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Existing Challenges – POC Introduction Lab Technical Working Group

Existing Challenges – POC Introduction Lab Technical Working Group. Jason Williams, Principal Laboratory Advisor, SCMS January 20-21, 2013. Overview. Procurement perspective Continuum of impact Current CD4 situation Existing POC challenges Coordinated strategic r esponse.

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Existing Challenges – POC Introduction Lab Technical Working Group

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  1. Existing Challenges – POC IntroductionLab Technical Working Group Jason Williams, Principal Laboratory Advisor, SCMS January 20-21, 2013

  2. Overview • Procurement perspective • Continuum of impact • Current CD4 situation • Existing POC challenges • Coordinated strategic response

  3. Procurement perspective • Overarching challenges: • Limited stakeholder coordination and communication regarding optimal use of diagnostic products • Limited strategic and long term planning for the integration of new POC products coming to the market place • Limited use of validated or accurate estimates of demand to inform deployment and work flow integration

  4. Continuum of impact Stakeholders Supply Chain Optimization Service Delivery Point

  5. PFSCM spend on laboratory commodities delivered through June 2012

  6. Optimization to reduce CD4 costs • Optimizing laboratory procurement Selecting and procuring the right product within the national tiered laboratory system, with an appropriate throughput and complexity, that is sustainable within it’s regional and local setting. • Strategy • Define the diagnostic coverage • Compare actual demand to capacity • Reduce instrument diversity • Increase utilization to reduce costs • Evidence based POC integration

  7. CD4: Finding the best cost / utilization FACSCount versus FACSCalibur utilization price per test Instrument Utilization Rate

  8. CD4 opportunities • Greater efficiency may be established by maximizing CD4+ instrument utilization rates. • Significant cost savings can be achieved by maximizing daily testing volumes per machine. • Important to develop appropriate instrument placement strategies before procurement. • Low-throughput point-of-care (POC) CD4+ testing platforms may contribute to lower costs per test.

  9. Existing POC Challenges • Lengthy and unclear introduction/validation process • Suboptimal instrument procurements and long term planning • Optimizing existing lab infrastructure • Evidence based POC integration • Long term impact not clearly understood • Instrument life span • Maintenance strategy development • Uptake – lessons learned

  10. Existing POC Challenges • Limited government, donor, and technical coordination • Competing priorities – treatment agenda (increased access) versus laboratory network development • Vendor pressures (misleading) • Logistics (SDP not lab) • Procurement, quantification, distribution, and maintenance

  11. Country X: PIMA POC example • Program expansion driven by PMTC programs • No MOH laboratory involvement • Existing warranties have expired • Maintenance costs to be negotiated (currently at $1,200/machine)

  12. Stakeholder relationships Governments and Local Partners REGULATORY DONORS PROCUREMENT UNITAID OGAC PRs/VPP MSF USAID GF WHO UNICEF SCMS CHAI FDA CDC TECHNICAL ASSISTANCE ASLM ADVOCACY

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