Last Mile Dispensing Distribution Collection of Medicines Fanie

Last Mile Dispensing, Distribution & Collection of Medicines Fanie Hendriksz (BPharm NWU) Managing Director – Right e. Pharmacy

Healthcare Challenges: Public Sector High Demand Shortage of Pharmaceutical Services Limited Infrastructure Medicine Availability Manual Patient Information Records Overburdened Facilities Patient Experience Negative Economic Impact Negative Impact on Adherence Poor Healthcare Outcomes

Products, Projects & Innovations

Methodology: 5 PDU TM Sites • Location: Peri-urban Community Shopping Centres. Alexandra Township, Diepsloot Township, Soweto & Mangaung • Dispensing & Counselling Capacity: 19 PDUTMs – 80 patients/hour • Average Collection Time: <3 minutes (2 months supply & consulting) • Extended Operating Hours: Extra 80 hours/month Weekdays: 07: 00 - 18: 00 Weekends & holidays: 09: 00 - 14: 00 • Adherence Support: Remote Tele-pharmacy Automated SMS notification reminders • Level of Care: Chronic medicine – Primary Health Care (PHC) Condition specific capability

Outcomes: Dispensing Trends (All Sites) Update – end Apr 2019 Patients & Repeat Dispenses Patient Collections 85 684 Repeats Dispensed 171 368 6616 7215 7288 91. 3% last 12 months 6801 95% 97% 95% 94% 93% 93%91% 93% 94%92% 91% 90% 91% 88%91% 85% 5347 4828 4635 4433 PDUTM Collection Compliance Mar- 19 Apr- 19 4608 Oct- 17 Nov- 17 Dec- 17 Jan- 18 Feb- 18 Mar- 18 Apr- 18 May- 18 Jun- 18 Jul- 18 Aug- 18 Sep- 18 Oct- 18 Nov- 18 Dec- 18 Jan- 19 Feb- 19 Mar- 19 Apr- 19 5636 2818 Oct- 17 Nov- 17 Dec- 17 Jan- 18 Feb- 18 Mar- 18 Apr- 18 May- 18 Jun- 18 Jul- 18 Aug- 18 Sep- 18 Oct- 18 Sep- 17 Aug- 17 Jul- 17 Jun- 17 May- 17 Apr- 17 146 50 73 25 Mar- 17 Feb- 17 Jan- 17 148 64 74 32 5142 2571 3598 1799 2526 2408 1263 1204 1642 821 566 312 283 122 160 156 80 61 6973 6269 Nov- 18 Dec- 18 6380 3190 Jan- 19 Feb- 19 28 459 Unique Patients 14430 14576 13946 13602 13230 12 538 10 694 9126 9656 9216 9270 4563 8866 Technical Maturity & Testing Phase Peak Dispensing Times 30% 22. 2% 23. 3%18. 1% 19. 6% 5. 5% Sat Thur Wed Tues Fri 8. 1% 3. 3% Mon 17: 00 -18: 00 16: 00 -17: 00 15: 00 -16: 00 14: 00 -15: 00 13: 00 -14: 00 12: 00 -13: 00 11: 00 -12: 00 10: 00 -11: 00 09: 00 -10: 00 08: 00 -09: 00 % Patients 20% Collecting 10% Sun 500 400 300 200 100 07: 00 -08: 00 Patients Collecting Most Popular Collection Day

Outcomes: Patient Demographics (All Sites) 85 684 Patient Collections 68% 1% First Line ART OTHER 2% Second Line ART 22% NCD 69% First Line ART FDC 32% Gender Distribution Nationality 87. 3% 10. 4% 1. 1%. 2% Therapeutic Categories Dispensed Other conditions covered include: South African Zimbabwean Botswana Mozambican Swazi - Asthma - Hypertension - Diabetes Mellitus Type 2 - Hyperlipidaemia - Epilepsy - Gout - TB Prophylaxis

Outcomes: Dispensing Trends (All Sites) Collection time < 3 min/dispense (2 Months supply) Patient Collections Unique Patients Repeat Dispenses 85 684 28 459 171 368 Collection Rate 91. 3% Collection Compliance 96% over a 24 month period Total Items Dispensed : 223 282 Average Items/Script 1. 67 over a 24 month period Calls Answered via Tele-pharmacy 122 397 Tele-pharmacy Reach 430 km Official Languages 11 over a 22 month period

Product Manufacturer Split: Dispensed Items (All Sites) ASPEN 37% MYLAN 14% CIPLA 13% AUSTELL 11% SONKE 4% ADCOCK 4% RESMED 3% ACCORD 2% ABBVIE 1% BIOTECH 1% other 10%

PDU Benefits: TM Before Location Convenience Optimised Process Efficiency Electronic Patient Records Electronic Inventory Management Personalised Labelling After Before Dispensing Accuracy Improved Capacity Patient Adherence Monitoring & Retention In Care Economic Benefits Quality Patient Care After

Collect & Go Smart Locker TM

Collect & Go Smart Locker TM Patients Benefits • • • Improved patient adherence Convenience and easy to access 24 x 7 (limited by facility) Automated SMS reminder service Call Centre support Last Mile Benefits • • • Optimised supply chain management Accurate & live commodity tracking (Supply Chain) Dashboard (Parcels, Delivery vehicles, Commodities) Controlled Reverse Logistics Software and mobile App integration Low cost scalability

Right e. Pharmacy Footprint Thembalethu ARV Clinic: (Jhb) In Pharmacy Automation Steve Biko Academic Hospital: (Pta) In Pharmacy Automation Helen Joseph Tertiary Hospital: (Jhb) In Pharmacy Automation Alex Plaza: Alexandra Township (Jhb) 4 PDUTM s Soweto - Ndofoya Mall: (Jhb) 5 PDUTM s Soweto - Bara Mall: (Jhb) 3 PDUTM s Diepsloot: Bambanani Mall: (Jhb) 4 PDUTM s Twin City Mall: (Free State) * Mangaung: Integrated 2 PDU s, CDU & PCU Solution TM (Zambia) * Ndola: CDU TM TM TM 150 PCUTMs for Gauteng (25 sites) 250 PCUTMs for Gauteng, Free. State, Mpumalanga (39 sites) *Not Shown on Map

“ Without Innovation and Collaboration, We Cannot Advance” Right e. Pharmacy Thank You