Physician preference items and specialty pharmaceuticals top the list of categories health system supply chain teams find hardest to manage, though leaders say the difficulty often stems less from the products themselves than from reimbursement pressure, market shifts and the clinical stakes attached to each decision.
Becker’s asked supply chain leaders: Which product category is the hardest to manage right now, and why? Here is how six leaders responded.
Editor’s note: Responses have been lightly edited for clarity and length.
Michael Alfaro. Director of Materials Management at Ventura, Calif.-based Community Memorial Healthcare: Physician preference items remain the most challenging category to manage as new market disruptors introduce aggressive pricing and creative capital placements that frequently bypass traditional GPO alignment. This dynamic forces us to rigorously balance contract compliance and total ROI against strong clinical preferences, ensuring we maintain financial discipline without risking the migration of provider case volumes to competing facilities.
Nalin Kulasekara. System Vice President of Ancillary Operations and Supply Chain Management at Springfield, Ill.-based Hospital Sisters Health System: The hardest area to manage continues to be physician preference products related to cardiac, neuro-spine and orthopedic implants. With a changing payer mix as the population ages and steady inflation taking hold, looking at cost alone is not enough. As the payer mix erodes and reimbursement declines, we need to find innovative ways to manage expense in these areas.
Joe Wilson. Vice President of Supply Chain Services and Chief Procurement Officer at New York City-based Montefiore Health System: In 2026, pharmaceuticals — particularly specialty drugs, oncology therapies and biologics — are the most difficult hospital spend category to manage due to rapid cost escalation, ongoing shortages and limited supplier competition. Drug expenses continue to outpace inflation in many health systems, while hospitals have little leverage to influence pricing for many high-cost therapies. Reimbursement often fails to keep pace with acquisition cost increases, creating significant margin pressure. For supply chain leaders, pharmaceuticals represent the greatest combination of financial risk, clinical sensitivity and limited controllability, making them the most challenging category to manage effectively.
Don Barton. Chief Technical Officer and Director of Supply Chain Management at Shelbyville, Ind.-based Major Health Partners: Biologics and skin substitutes are among the most challenging product categories to manage because their complexity extends well beyond purchasing and inventory control. They require careful coordination of prior authorizations, accurate coding and clinical documentation, reimbursement requirements and specialized handling and storage, all while ensuring the right product is available when needed for patient care. The combination of clinical, regulatory, financial and operational considerations makes this a category where supply chain must work closely with clinical teams, revenue cycle and vendors to ensure both patient access and financial sustainability.
Vini Manchanda. Vice President of Supply Chain Services at Bloomington, Minn.-based HealthPartners: At the macro level, manufacturers divesting from a parent organization are causing multiple disruptions in the market and continue to pose significant challenges. Another is the ATEC breast biopsy needle, which is playing out in real time.
Mark Campbell. Senior Vice President of Supply Chain at Tampa, Fla.-based Tampa General Hospital: The categories vary based on their particular issue, but tubing is a key category, and sterility issues continue to impact many manufacturers. More important than the specific category is the response. Regardless of category, we have to be diligent in identifying disruptions and having a consistent response to ensure supply resiliency.
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