Thursday, June 9, 2022

Ramifications of Pharmaceutical Supply Chain Challenges

By: Ranier Simons, ADAP Blog Guest Contributor

The COVID-19 pandemic has globally brought awareness to many aspects of daily life that previously remained in the shadows, discussed only by select groups of people in siloed industries and centers of knowledge. A spotlight has been shone on food insecurity, lack of infrastructure to effectively manage global public health crises, inequalities regarding social determinants of health, and supply chain issues affecting everything from housing building materials to Starbucks menu ingredients. One serious supply chain pain point is the pharmaceutical supply chain. Drug supply chain issues are more than just an inconvenience, and they can lead to grave harm or death.

The Drug Supply Chain
Photo Source: theworldcreate.net

Drug supply chain issues come in many forms: production limits, storage, and distribution problems, reduced shipping capacity, and even transportation problems.[1] These problems lead to drug price inflation, the proliferation of counterfeit drugs, the dissemination of contaminated or poorly manufactured drugs, and even extreme shortages, leaving people without needed pharmaceuticals.

Zebra Technologies Corporation conducted a study called the Pharmaceutical Supply Chain Vision, releasing the results on February 8, 2022. The company specializes in technological solutions to workflow concerns. Zebra surveyed over 3,500 patients and pharmaceutical executives to gauge perceptions of the drug supply chain in terms of its resilience, responsibility, and trust and examine ways to improve visibility and transparency.[1] 

The most important issue identified by patients regarding drug supply chain issues is the quality of the pharmaceuticals. Ninety percent desired a guarantee that their medications were not counterfeit, were stored at correct temperatures, and had not been tampered with.[1] Eighty percent of the patients desired to know the country of origin of their medications and the manufacturing standards of those countries.[1] Other significant concerns were drug affordability and shortages. Many reported that their needed medications were often out of stock, and 69% said they feared taking the improper dosage due to misleading or incorrect label information.[1] Seventy percent reported changing medications, pharmacies, or healthcare providers due to drug supply chain issues.[1]

It is of the utmost importance to keep medications safe throughout the supply chain. Patients, healthcare professionals, and pharmaceutical executives agree that transparency and traceability in the drug supply chain are potent solutions to many present problems. Technology can be leveraged to provide tracking of medication shipments, pharmaceutical production workflow from raw material to final product, and even improvements in the ways drugs are produced. 

The only way to improve the status quo is a group concerted effort to report and gather the data. This sort of data needs to be in publicly accessible databases. These databases would bolster consumer confidence as well as enforce accountability for those along the supply chain. The National Academies of Sciences, Engineering, and Medicine (NASEM) recommends that “the FDA make sourcing, quality, volume, and capacity information publicly available for all medical products approved or cleared for sale in the U.S.”[2] 

This sort of information would make it possible to monitor weaknesses in the supply chain and address them. It would also enable predictions of shortages. Moreover, just like credit bureaus, third-party companies could use the data to create rating systems. Rating systems would enable healthcare systems and other large purchasers to make informed decisions to purchase the best possible medications for their populations. This would also create competition among manufacturers giving the incentive to create the best environment for producing and transporting high-quality medicines to patients.[2] There are legal regulatory hurdles to be overcome for such a public repository of information, but it is a very practical solution.

Drug Supply Chain flow chart
Photo Source: Association for Accessible Medicines

During the pandemic, people living with HIV have been especially concerned about drug shortages for their life-saving antiretroviral medications. In 2020, the ADAP Advocacy Association took action to address those concerns. It contacted antiretroviral drug manufacturers directly to inquire about what steps they were taking to secure the supply.[3] 

The ADAP Advocacy Association contacted AbbVie, Jansen Pharmaceuticals, Gilead Sciences, Merck, Theratechnologies, and ViiV Healthcare, all manufacturers of HIV antiretrovirals. Discussions with the companies resulted in the optimistic projection of no foreseen disruption in their drug supply chain. Brandon M. Macsata, CEO of the ADAP Advocacy Association, stated that “their combined assurances provided significant peace of mind for the people living with HIV/AIDS who we represent, and who rely on these life-saving medications.” 

Continuing to innovate to improve the drug supply chain is not just good for manufacturers' bottom line. It also means improved quality of life and lowered mortality for the global population.

[1] Beusekom, M. (2022, February 24) Patients, pharma execs express low trust in drug supply chains. Retrieved from https://www.cidrap.umn.edu/news-perspective/2022/02/patients-pharma-execs-express-low-trust-drug-supply-chains
[2] Frieden, J. (2022, March 4). How can the U.S. preserve its medical supply chain? Retrieved from https://www.medpagetoday.com/publichealthpolicy/healthpolicy/97524
[3] 
Macsata, B. (2020, April 24). Nation's HIV drug supply secure despite coronavirus pandemic. Retrieved from https://adapadvocacyassociation.blogspot.com/2020/03/nations-hiv-drug-supply-secure-despite.html

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.  

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