# \[e-drug\] Allocation formula for essential medicines (4) **URL:** \ **Category:** e-drug\ **Created:** [April 16, 2013, 5:48pm UTC](https://talk.edrugplus.org/t/e-drug-allocation-formula-for-essential-medicines-4/38842 "2013-04-16T17:48:05Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Libby\_Levison](https://avatars.discourse-cdn.com/v4/letter/l/e5b9ba/32.png) [@Libby\_Levison](https://talk.edrugplus.org/u/Libby_Levison)\ **Post date:** [April 16, 2013, 5:48pm UTC](https://talk.edrugplus.org/t/e-drug-allocation-formula-for-essential-medicines-4/38842/1 "2013-04-16T17:48:05Z")
E-DRUG: Allocation formula for essential medicines (4) ----------------------------------------------------- Dear Donna, If I understand your question correctly, you are looking for advice on how to share out a limited quantity of supplies, when your available stock doesn't match the quantity requested by the health facilities. In my experience, this is a hard problem which is not often discussed and requires some serious planning on the part of the organization filling requisition orders. If they fill requisitions in alphabetical order of health facility name, then facilities with names later in the alphabet won't get their full order. If they fill requisitions in the order they arrive, then a facility that didn't have transport or a working phone, and couldn't send the requisition in on time, might lose out on supplies. It's not an easy decision, and I think that this is a policy decision that has to be included when planning the supply chain. In addition to deciding how to do this allocation, I think that a system to track what was not delivered (the back orders) could also be discussed. That said, I have two real world examples for you. Example 1. I worked for several months in an HIV/AIDS project in Bukavu, DR Congo, in the project Warehouse (it was a small warehouse). There were 12 clinics that had to be supplied from the Warehouse. The program was lucky to have a pharmacist running the warehouse. He had been in the job for 3 years and knew from experience approximately what each site used on a monthly basis. When it came to filling requisitions, he could adjust the allocation of low stock level items based on his experience and the patient load at each clinic. So when he was short on amoxicillin 250mg tablets, he said: Stock on hand: 12 bottles x 1000 tablets/bottle Clinic A: 400 patients Clinic B: 200 patients Clinic C: 20 patients And his allocation was: Clinic A: 6 bottles Clinic B: 3 bottles Clinic C: 1 bottle (because he didn't open bottles) Warehouse: 2 bottles It is important to point out that all three clinics were within 1 hour of the warehouse, and there was semi-reliable transportation and a radio/phone, so he could relocate more medicines within a day if necessary. The question is, could this scale to a country-wide program? Example 2: The Department of HIV and AIDS in Malawi is responsible for distributing ~30 HIV/AIDS medicines and OI commodities to ~650 health facilities across the country. This includes first- and second-line ARVs. The Department had concerns about putting full buffer stocks of slow-moving items at all 650 health facilities, because of concerns some might expire. What they did was to identify about 50 larger facilities (they call them "hubs") that would hold the buffer stocks of these lower-demand, slow-moving items. If a health facility needed one, the health facility could contact any hub in their area and ask for it. Any stock transfer had to be reported to the capitol (sometimes quite hard).     Also, just to be honest about this, the hub provided the missing supplies on a first come, first served basis -- I'm not sure I would call it allocation. But it was a new way to preposition stock closer to the facilities, without having to build additional storage depots. Maybe there's an idea in there that you can apply to your situation. I hope that some of this is helpful to you. I do apologize for the length of this email. Kind regards, Libby Levison Independent consultant, medical logistics libby@theplateau.com