Cost efficiency through decentralised chronic medicine delivery: Economic implications of the central chronic medicines dispensing and distribution programme in South Africa
1
National Department of Health, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3619
ABSTRACT
INTRODUCTION:
Health systems globally are seeking cost-efficient models to manage the growing burden of chronic disease. Traditional facility-based dispensing is resource-intensive, contributing to congestion, staff burnout, and patient dissatisfaction. The Central Chronic Medicines Dispensing and Distribution (CCMDD) programme was designed to improve allocative efficiency by shifting stable patients away from routine facility visits, thereby reducing the direct and indirect costs of care delivery.
METHODS:
We reviewed national programme performance data (Quarter 3 2025/26) alongside operational reports to examine the economic impact of dispensing models and medicine supply intervals. The analysis focused on system-level efficiencies, specifically using "visits avoided" and "dispensing events reduced" as proxies for operational cost savings and workforce capacity relief.
RESULTS:
The programme supports over 3.7 million patients nationally. A critical driver of efficiency is the shift to multi-month dispensing, with 79% of patients now receiving three-month supplies. Combined with the 61% of patients collecting from external pick-up points, this model significantly reduces the frequency of facility attendance. This reduction in patient volume translates to lowered administrative and dispensing workloads at clinics, allowing healthcare workers to reallocate time to complex clinical care. While direct monetary savings vary by province, the reduction in dispensing events represents a substantial decrease in the unit cost of service delivery per stable patient.
CONCLUSIONS:
The programme illustrates how decentralized medicine delivery can generate meaningful cost efficiencies at scale without compromising quality. By reducing the frequency of facility visits, the model decreases the operational burden on the public health system, fostering a more sustainable use of finite human and financial resources. These findings support the inclusion of decentralized access models as a central pillar of long-term health financing and universal health coverage strategies.
Health systems globally are seeking cost-efficient models to manage the growing burden of chronic disease. Traditional facility-based dispensing is resource-intensive, contributing to congestion, staff burnout, and patient dissatisfaction. The Central Chronic Medicines Dispensing and Distribution (CCMDD) programme was designed to improve allocative efficiency by shifting stable patients away from routine facility visits, thereby reducing the direct and indirect costs of care delivery.
METHODS:
We reviewed national programme performance data (Quarter 3 2025/26) alongside operational reports to examine the economic impact of dispensing models and medicine supply intervals. The analysis focused on system-level efficiencies, specifically using "visits avoided" and "dispensing events reduced" as proxies for operational cost savings and workforce capacity relief.
RESULTS:
The programme supports over 3.7 million patients nationally. A critical driver of efficiency is the shift to multi-month dispensing, with 79% of patients now receiving three-month supplies. Combined with the 61% of patients collecting from external pick-up points, this model significantly reduces the frequency of facility attendance. This reduction in patient volume translates to lowered administrative and dispensing workloads at clinics, allowing healthcare workers to reallocate time to complex clinical care. While direct monetary savings vary by province, the reduction in dispensing events represents a substantial decrease in the unit cost of service delivery per stable patient.
CONCLUSIONS:
The programme illustrates how decentralized medicine delivery can generate meaningful cost efficiencies at scale without compromising quality. By reducing the frequency of facility visits, the model decreases the operational burden on the public health system, fostering a more sustainable use of finite human and financial resources. These findings support the inclusion of decentralized access models as a central pillar of long-term health financing and universal health coverage strategies.
| eISSN: | 2654-1459 |
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