Translating medicines to patients: A novel methodology for quantifying the global medical supplies and donations program

BACKGROUND: International medical donation programs can help alleviate the burden of illness and serve as a safety net for the global health care system. However, to our knowledge no studies have assessed the number of individuals served through medical donation programs. As such, this study aimed to evaluate the impact of the Americares Foundation’s (Americares) medical donation program in terms of the number of patients served. METHODS: We conducted an outcome evaluation study in 34 health facilities in 10 countries that receive medical donations from Americares. Medical records were randomly sampled at each participating facility and evaluated for types of medications and number of courses of prescribed treatments. Facility level data and donation inventory data were also collected. We developed an algorithm for converting quantities of donated medicines into the number of individuals served at the facility level. These estimates were then extrapolated to the country and region levels to assess the total impact of medications donated in 2015. Probabilistic sensitivity analysis was conducted to derive 95% credible ranges for projected estimates and to assess model uncertainty. RESULTS: Records of 3,205 unique patients were reviewed, encompassing 10,449 medical visits. The average number of medications and courses of treatments prescribed per visit were 2.63 and 2.68, respectively. The average medication destruction rate ranged from 0% to 24% at facilities, with a cross-country average of 7%. For the 10 countries included in the study, we project that 700,377 unique individuals were served through the program (95% credible range: 518,401–905,982). Scaled across all regions receiving Americares donations, we project that the program supported an estimated 5.1 million beneficiaries, including 484,188 chronic care and 4.65 million acute care patients. CONCLUSIONS: This study provides a novel methodology for medical donation programs seeking to estimate one of their key outcomes—patients served—and global reach. Rigorous assessments of program outcomes can provide important insights into the value of medical donation initiatives. TRIAL REGISTRATION: Human subjects approval was received from the University of Washington Institutional Review Board (Approval #52316; 7/19/2016).