P47.04
Background: In financially constrained research settings, it is critical to explore and implement methods for optimising resource allocation. The Wits RHI Clinical Research Site was renovated with the explicit intention of accommodating multiple concurrent studies under one roof, reducing duplicative effort and maximising resource use while providing quality care to the population it serves. Key to the design efficiency has been centralisation of pharmacy services across several studies. While clinical services are often study-specific, pharmacy services provide broad coverage and can be shared.
Methods: The Wits RHI Research Centre Pharmacy services several ongoing studies including MTN 020, MTN 015, MTN 016, HARP and HIM-SA. Operational expenses are fixed regardless of the number of studies serviced by the pharmacy. While only MTN 020 is an Investigational New Drug (IND) study, participants enrolled in all five studies are provided with non-IND medications by the pharmacy. The fixed operational expenses of this multi-study pharmacy were investigated for 2013 by reviewing expenses incurred for staffing, pharmacy licence, electricity, maintenance, calibrations and temperature monitoring.
Results: The fixed operational costs for the pharmacy were±R800 000 (±$80 000). If an additional pharmacy was established, operational costs would be approximately doubled, as most of these costs would be duplicated. By sharing pharmacy services, the consequent economies of scale are significant, where cost per unit of work output decreases with an increase in scale as fixed costs are spread out over several studies and operational efficiency is increased.
Conclusions: Centralisation of Pharmacy Services significantly reduces costs when the service is shared across multiple budgets. It also allows for the rolling over of studies, where new studies can start before older studies have ended and staff can be retained. In addition, it reduces study staffing requirements, as pharmacy staff can be cross-trained on all studies.
