Abstract:
Objectives A pressing challenge in low and middle-income countries (LMIC)
is inadequate access to essential medicines, especially for chronic diseases. The
Revolving Fund Pharmacy (RFP) model is an initiative to provide high-quality
medications consistently to patients, using revenues generated from the sale of
medications to sustainably resupply medications. This article describes the uti lization of RFPs developed by the Academic Model Providing Access to Health care (AMPATH) with the aim of stimulating the implementation of similar
models elsewhere to ensure sustainable access to quality and affordable medica tions in similar LMIC settings.
Methods The service evaluation of three pilot RFPs started between April 2011
and January 2012 in select government facilities is described. The evaluation
assessed cross-sectional availability of essential medicines before and after
implementation of the RFPs, number of patient encounters and the impact of
community awareness activities.
Findings Availability of essential medicines in the three pilot RFPs increased
from 40%, 36% and <10% to 90%, 94% and 91% respectively. After the first
year of operation, the pilot RFPs had a total of 33 714 patient encounters. As
of February 2014, almost 3 years after starting up the first RFP, the RFPs had a
total of 115 991 patient encounters. In the Eldoret RFP, community awareness
activities led to a 51% increase in sales.
Conclusions With proper oversight and stakeholder involvement, this model is
a potential solution to improve availability of essential medicines in LMICs.
These pilots exemplify the feasibility of implementing and scaling up this
model in other locations.