EVD Consignment Programs: Par Levels, Rotation and Expiry

An EVD consignment program places distributor-owned drainage kits on the hospital’s shelves, and the hospital pays only for the kits it uses. It works when three things are agreed in writing: par levels for each location, a first-expiry-first-out rotation routine, and a reconciliation process that matches usage, billing and replenishment every cycle.

For low-volume, high-urgency products such as external ventricular drains, consignment is often what makes a hospital willing to stock a new system. The hospital avoids tying up capital and keeps the product available at all hours; the distributor gains a stable position in the account. The risk is that poorly managed consignment turns into expired stock, unexplained losses and billing disputes. This article sets out a practical model.

Why is consignment common for EVD products?

Hospitals cannot plan most EVD placements. A trauma patient or a hemorrhage arrives without notice, and the kit must be at hand in the emergency department, the ICU or the OR. At the same time, each location uses relatively few kits per month. Owning that inventory outright means paying for stock that may sit for weeks. Consignment shifts that carrying cost to the distributor in exchange for preferred status on the shelf.

The model also suits a hospital evaluating a new manufacturer. Stock can be placed for a trial without a large purchase order, and removed cleanly if the evaluation ends.

How should par levels be set?

A par level is the quantity that should be on the shelf after each replenishment. Setting it well requires data, not guesswork. Start with the account’s own history:

• Monthly EVD placements per location over the past twelve months, from procedure logs or purchasing data.
• The split between standard and antibiotic-impregnated catheters, if the hospital uses both.
• Peak usage weeks, which in trauma centers can be noticeably higher than the average.
• Replenishment frequency and the time from a usage report to delivery.
• Any lumbar drainage usage, if the account also uses a lumbar drainage catheter kit.

A simple rule many distributors use is to cover expected usage during the replenishment interval plus a safety buffer sized to the account’s peak weeks. For EVDs, a stock-out is unacceptable, so the buffer should lean generous for the core item and leaner for slow-moving variants.

A worked example of a stocking map

The table below illustrates how a distributor might lay out par levels by location. The numbers are placeholders for planning; real values come from the account’s data.

How do you rotate stock and control expiry?

Expiry is the largest avoidable cost in consignment. Every sterile kit carries an expiry date on its label, and kits that expire on a hospital shelf are usually the distributor’s loss. Three habits keep that loss low.

• First-expiry-first-out: place the shortest-dated kits at the front, every time stock is replenished.
• Expiry watch list: flag any kit within a set number of months of expiry at each count and move it to a higher-use location.
• Transfer between accounts: where agreements allow, move short-dated stock from a slow account to a busier one before it expires.

Rotation depends on readable labels. Teach shelf staff to read the expiry symbol and the lot number on the label; ISO 15223-1 defines the standard symbols manufacturers use. Ask the manufacturer for the shelf life of each item and plan incoming shipments so that new stock arrives with most of its life remaining.

How should usage be reconciled?

Reconciliation is where trust is built or lost. Each cycle, the distributor compares three numbers: kits on the shelf at the last count, kits delivered since, and kits on the shelf now. The difference should match the kits the hospital reports as used and billed.

Agree in advance how usage is reported: through a bill-only purchase order issued after each case, through a periodic usage report, or through a scan at the point of use. Record the lot number of every kit used. That supports billing accuracy and lot traceability at the same time, which helps if a field safety action ever needs to reach specific patients.

Handling discrepancies

Discrepancies happen: a kit opened and discarded without documentation, a kit borrowed by another unit, a damaged package. The consignment agreement should state who bears the cost of unexplained losses, of kits opened but not used and of damage on the hospital’s premises. Without that clause, every discrepancy becomes a negotiation.

When should par levels be reviewed?

Par levels set at the start of a program are an estimate. Review them after the first quarter and then at least twice a year, or sooner when something changes in the account. Triggers for an early review include a new neurosurgeon joining the department, a new trauma designation, a change in the hospital’s protocol for antibiotic-impregnated catheters, the opening of a new ICU or a change in replenishment frequency.

Bring data to the review: actual usage by location and item, the number of emergency replenishments, kits approaching expiry and any stock-outs. A par level that never triggers a replenishment between counts is probably too high; one that regularly needs emergency deliveries is too low. Adjusting by small steps, and documenting each change, keeps both sides comfortable.

Which metrics show the program is working?

A consignment program is easier to defend, and to renew, when both sides track a few simple measures and review them together:

• Stock-outs per quarter by location, with the target being none.
• Emergency replenishments outside the normal cycle.
• Kits written off for expiry, as a count and as a value.
• Unexplained discrepancies at reconciliation.
• Time from usage report to replenishment.
• Completeness of lot recording at the point of use.

Share these in a short quarterly summary with the materials manager. It demonstrates that the distributor is managing the program actively, which matters when the hospital reviews its suppliers.

What belongs in the consignment agreement?

Hospitals usually have their own template, but a distributor should check that it covers:

• Ownership of the stock until use, and the trigger for billing.
• Par levels by location and the procedure for changing them.
• Count frequency, who performs counts and access to storage areas.
• Responsibility for expired, damaged, lost and opened-but-unused kits.
• Storage conditions the hospital must maintain.
• Lot recording at the point of use.
• Removal of stock at the end of the agreement or an evaluation.

How does the manufacturer support a consignment program?

A distributor carries consignment risk, so it needs a manufacturer that supports planning. Useful support includes clear shelf-life information, consistent lead times, forecast discussions and help with rotating short-dated stock. DESU designs and manufactures its EVD systems, including the EVD-010 Series, the ventricular catheter kit and the lumbar drainage catheter kit, in its own facility in Ankara, Türkiye, under ISO 13485. Working directly with the manufacturer makes those planning conversations faster.

Talk to a DESU product specialist

If you are planning a consignment program for EVD products, DESU’s product specialists can discuss shelf life, packaging, lead times and assortment for your market. Email sales@desu.tr or request a quote to start.