Determine what quantity of LPV/r pellets to initially send to facilities where they are being rolled out.
Successful LPV/r pellet rollout requires having an appropriate amount of product available at health facilities. Ideally, delivery of initial LPV/r pellets supplies to facilities should take place at the time of, or soon after, training of health care workers on LPV/r pellets, and just before pellets dispensing should begin.
Example: Service providers who are trained in March should get their supplies in March or April to begin dispensing in April or May, respectively. Also consider providing the initial supply quantities to the service providers at the training workshop; then they can return to their sites and begin dispensing immediately after training.
Initial supply quantities to facilities should take into account their maximum and minimum stock levels and expected average monthly consumption. Resupply quantities will be determined according to normal procedures for calculating resupply requirements.
Example: Based on the number of patients who currently use LPV/r and are expected to switch to LPV/r pellets, the estimated average monthly consumption at a single facility with 25 patients may be 50 bottles per month. The facility's maximum stock level is 4 months of stock. The initial supply of LPV/r pellet capsules should be 50 bottles x 4 = 200 bottles.
Specific Questions to Consider when Planning Distribution
Initial Supply Quantities
- For the initial quantities that will be given to each facility, what is the expected average monthly consumption?
This can be determined by calculating how many patients per month will receive LPV/r pellets during the first few months after LPV/r pellets are introduced, and should take into account:
- What portion of current LPV/r patients will be switched to LPV/r pellets.
- Number of new patients who will be initiated directly on LPV/r pellets.
If the facility is already receiving other antiretrovirals:
- It is important to consider the amount of storage space the pellets will occupy, since many facilities have limited storage space.
- Can the delivery of LPV/r pellets be included within the normal delivery schedule of other products and still be available in time for use?
- Will you need to schedule an extra delivery of LPV/r pellets outside of the normal delivery schedule, in order for the LPV/r pellets to be available in time for use?
- If the initial distribution of LPV/r pellets will be done outside of the normal delivery schedule, are adequate transportation resources available to make the extra deliveries, without disrupting the normal delivery schedules?
Example: If facilities normally receive their supplies monthly, then you should be able to include the initial supply of LPV/r pellets along with the other products that the facility receives. Ensure that the supply quantity calculations are completed in plenty of time, so that the LPV/r pellets are ready to distribute with the normal delivery schedule and without disrupting the schedule.
- What strategy will you use to begin collecting LPV/r pellets supply and consumption data (and patient data)?
- Plan to develop new stock cards at each storage level to keep track of LPV/r pellet inventory.
- Will LPV/r pellets consumption data be collected on an existing logistics management information system (LMIS) form?
- If yes, will a new LMIS form be printed that includes LPV/r pellets, or will they be added manually to an existing form?
- If LPV/r pellets cannot be added to a revision of an existing form (and the new version distributed to all relevant service delivery points), is there adequate space on the existing form to manually add in LPV/r pellets?
- If the LMIS form is electronic, can the new formulation be added to the form?
- Service providers will need to receive any new or supplemental reports/requisition forms at the time of their training or very soon after, so that they can start collecting data as soon as they start dispensing.
- Facility Level Initial Requirements Tool: This tool calculates the initial supply of LPV/r pellets to deliver to individual facilities. Subsequent deliveries will account for changes in consumption patterns through the normal resupply calculation system.