Developed in collaboration with Management Sciences for Health and PAHO, this manual presents an indicator-based approach for rapidly assessing pharmaceutical management systems and programs. The step-by-step manual contains 46 indicators of performance, grouped under eight topics of pharmaceutical management, that provide a framework for analyzing why the pharmaceutical system problems that exist have come to pass, which problems can be solved, and what interventions are feasible in terms of cost-effectiveness and sustainability. The manual includes sample data forms, the formulas for deriving the indicators, and data collected from nine countries.