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Roundtable #3: Franchise Initiatives
| Moderator | Zafrullah Chowdhury, Gonoshasthava Kendra (The People's Health Center), Bangladesh |
| Resource persons | Denis Broun, John Chalker, Michael Gabra, Liza Kimbo |
| Note takers | Ida Grum (lead), Paul Lalvani |
View the PowerPoint presentation online.
View the transcript of the presentation online.
Download the transcript of the presentation (PDF - 114KB).
Background and Issues
The development of a network of franchised private pharmacy outlets is based on the premise that its combination of large-scale procurement, product standardization, intense training, and close supervision of franchisees would successfully address many of the issues of poor access to essential drugs. A franchise mechanism would harness the incentives of the private sector to achieve the public health goal of access to high-quality and inexpensive essential drugs and dispensation services.
The purpose of this roundtable is to:
- Better define the franchise model for drug distribution and reproductive health
- Understand the potential and the limits of the franchise model for public health
- Analyze the factors that can lead to success or failure of franchise initiatives
- Identify the settings in which a franchise model can be introduced, and where it would not be possible to implement it
- Receive other comments and suggestions from participants on franchising and public health
Discussion Points
- To improve the access situation, a franchise needs to focus on the provision of essential generic drugs. How can one ensure that a franchise set up as a public health resource does not slip into making profit as its main goal, rather than serving the poor?
- Given the restrictions relating to the establishment of a successful franchise (e.g., size of population, price levels), what does a franchise require to serve the very poor?
- When a franchise moves from a pilot to a full-scale operation, who are its likely detractors (public and private) and how can they be brought on board?
- Can a public health franchise work through retail pharmacies and still serve the poor? Or does it need to be limited to small "informal" outlets?
- How is it possible to avoid establishment of competing for-profit franchises that build on the good will of true public health franchises, thereby deceiving customers and possibly not offering high quality drugs and services?
- How does a franchise of private retailers interact with public sector facilities? How does it relate to "pharmaceutical inspection"?
- Franchises provide retailers an increased level of power in dealing with manufacturers and wholesalers. How can potential hostility from manufacturers and wholesalers best be dealt with?
- When a franchise is "for profit," it may drift towards serving wealthy patients, and when it is "not for profit," it may have difficulty attracting investors and financing the opening of new outlets. Which approach is most likely to contribute to increased access of essential medicines?
- Is it possible to define a set of criteria that can be applied to help determine when a franchised network of outlets or health facilities represents the best option to improve access and performance?
- Is it possible to identify situations where it is impossible to organize a franchise for health facilities or drug outlets? What are the major obstacles?
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