SCMS Quantification

Publication date: 2007

Quantification Accurately forecasting the need for life-saving medicines and supplies Accurate quantification for HIV/AIDS care and treatment programs—estimating the quantities needed and planning procurement for appropriate pharmaceuticals and supplies—is essential to ensuring that patients receive a continuous supply of medi- cines. The Supply Chain Management System (SCMS) develops harmonized national forecasts of needed products and shares this information with our donors and other stakeholders. The result is a systematic, coordinated response that helps ensure the effective use of resources. The Challenge Many countries lack a clear picture of the medicines and supplies required as part of the national scale-up of HIV/AIDS prevention, care and treatment programs. Producing an accurate quantification poses several chal- lenges, including the following: • Ensuring stakeholders reach consensus on assump- tions (e.g., the rate of scale-up for people receiving treatment) • Collecting reliable treatment data, including the proportion of patients prescribed each regimen and past usage of HIV/AIDS commodities • Correctly and efficiently using appropriate, best practice tools for quantification Poor estimates can result in drug shortages, dangerous interruptions in treatment, expensive emergency ship- ments or inappropriate drug substitution. Over- estimating can tie up precious financial resources and storage space and can increase the risk of expired stock, waste, theft and diversion. Meeting the Need SCMS works closely with stakeholders, including host governments, program managers, donors and recipients, to accurately quantify the commodities needed to meet short- and long-term program goals. Our approach can be tailored to the program or national level. Training, mentoring and sharing best practices will help increase the capacity of host govern- ments, program managers and recipients for conducting quantification and for supply planning. To ensure effective forecasting and supply planning, SCMS takes the following steps with our in-country partners: Step 1. Determine scope. We determine and document the scope of the quantification by addressing several ques- tions: What will be procured (e.g., pharmaceuticals, test kits, supplies)? What level—program or national—will the procurement support? What patient group(s) will be treated? During what time? Step 2. Identify data elements. Next, we identify data needed for the quantification, including details of standard treatment guidelines, product selection, past consumption, estimated costs and numbers, and per- centages of patients on each regimen. Assessing whether the available data are sufficient and reliable is an impor- tant part of this step. Step 3. Agree on assumptions. We coordinate with our clients and stakeholders to reach consensus on the key assumptions needed for forecasting, including fac- tors such as rate of new patient recruitment, health program capacity, changes in standard treatment guide- lines and products used, attrition rates, and percentage of patients needing to switch to second-line treatments. Step 4. Validate assumptions. In partnership with clients and stakeholders, we review all assumptions to ensure they are appropriate based on patient data, his- torical program consumption data and expert opinion. In the absence of country- or program-specific data, evidence from other programs can be used as a proxy. Step 5. Create and analyze forecast scenarios. Next, we enter data representing the key assumptions into a desktop software tool that is best-in-class— Quantimed—to generate forecast scenarios. We then determine an optimal scenario with the client using scale-up capacity while taking into account budget and number of clinicians or nurses available. Scenarios and assumptions are reviewed and modified as needed. Step 6. Generate supply plan. The forecast data from Quantimed are transferred into another best-in-class software tool—PipeLine—to generate a supply plan. Using inventory on hand, amount of buffer stock desired and total lead time to procure products, this tool shows the optimal procurement and delivery schedule. Step 7. Validate supply plan. We validate the supply plan with stakeholders and refine it as needed, taking into account sources of funds for the quantities to iden- tify gaps or overlaps in resources. Step 8. Share national-level quantifications. The process does not stop when the supply plan is com- pleted. We also prepare and, where authorized, share national-level quantifications with national and interna- tional stakeholders to better coordinate and plan efforts that meet all programs’ needs while preventing duplica- tion. Information from national forecasts can be combined to produce an increasingly useful global pic- ture of commodity needs. Step 9. Conduct quarterly review. SCMS and the stakeholders review all assumptions and update the fore- cast and supply plan on a quarterly basis. Step 10. Analyze forecast accuracy. On a yearly basis, we review the accuracy of forecasts with clients and stakeholders to determine future assumptions and planning. Sustained Benefits Effective quantification supports programs by ensuring product availability and by minimizing the need for costly emergency shipments. It also facilitates pooled procurement (consolidating orders to buy in larger vol- umes), which further reduces prices. Our systematic approach to quantification contributes to the knowledge base of HIV/AIDS epidemiological trends and program metrics in the countries where we work. This approach also helps to identify any gaps in essential data. Where gaps are found, we can assist in- country partners in developing systems that collect the necessary information. Additionally, quantification addresses one potential ma- jor constraint to scale-up: ensuring that sufficient quantities of products are manufactured. When pre- sented with forecasts that are based on sound metho- dologies and carefully considered assumptions, vendors can have greater confidence in the estimates, can use the information for their production plans and can invest in new manufacturing capacity where needed. ABOUT SCMS The Supply Chain Management System (SCMS) was established to collaborate with in-country and global partners to ensure a reliable, cost-effective and secure supply of high-quality medicines and health products for HIV/AIDS prevention, care and treatment. SCMS is funded as part of the US President’s Emergency Plan for AIDS Relief through the US Agency for Interna- tional Development. Visit www.scms.pfscm.org or write to scmsinfo@pfscm.org for more information. The author's views expressed in this publication do not necessarily reflect the views of the US Agency for International Development or the United States government. 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