Direct Relief International, based in Goleta, has been ranked by Forbes magazine as one of the 20 most efficient large charities in the United States in the magazine’s 13th annual ranking of the 200 largest American charities based on private support.

Forbes’ annual rating of the 200 top American charities calculates three major efficiency ratios for each nonprofit: charitable commitment, fundraising efficiency and donor dependency. Direct Relief received a perfect score of 100 percent in fundraising efficiency for the ninth time in the past 10 years and a 99 percent score for charitable commitment.

Forbes noted that the organizations included in the top 200 list represent less than 2/100th of 1 percent of the more than 1 million tax-exempt organizations in the United States.

The rating of Direct Relief is based on its 2011 fiscal year, during which the organization responded to emergencies both in the United States and around the world, expanded its support within the United States for uninsured, low-income patients to receive free medications, and worked to improve maternal and child health in developing countries.

Direct Relief is the only nonprofit in the United States to be licensed to distribute prescription medications in all 50 states, and it works with more than 1,000 nonprofit clinics and community health centers to furnish free medications to low-income, uninsured patients.

The organization was recently awarded the 2011 Peter F. Drucker Award for Nonprofit Innovation for networking disparate nonprofit health facilities together, enabling much more efficient distribution of medications and supplies for people in chronic need as well as in emergencies, such as the tornado in Joplin, Mo., six months ago to which Direct Relief responded immediately with needed vaccines, medications and emergency supplies.

Click here for the complete list. Click here to view the full list ratings and methodology.

— Kelley Kaufman is the communications manager for Direct Relief International.