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

The Supply Chain Management System (SCMS) is a contract managed under the Partnership for Supply Chain Management consortium by the United States Agency for International Development. SCMS procures commodities for programmes supported by the US President's Emergency Plan for AIDS Relief (PEPFAR). From 2005 to mid-2012, PEPFAR, through SCMS, spent approximately $384 million on non-pharmaceutical commodities. The purpose of this article is to highlight the cost differences between low, medium and high utilisation rates of common CD4 testing instruments that have been procured though PEPFAR funding. A scale of costs per test as a function of test volume through the machine was calculated for the two most common CD4 testing machines used in HIV programmes: Becton Dickinson (BD) FACSCount and BD FACSCalibur. Cost analyses indicated that a target of at least 40% utilisation for FACSCount and 15% utilisation for FACSCalibur, respectively, closely approach maximal per-test cost efficiency. The average utilisation rate for CD4 testing instruments varies widely by country, level of laboratory and partner.