April 25, 2018

Alleviating the Effects of Drug Shortages Requires Cooperation and Communication

In late February, Christine Donaldson, HealthPRO’s Vice President, Pharmacy Services participated in a panel to discuss drug shortages and related mitigation strategies. The presentation, titled Ensuring Continuity of Care for our Patients: Addressing Drug Shortages in Canada and Industry-wide Mitigation Techniques, provided delegates with tangible strategies to address this situation.

Joined on the panel by Marc Boisvert, Director, ComOps Supply Chain, Sandoz Canada and Jill Craven, Vice President, Pharmacy Services, Mohawk Medbuy Corporation, Ms. Donaldson shared her perspective on the current shortage landscape and the impact on patients and hospital staff.

“When a product is unavailable, it can lead to patients receiving less than optimal therapy and/or delayed treatment which can have serious consequences, says Ms. Donaldson.  “Further, each drug shortage triggers, on average, 300 additional tasks in the hospital which puts an additional strain on hospital pharmacy staff.”

To alleviate these impacts, the panelists provided their input on key strategies and recommendations.

  1. Communication and Over Communication

Timely, and in some cases, over communication, was underscored by all the panelists, noting that early and complete information from suppliers regarding impending supply disruptions is invaluable when it comes to ensuring hospitals and patients alike are as prepared as possible.

“In our role, HealthPRO collects and distributes complete, accurate and timely information to health care professionals across Canada about drug shortages, their causes and potential alternatives in the market,” shared Ms. Donaldson, adding that HealthPRO plays an active role on Canada’s Provincial/Territorial (P/T) Drug Shortage Task Team. “And, when necessary, we escalate issues to Health Canada as we did recently to get a drug to a remote northern Canadian community.”

  1. A Good Allocation Strategy

Employing a good allocation strategy—one that focuses on equitable distribution of critical multi-source and single-source medications—can help. “To be effective, the allocation strategy should be implemented as soon as the potential supply disruption is known at 100% or more of the customer’s historical purchase pattern,” advised Ms. Donaldson. “Whenever possible, the goal is to avoid a supply gap altogether.”

  1. Contract Strategies and The Future

Carefully designed contract strategies can help mitigate risks of supply disruptions. For example, HealthPRO leverages a split award strategy for critical hospital-specific drugs, where contracts are awarded to two suppliers, 60% of the business going to one, and 40% to the other. If one supplier experiences a shortage, the alternate manufacturer increases its production to supply the other segment of the market.

It was identified that the next opportunity will come from more strategic discussions about the global supply chain. “We need to know, for example, if two different suppliers get their Active Pharmaceutical Ingredients — APIs — from the same source,” says Ms. Donaldson. “This information will become increasingly critical to ensure we are achieving diversity in supply.”

Panelists also noted that it would be important to work with regulatory bodies to establish a mechanism to more quickly get access to drugs outside of our jurisdiction when no other viable options are available. “This would go a long way towards maintaining good patient outcomes,” noted Ms. Donaldson.