The economics of medical drones
Authors: Timothy Amukele
Journal: The Lancet Global Health (2019)

Cargo drones emerged around 2014 as a new way to address the public health needs of victims of natural disasters as well as the approximately 2 billion people living in isolated communities worldwide.1WHOGlobal evidence on inequities in rural health care. Geneva: World Health Organization.https://www.who.int/gender-equity-rights/news/global-evidence-on-inequities/en/Date accessed: November 11, 2019Google Scholar, 2World Bank Open DataThe World Bank.http://data.worldbank.org/?display=graphDate accessed: November 11, 2019Google Scholar Yet, despite this massive public health potential, drones have not yet been widely adopted as a means of cargo transportation by hospitals, clinics, and other stakeholders in hard-to-reach places around the world. There are many reasons for the lack of adoption,3Amukele T Current state of drones in healthcare: challenges and opportunities.J Appl Lab Med. 2019; 4: 296-298Google Scholar but perhaps the most important is that the costs of acquiring and operating drones is unknown. In The Lancet Global Health, Walter Ochieng and colleagues4Ochieng WO Ye T Scheel C et al.Uncrewed aircraft systems versus motorcycles to deliver laboratory samples in west Africa: a comparative economic study.Lancet Glob Health. 2020; 8: e143-e151Google Scholar attempt to answer this question by comparing the costs of drones (referred to as uncrewed aircraft systems [UAS] in the Article) to those of motorcycles doing the same task of transporting laboratory specimens from remote clinics to central laboratory hubs in Liberia. The comparisons are the most thorough I have seen to date and were done under simulated conditions of a routine scenario and a public health emergency scenario (based on the 2013–16 west African Ebola virus disease epidemic). For both conditions, Ochieng and colleagues4Ochieng WO Ye T Scheel C et al.Uncrewed aircraft systems versus motorcycles to deliver laboratory samples in west Africa: a comparative economic study.Lancet Glob Health. 2020; 8: e143-e151Google Scholar used the real historical costs of the Riders for Health charity motorcycle fleet including distances travelled, fuel consumption, accident rates, breakdowns, and maintenance. For the drones, they assumed $15 000 acquisition costs, a 3000 h lifespan, 10% weather inoperability, as well as training, personnel, and other costs. Their findings were two-fold. First, per-sample transport costs were lower via motorcycle than via drones with an operational range of 65 km, in both the routine and the emergency scenarios. Second, longer-range drones (up to 100 km) had better geographical coverage and lower sample transport costs than shorter-range drones, low enough to rival those of motorcycles. These key findings are interesting but are not directly applicable for most readers because they are not generalisable. The reason is that the diversity and rapid evolution of transport drones obviates findings such as these that are based on the characteristics of a specific drone. For example, studying the economics of one type of manual bicycle is somewhat applicable to other manual bicycles, less so to battery-powered bicycles, and even less so to motorcycles. There is a similar issue here: if we, for example, examine drones targeted at the medical industry, there is more than a ten-fold difference in drone costs across the various suppliers (data not publicly available for commercial reasons) and this difference in price expands going beyond medical drones to other types of drones. Nevertheless, I find the article by Ochieng and colleagues to be valuable for two reasons. First, the diversity in cost and characteristics we see in the transport drone world will condense as the field matures. Second, the investigators have created something that is necessary for the rest of us who are considering medical drone transport: they have created a blueprint to undertake similar head-to-head cost comparisons. Thanks to the work of Ochieng and colleagues, other stakeholders will be able to replicate this kind of analysis for other drones, settings with completely different cost structures, and new transportation benchmarks such as cars or bicycles. I declare no competing interests. Uncrewed aircraft systems versus motorcycles to deliver laboratory samples in west Africa: a comparative economic studyGiven the current level of technology, purchase prices, equipment lifespans, and operational flying ranges, UAS are not a viable option for routine transport of laboratory samples in west Africa. Field studies are required to generate evidence about UAS lifespan, failure rates, and performance under different weather conditions and payloads. Full-Text PDF Open Access