pharmaceutical distribution channels, firms sometimes can surcharge imported medicines.
The origin of the surcharge experienced by the phar- macists who participated in this survey was the pharmaceutical firms. As the price for the imported medicine is determined according to the correspond- ing exchange at the time, incidents of surcharge ori- ginating with the firm and, very rarely, with impor- ted medicine warehouses, are seen.
36.3% of pharmacists who participated in the study stated that they were always satisfied with the pack- aging of medicines in the pharmaceutical distribu- tion channels, 45.2% often, 14.2% sometimes and 3.2% rarely; 1.1% of them stated that they were ne- ver satisfied with the packaging of medicines in the pharmaceutical distribution channels ((TTaabbllee 1100)).. All the pharmacists who participated in the survey an- swered this question. As the medicines are not pack- aged according to a certain standard in the distribu-
tion channels and the packing material used is that preferred by distribution channels, undesirable situ- ations may sometimes occur.
77.4% of pharmacists who participated in the survey have been working with the distribution channel with which they started at the opening of their phar- macies; 22.6% had started to work with new distri- bution channels ((TTaabbllee 1111)).. The drug distribution channels always present the best conditions during the opening of pharmacies. Today the increase in the number of pharmaceutical warehouses and the in- tensified competitive atmosphere have resulted in highly beneficial conditions being presented during the opening of pharmacies. Pharmaceutical distribu- tion channels try to extend unlimited services in or- der to work with the newly opened pharmacies and gain customers. Thus, the pharmacist, who is sup- ported in the opening of her/his pharmacy, contin- ues to work with the same pharmaceutical wareho- use unless a contrary situation occurs.
When asked regarding the characteristics of an effi- cient and good distribution channel, 100% of phar- macists stated they would prefer a distribution channel which can deliver the desired kind of medi- cine on time, 86.3% wanted a sales person with whom they could establish good relations, 65.3%
wanted a distribution channel with a team which could establish good relations with them at every stage and 57.4% wanted a distribution channel with appropriate payment and campaign conditions ((TTaabbllee 1122))..
The results of the survey conducted in 190 pharma- cies in Ankara concerning the pharmaceutical distri- bution channels are as follows:
• Almost all the pharmacists can obtain the medi- cine they desire from the pharmaceutical ware-
houses whenever they want.
• Pharmacists can reach the pharmaceutical ware- houses whenever they want.
• 98.4% of pharmacists obtain the medicine from pharmaceutical warehouses and 1.6% from drug firms.
• Most of the pharmacists have been using the same pharmaceutical distribution channel from the time their pharmacies opened. For various reasons, a limited number of pharmacists no longer work with the previous drug distribution channels.
• Some pharmacists have problems with the ex- change of medicine and refunds and with expired or nearly expired medicines.
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REEFFEERREENNCCEESS
1- Kerman A. The Marketing Structure of Turkish Drug Sector, Director’s Report, 1995.
2- Monthly Report Magazine, Drug Industry Employer Trade Union, Monthly Report, 113, 2002.
3- Kurtulufl K. Distribution Channels, General View, Mea- surement of Effectiveness and Turkish Model, Istanbul University Faculty of Business Administration Public of Marketing Institute, 1979.
4- Kapudere G. Distribution Channels Conception and the Application of Total Quality Management, Mar- mara University Social Science Institue, 2001.
5- Monthly Report Magazine, Drug Industry Employer Trade Union, Monthly Report, 111, 2001.
6- Akal›n K. Medicine and Pharmacy, International Agree- ments, Laws, Regulation, Circulars, Expanded Edition II, 1996.
7- Baybars Ö, Tuna O. Total Quality Management of Physical Distribution, I. International Marketing Symposium (Marketing Quality), 1995.
8- Bozkurt P. The system of total quality management, Productiveness Magazine, 4, 11, 1994.
9- Sümbülo¤lu K, Sümbülo¤lu V. Biostatistic, Özdemir Publishing, 6thEdition, 1995.
10- Ç›ng› H, Theory of Sampling, University of Hacettepe, Faculty of Science, Publishing, Ankara, 1994.
