Please send any questions you may have and we will save them for a Q&A at the end. Thanks!

Please what is the profile of clients who generally prefer this DDD model?

Thanks for informative presentations.Do the Decentralized 'ATMs' serve patients nearest to the ATMs?Are all the machines specifically for ARV drugs refills?If yes,how were the issues of stigma addressed.

Our MoH is worried of sending ARVs to private pharmacies because there is fear that they will be sold to max profits. How are you ensuring that this does not happen? What has been your experience?

How do patients interface with the online aspect of this - is there an app or is it all via SMS? can patients schedule their own pickups or access telemedicine services?

We have not had a case of private pharmacies selling government ARVs. Pharmacies are carefully selected with involvement of government and professional/regulatory authorities

The Private pharmacies sign an MOU clearly stating the roles and responsibilities of each party

Is their a motivation given to private pharmacies to participate in the program or is it purely voluntary i.e.How do private Pharmacies benefit given that they are profit driven

The DDD app is used to track both patients and drugs sent to the pharmacy. The pharmacy does not have control on who to dispense the ARVs to because the patients are referred from the facility therefore it is easy to track

Are there plans to incorporate other NCDs into the automated dispensing so that patients will have multiple services

Any cost to the patient in automated dispencing model or pickup units?

The pharmacy will report the drug consumption based on the number of patients that have been devolved them. In addition the patients are properly sensitized in that they will report back to the facility incase they go to the pharmacy and do not receive their drugs or asked to pay more

Patients accessing ART on automated system how are they linked to clinicians if they develop opportunistic infections?

Any cost to the patient while using pick up units?

In addition EpiC organizes regular review meetings between the hub and its linked pharmacies to provide feedback

if we could talk more about financing overall, who is paying for which aspects, if there is a fee to the patient, if there is anything paid to incentivize the pharmacies, how mechanics maintenance checks are paid for, etc.

For the business case - did you do any sensitivity analyses or look at how to optimize the model? For instance did cost savings really increase through integrating additional chronic care meds (besides ARVs)? What might make it even more cost-effective?

are presentations going to be shared

How do you treat clients who miss to pick up drugs at designated points and how does feedback get to the clinicians at the facility?

i guess patients from different facilities could pick drugs from one unit. How does the patient level data link to their respective patient medical records in their respective primary care facilities for the facility to report the patient as active or currently on treatment

Thank you for the great presentations. Along the lines of Jemutai's question (above), can Phil walk us through what happens when a patients fails to pick up their meds? What happens to those meds?

Is will be possible to share with us documentation and tools (forms) that are using in countries where DDD are running pretty? Thanks

Many thanks to Sarah and all the presenters. This was very informative. I have to drop off for another meeting. Please kindly share the presentations

@Christian, the recording, slides and Q&A will be shared together with the registration link for the next session

I guess this platform , if a stand alone ,requires regulatory approval in a country just the way clinics,hospitals, private Pharmacies are licenced to operate ?

How did you integrate pre existing EMRs and electronic systems for logistics and supply chain to achieve the fully automated system?

Hi @ SCH - Patients are sent SMS’s 2 days before the parcel reaches the PUP,another reminder when it arrives and another reminder after 2 days if they haven’t collected.At this point the Public Health facility that is responsible for the Patient is also advised and they will attempt to trace him/her .After 7 days the medicines are returned and the patient will revert to the healthcare facility to receive their meds.Defaulters are less than 1%

how do we ensure that community pharmacist don't see automated pharmacies as threat to their survival

Have you considered setting up more of machines in public health facilities like create rooms for automated dispensing within a facility

Given the ATM is much higher upfront cost, what are its advantages over the lockers?

@jemutai - this exists in some of our supported hospitals & Clinics in SA - more info on these installations available at www.right-epharmacy.co.za

Thanks Tawanda

Your patient data looks to skew older and more female than the PLHIV population - any idea why that's the case?

Thank you presenters and all for really great presentations and participation. We apologize for the delay in opening the session. Please look out for the slides that will be shared and don't forget to register for the next session in two weeks.

To register for the next session, please click here: https://zoom.us/webinar/register/WN_H9z0GqPpRxiQtHMoeuwg3g

Thank you all!

thanks you all