At the start of the COVID-19 pandemic, hospitals and health systems raced to keep up with fast-changing recommendations for drug and treatment options for patients. Distributors were tasked with delivering drug products to health systems faster than ever before and discovered a need to adapt traditional supply chain methods to meet the increased demand.
Willis Chandler, president of health systems and services at AmerisourceBergen, one of the largest drug distributors in the U.S., recently spoke with Becker's Hospital Review about how all members of the pharmaceutical supply chain have responded to meet the new demands of the pandemic.
Editor's note: Responses were edited lightly for length and clarity.
Question: What do hospitals, distributors and drugmakers need to do to adapt to the fast-paced reality of the pandemic?
Willis Chandler: We've learned that health systems need access to information and real-time dialogue with drugmakers, government agencies and distribution partners. In other words, open lines of communication are key.
The desire for new COVID-19 therapies has been immense, and it is remarkable how much we have learned in such a short amount of time, relatively speaking. Usually, it takes years of preparation to launch a new drug. Drugmakers and distributors have time to plan supply chain channels for that drug, and providers have time to review the clinical trial data. When the pandemic hit, we did not have time on our side, but amazingly, given the advances in modern medicine and life sciences, we were able to see progress in COVID-19 drugs relatively quickly. When the FDA began issuing emergency use authorizations for drugs to treat COVID-19, the healthcare system and pharmaceutical supply chain needed to condense years' worth of work into months to ensure the products could rapidly get to the patients who needed them.
More than 590 drugs are in the development planning stages, over 390 are being reviewed or have been reviewed by the FDA, eight have received EUA approval, and one has been fully approved by the FDA. These numbers show that the COVID-19 drug pipeline continues to grow, and many drugs are still being considered for the EUA pathway. This makes the distributor's role — as a conduit between manufacturers and sites of care — even more critical.
Q: How did AmerisourceBergen adjust its allocation method to accommodate the changes in drug demand caused by the pandemic?
WC: Back in March, we implemented safeguards and adjusted allocation methods to ensure supply stability and prevent well-intentioned customers frm stockpiling drug products.
When the White House recommended the use of hydroxychloroquine — which is traditionally an antimalarial drug — to fight COVID-19, we saw demand for antimalarial drugs increase 1,130 percent in just one month. AmerisourceBergen immediately put hydroxychloroquine on allocation. This allowed us to continue delivering the drug to as many patients as possible, as quickly as possible.
However, through conversations with our health system customers, we recognized the pressing need to evolve our allocation methodology. Our allocations couldn't be based on historical purchasing patterns, because hospitals were experiencing significant increases in product demand in only a matter of days.
Once this was realized, a team worked to rapidly develop a new allocation system that addressed the specific realities of the pandemic, such as the emergence of hot zones where cases were highly concentrated in specific geographies. The model had to account for a number of factors, such as existing and developing hot zones, the prevalence of COVID-19 patients, and the number of [intensive care unit] beds at a facility. It also layered in objective, third-party data — such as the John Hopkins Hospital's COVID-19 database — that identified the specific areas with the most pressing drug needs across the U.S.
Q: How was AmerisourceBergen able to quickly ramp up its supply of drugs to meet hospitals' demand?
WC: At the start of the pandemic, drugmakers didn't realize we were experiencing shortages because the product in the supply chain was initially the same amount as in previous months. However, at the distributor and provider levels, there were shortages because providers' needs were far surpassing what was historically requested. In other words, current demand was outstripping historic supply levels.
As a new partner, getting a drug product into a health system can sometimes take up to two years. AmerisourceBergen was able to work with drugmakers to get in-demand products into health systems within 30 days. In some cases, this meant working with hospitals and the federal government to prepare to store and deliver therapies to infected patients as quickly as possible. This level of collaboration and information-sharing between manufacturers, distributors and providers will continue to be essential in effectively managing current and future supply chain challenges.