An Integrated Supply Chain: Addressing Essential Medicine Shortages

By Anthony Flammia, DBA, Bridge Life Sciences Advisory, LLC, Richard Manning, PhD, Bates White Economic Consulting, Kristina McKean, Phlow Corporation, Patricia Watson, M.S., Phlow Corporation

Drug shortages have been a persistent challenge for the U.S. healthcare system for more than a decade. The COVID-19 pandemic has revealed significant vulnerabilities in the U.S. hospital supply chain, particularly regarding generic essential injectable drugs.ⁱ An FDA analysis between 2013 and 2017 showed that sterile injectable drugs account for 63% of drug shortages.ⁱⁱ The dramatic depletion of our Strategic National Stockpile (SNS) as a result of the COVID-19 crisis has placed the pharmaceutical supply chain under unrivaled stress and demand for high-quality injectable drug products. The production process required for sterile injectables is complicated and costly, which is an important factor in why sterile injectable drugs are a significant percentage of drugs in shortage.ⁱⁱⁱ There are a limited number of drug manufacturers operating within a global supply chain; this makes the system vulnerable to international economic, political, and public health crises and limits its capacity to deliver essential drugs to the people who need them. The current supply chain is broken. A comprehensive domestically oriented supply chain would alleviate drug shortages and create a less vulnerable and potentially more efficient model.