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

Area of Science:

• Public Health
• Health Economics
• Biomedical Technology

Background:

• The US President's Emergency Plan for AIDS Relief (PEPFAR) has funded significant investments in flow cytometry technology for HIV programs.
• The Supply Chain Management System (SCMS), managed by the Partnership for Supply Chain Management (PFSCM) consortium, procures these essential commodities.
• Approximately $90 million was allocated to flow cytometry platforms and reagents between 2005 and mid-2012.

Purpose of the Study:

• To analyze cost variations associated with different utilization rates of CD4 testing instruments.
• To identify optimal utilization targets for common CD4 testing platforms funded by PEPFAR.

Main Methods:

• Calculated cost per test based on test volume for Becton Dickinson (BD) FACSCount™ and BD FACSCalibur™.
• Utilized facility-level instrument utilization data from three countries to determine onsite cost per test.

Main Results:

• Maximal per-test cost efficiency is approached with at least 40% utilization for FACSCount™ and 15% for FACSCalibur™.
• Observed wide-ranging average utilization rates (0%-68%) across different countries, laboratories, and partners.
• Underutilization was identified as a significant factor impacting cost-effectiveness.

Conclusions:

• Lower instrument utilization directly correlates with higher average cost per test.
• Improving the throughput and utilization of flow cytometry machines is essential for reducing costs in HIV diagnostics.
• Strategic management of diagnostic equipment is critical for maximizing the impact of PEPFAR funding.