Original Research

Optimising the laboratory supply chain: The key to effective laboratory services

Dianna Edgil, Jason Williams, Peter Smith, Joel Kuritsky
African Journal of Laboratory Medicine | Vol 3, No 1 | a101 | DOI: https://doi.org/10.4102/ajlm.v3i1.101 | © 2014 Dianna Edgil, Jason Williams, Peter Smith, Joel Kuritsky | This work is licensed under CC Attribution 4.0
Submitted: 14 March 2013 | Published: 05 September 2014

About the author(s)

Dianna Edgil, United States Agency for International Development (USAID), Washington, United States
Jason Williams, The Partnership for Supply Chain Management (PFSCM), Arlington, United States
Peter Smith, The Partnership for Supply Chain Management (PFSCM), Arlington, United States
Joel Kuritsky, United States Agency for International Development (USAID), Washington, United States

Abstract

Background: The Supply Chain Management System (SCMS) is a contract managed under the Partnership for Supply Chain Management (PFSCM) consortium by the United States Agency for International Development (USAID). SCMS procures commodities for programmes supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR). From 2005 to mid-2012, PEPFAR, through SCMS, spent approximately $384 million on non-pharmaceutical commodities. Of this, an estimated $90m was used to purchase flow cytometry technology, largely for flow cytometry platforms and reagents.

Objectives: The purpose of this paper is to highlight the cost differences between low, medium and high utilisation rates of common CD4 testing instruments that have been procured though PEPFAR funding.

Method: A scale of costs per test as a function of test volume through the machine was calculated for the two most common CD4 testing machines used in HIV programmes: Becton Dickinson (BD) FACSCount™ and BD FACSCalibur™. Instrument utilisation data collected at the facility level in three selected countries were then used to calculate the onsite cost-per-test experienced in each country.

Results: Cost analyses indicated that a target of at least 40% utilisation for FACSCount™ and 15% utilisation for FACSCalibur™, respectively, closely approach maximal per-test cost efficiency. The average utilisation rate for CD4 testing instruments varies widely by country, level of laboratory and partner (0% − 68%).

Conclusion: Our analysis indicates that, because cost-per-test is related inversely to sample throughput, the underutilisation of flow cytometry machines is resulting in an increase in average cost-per-test for many instruments.

 


Keywords

HIV Diagnostics; Public Health Supply Chain

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Crossref Citations

1. The 90 90 90 strategy to end the HIV Pandemic by 2030: Can the supply chain handle it?
David Jamieson, Scott E Kellerman
Journal of the International AIDS Society  vol: 19  issue: 1  year: 2016  
doi: 10.7448/IAS.19.1.20917