Ten questions to ask about revolving drug funds

For any health financing scheme, the key issue is how to raise sufficient resources to provide a reasonable service when poverty means that many people are unable to afford such a service. A revolving drug fund is a scheme where drugs are sold at cost-price, plus a mark-up, and the revenue is used to replenish the drug stocks. Probably the most difficult part of establishing an RDF is setting prices. There should be sufficient mark-up to cover exempt treatments, transport costs, inflation and currency devaluations. Adequate records must be kept. If the amount of money and/or drugs in the RDF appears to be declining, the reason can be established. RDFs should not be seen in isolation from other considerations of the health care system. Drugs should not be sold without an adequate check on prescribing habits. Care should also be taken that the money-making potential of drugs does not distract from preventive activities.