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CLICK TO ADD TITLE. The 5th Global Health Supply Chain Summit November 18 -20, 2013 Addis Ababa, Ethiopia. Understanding Distribution of Medicines to Private Sector Drug Shops and Pharmacies Prashant Yadav. [SPEAKERS NAMES]. [DATE].

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  1. CLICK TO ADD TITLE The 5th Global Health Supply Chain Summit November 18 -20, 2013Addis Ababa, Ethiopia Understanding Distribution of Medicines to Private Sector Drug Shops and Pharmacies Prashant Yadav [SPEAKERS NAMES] [DATE]

  2. Understanding Distribution of Medicines to Private Sector Drug Shops and Pharmacies • Prashant Yadav, Jessica Cohen, Jean Arkedis, Sarah Alphs, Pete Larson, Julius Massaga, Oliver Sabot

  3. Tanzania: Understanding Remote Distribution N = 356 accredited drug shops Inventory and stock audits every other month for 12 months 3

  4. How do the drug shops obtain their medicines?

  5. Where do the drug shops obtain their medicines?

  6. Road, trade networks and product availability

  7. Understanding product diffusion in remote areas Source: Yadav P, J. L Cohen, S. Alphs, J. Arkedis, P. L Larson, J. Massaga and O. Sabot. Trends in availability and prices of subsidized ACT over the first year of the AMFm: evidence from remote regions of Tanzania, Malaria Journal 2012, 11:299

  8. Understanding product diffusion in remote areas Source: P.S. Larson, P. Yadav, J. L Cohen, S. Alphs, J. Arkedis, J. Massaga Stocking Patterns, Market Competition, and Customer Demand of Subsidized ACTs in Private Drug Shops in Tanzania. 2012

  9. Traditional measures of competition do not help understand stocking behavior Traditional measures of competition do not help understand stocking behavior Source: P.S. Larson, P. Yadav, J. L Cohen, S. Alphs, J. Arkedis, J. Massaga Stocking Patterns, Market Competition, and Customer Demand of Subsidized ACTs in Private Drug Shops in Tanzania. 2012

  10. New models for understanding retail competition in a network Competition/Wholesaler Network. Colors represent city of supplier, size represents degree of centrality (number of connections each shop has with other shops through perceived competition) Source: P.S. Larson, P. Yadav, J. L Cohen, S. Alphs, J. Arkedis, J. Massaga Stocking Patterns, Market Competition, and Customer Demand of Subsidized ACTs in Private Drug Shops in Tanzania. 2012

  11. New models for understanding retail competition in a network Source: P.S. Larson, P. Yadav, J. L Cohen, S. Alphs, J. Arkedis, J. Massaga Stocking Patterns, Market Competition, and Customer Demand of Subsidized ACTs in Private Drug Shops in Tanzania. 2012

  12. Other issues impacting private sector medicine availability and price

  13. Understanding retail competition (or lack of) Source: Joint study with CHAI and UNZA in Zambia

  14. Retail competition impacts retail markups and thus sales volume P value = 0.0854 Study of over 100 outlets in 4 districts in Zambia • Stocking your product in a wider number of retail outlets helps reduce retail markups

  15. Incentivizing distributors to distribute to underserved markets • Many new models such as • Consolidated drop-off point, • Van sales, • Coca-Cola like MDC • allow wholesaler distribution to small shop clusters at reasonable costs • Demand aggregation with technology Wholesaler distributes Wholesaler distributes

  16. Access to capital constraints at the retail level P. Yadav, L. Smith & S. Alphs 2012. Enhancing Access to Medicines through Innovations in Working Capital Financing for Drug Shops. Technical report for SDSI, MSH

  17. Lack of working capital in the overall system 30-45 Days Letter of Credit • Higher Working Capital Needs • Lower Product Availability • Higher Prices • Lower Sustainability Delivery - 30 Days Credit Cash &Carry / Cash Van Sales

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