Sustainable Innovations: The Revolving Fund Pharmacy

Eldoret RFP with the staff

The revolving fund pharmacy (RFP) model was initiated with the hope of improving access to essential medicines in rural health facilities. The RFPs provide back-up supplies of crucial medications in the event that pharmacies in government health facilities stock out of them. Patients purchase the medicines from the RFPs when those medicines are not available in the government pharmacy, and the money collected is used to restock the pharmacy thereby ensuring continuous availability of essential medicines and eliminating life-threatening shortages of medicine. The prices of medications at the RFPs are slightly higher than the government pharmacies, making it the second place a patient would try, but are much lower than in private pharmacies.

The RFP model has been implemented at three AMPATH primary health care sites and the AMPATH Centre in Eldoret. In addition, a smaller-scale version has also been implemented for chronic disease medications within 25 dispensaries and 2 sub-district hospitals. More than 55,000 patients have benefitted from the RFPs across these sites. One such patient is Pamela, who has been visiting the Turbo Health Centre Chronic Disease Clinic for the past two years since she was diagnosed with diabetes. Ensuring that she always had her medications was never easy given her financial restrictions as a single mother. Moreover, the government pharmacy at the health center was almost always stocked out of the medications she needed, and so she was often forced to spend less on essential items like food for her children and herself in order to purchase her medications at costly private pharmacies. But now she has a reason to smile when she talks about how the new revolving fund pharmacy at Turbo has helped her. She has been able to buy her diabetes medications from the pharmacy at almost half the cost she would have spent in a commercial pharmacy in town. She no longer worries about how she is going to pay for her next prescription refill.

AMPATH only provides a seed stock of medications for the first three months of operation, after which each RFP is expected to be self-sufficient using the funds collected from the sale of the medicines. All the RFPs have shown sustainability and are completely independent of donor funding. In some of the pilot sites, the income from the RFP has been able to support improvement of services in other areas of the health facility such as laboratory, dental, nursing, stores etc. The pharmacy team has recently been awarded a grant from Grand Challenges Canada to expand this model to 8 other sites within the AMPATH catchment area.