If a ship is a floating village, its medical centre is the village pharmacy. But keeping the medicine cabinet stocked, compliant and cost-effective requires expertise in supply chains, policy, logistics, inventory management and more. It also calls for a detailed understanding of global policies and industry guidelines.

Every cruise ship must have a pharmacy equipped to respond to accidents, illnesses and chronic conditions. This medicine cabinet is particularly crucial for emergency response management, and effective oversight of its contents is essential to supporting both passenger and crew health. In fact, it’s no exaggeration to say that it can be the difference between life and death

In this article, we’ll take a closer look at the mighty medicine cabinet and its outsized role in keeping ships safe across the world’s oceans.

CLIA and ACEP Standards
The two main organisations that set standards for cruise ship medical preparedness are Cruise Lines International Association (CLIA) and the American College of Emergency Physicians (ACEP). CLIA sets industry-wide policy and ACEP sets medical standards that CLIA members agree to follow. These include maritime healthcare standards, facility requirements, staff licensing, emergency protocols, infectious disease control, shore-based coordination, medico-legal issues and more.

CLIA and ACEP also dictate essential onboard medications and supplies. As ships crisscross international waters and explore the far corners of our world, their medicine cabinet must be adequately stocked with supplies, such as:

• Emergency Medications: Cardiac life support drugs, anaphylaxis treatments, respiratory support, and pain management, including opioids and non-opioids.
• Antibiotics & Antivirals: Broad-spectrum IV and oral antibiotics, antivirals for influenza and herpes, and antifungals for systemic and topical use.
• Gastrointestinal Medications: Anti-nausea drugs, anti-diarrhoeal, IV fluids, and electrolytes.
• Cardiac Management: Beta-blockers, calcium channel blockers, anticoagulants, diuretics and thrombolytics
• Mental Health Management: Sedatives, anxiolytics, antipsychotics, and anti-seizure medications.
• Medical Supplies: Defibrillators, advanced cardiac life support (ACLS) equipment, oxygen, sutures, surgical supplies, insulin, and more.
• Emergency Obstetrics & Gynaecology Supplies: Sterile obstetric delivery kit, gynaecological examination kit and emergency contraceptive pills
• Itinerary specific medication, like malaria prophylaxis and treatment when visiting countries where malaria is endemic.

Government Regulations

While essentially all cruise operators agree that complying with CLIA and ACEP standards is in the industry’s best interest, adequate medical supplies are also strictly regulated by international maritime laws and national authorities.

Regulations set forth by the International Maritime Organization (IMO) stipulate specific guidelines for medications and medical equipment required onboard, and operators are legally required to keep a fully stocked and well-maintained medical inventory capable of handling illnesses, injuries and emergencies.

Ship operators must maintain up-to-date medical inventories and adjust stock levels based on changing legal frameworks. Compliance also mandates regular audits and inspections to ensure that nothing is expired, and all items are ready to use.

The Challenge of Cost Control

Predicting the exact amount of medication a ship will need is difficult. For instance, unexpected rough seas may cause a spike in demand for motion sickness medication, while expensive yet rarely used drugs like alteplase, which dissolves blood clots, must be on hand in case of emergencies. Some ships are in port on a daily basis and medication can be bought at short notice, if needed. For longer and more remote itineraries a larger stock is needed. Buying stock in bulk is cheaper than buying medication ad hoc as handling fees can be higher than the price of the items.

Overstocking creates waste, as medications often expire before use, but understocking can leave a ship unprepared. Striking the right balance requires expertise. VIKAND works with the on-board teams to keep a close eye on medication’s burn rate and par levels.

Restocking medicines at sea is another challenge. Some ports offer easy access to supplies while others present logistical headaches, and urgent deliveries to remote locations can be prohibitively expensive, making proper inventory management all the more important. Sometimes ships miss a scheduled port due to adverse weather and items which have been ordered in advance will then need to be shipped to the next suitable port.

A ship’s medical supply needs vary based on its size, voyage duration, itinerary, passenger and crew count, risk assessments and more. Smart inventory oversight, therefore, means making sure a ship has everything it needs—and nothing it doesn’t. 

VIKAND Provides Expert Support

As maritime health management evolves, expert service providers like VIKAND play a vital role in optimising onboard medical inventory.

Our team manages inventories on more than 80 ships, with a global logistics network that ensures no ship sets sail without essential medical supplies. This gives us detailed visibility on usage trends and what’s needed to maintain stock levels accordingly. 

Operators rely on VIKAND’s team for several key reasons:

• Continuous Communication: Shipboard Medical Operations (MSMO) managers maintain direct communication with onboard medical teams, offering guidance and support.
• Inventory Optimisation: We account for Flag State regulations, CLIA/ACEP requirements, guest demographics, vessel itineraries and more when strategically managing a ship’s onboard medical inventory.
• Proactive Oversight: We minimise waste and overstocking—saving operators many thousands of dollars per year—by monitoring stock levels and expiration dates, prioritising near-expiry medications and recommending suitable alternatives as needed.

A Cornerstone of Maritime Health & Safety

A ship’s medicine cabinet plays a key role in maritime health and safety. VIKAND collaborates with every client’s onboard medical team to fine-tune stock levels, ensuring preparedness for any medical situation.

Through strategic inventory management, compliance oversight and global supply solutions, we help ships maintain medical readiness at the highest standards.