PRODUCTS & SERVICES
systems and technology gaps,” Turner continued. “Then things get thorny. How much do you have that’s available-to- promise? What’s your pipeline inventory? What happens if your next tier of eligibility is bigger or smaller than expected? Sure, we can sit on supply buffers and reschedule appointments when we stock out, and we’ll make it out the other side vaccinated, if not a little shell-shocked. But without expert supply chain orchestration, all those other problems are not only going to surface, they’re going to bubble over.”
Any lack of non-acute supply logistics expertise can be disastrous, according to Turner.
“Often, supply chain is about putting out
fires before the flames of disruption are fanned,” he noted, “so, while challenges across the board are to be expected, a lack of supply chain expertise is likely to add fuel to those problems. We’re talking about the largest scale and arguably most complex just-in-time last-mile distribution effort in history, and every link in the supply chain needs to be strong and connected so that vaccines move one way, and data moves the other. ithout both those things flowing smoothly, there will be a kink in the chain.” Darren Marani, Senior Vice President, Non-acute and Inside Sales, Cardinal Health Inc., points to several mitigat- ing factors. “Non-acute care facili- ties have faced several obstacles when it comes to obtaining enough COVID-
Darren Marani
19 vaccines to meet the demand,” Marani observed. “The two most prevalent con- straints are centered on market type and acquisition options. To date, vaccine distri- bution has been limited to retail pharmacies and long-term care facilities via a single pharmaceutical distributor. This creates issues with product selection, facility staff- ing and patient access. Logistics remains a challenge for geographically remote facili- ties, as well as the additional storage space needed for the vaccines.”
Initially, however, the industry faced a seminal problem from a confluence of factors, according to Jamie Chasteen, Director of Corporate Development, Cold Chain Technologies.
“The big challenge for non-acute facili- ties was the same as for everyone at the regional, state and local level,” Chasteen noted. “All organizations, whether public or private, were left to figure out vaccine supply, storage and distribution on their own. This causes duplicated work and cost and potentially runs the risk that many organizations will implement the wrong
products or procedures, which could cause spoilage and waste or, even worse, adverse patient results due to improper handling and storage.” Compounding the challenge? ne of two early vaccines required specific temperature limits. Azra Behlim, Senior Director, Contract Services, Pharmacy, Vizient Inc., argues that the data requirements for submission to the federal government pose the first problem. “In pandemic planning, the timely and accurate transmission of data to the federal stakeholder is critical so that stakeholders can monitor progress and
Azra Behlim
identify any opportunities for improve- ments,” Behlim said. “In the COVID-19 vaccine administration, many non-acute care facilities struggle without the correct infrastructure or technology to communi- cate regularly in an electronic format with the pertinent required data fields. Initially, limited supply availability
through production leads the charge, asserts John Jordan, Vice President, Phar- macy Field Services, Premier Alternate Site Programs. The cascade of concerns progress from there.
“As vaccine supply increases over the coming weeks and months, distri- bution and logistics will become the biggest obsta- cle,” Jordan predicted. “With vaccine allocations and distribution managed by the federal government, providers must work directly with their state/local jurisdic- tions or the Centers for Disease Control and Prevention (CDC) in order to become a COVID-19 vaccine administrator. “The storage, handling and data report-
John Jordan
ing requirements are also challenging for many providers, creating a barrier for many smaller, community healthcare organiza- tions,” Jordan continued. “Vaccine access may differ depending on provider or facil- ity type as well. Retail and long-term care pharmacies have generally been part of the federal partner program for accessing vac- cines, while access for other provider types varies by jurisdiction.” Scrambling for limited supply quanti- ties can be traced to faulty forecasting, according to Wesley Crampton, COO, Medspeed. “While there have been a number of roadblocks, demand planning is likely the leading challenge,” Crampton asserted. “Non-
Wesley Crampton
acute care facilities rely on federal alloca- tion and state vaccination rollout plans to provide vaccines to their patients and communities. Limited information has been given by governmental entities regarding the expected allocations and distribution timelines. At the same time, healthcare leaders are trying to understand patient refusal rates and no-show frequency. All of this results in incredibly difficult planning that requires a logistics infrastructure with end-to-end agility – something that is dif- ficult for certain types of nonacute facilities to accomplish.”
Cold chain requirements for at least one of the available vaccine products proved a compounding challenge, Crampton acknowledged. “Product has been shipped and trans- ported in specially designed contain- ers used to maintain temperature state requirements until the time of use,” he said. “Initially, many non-acute facilities were not using the fier vaccine because of the ultra-cold storage and short-shelf life in thawed conditions. The FDA update in late ebruary, which allows the fier vaccine to be stored at more conventional freezer temperatures for a period of up to two weeks, was a positive for non-acute vaccination sites – it meant that they could increase capacity for vaccination with abil- ity to use the fier vaccine.
Don’t worry, be happy Ken Fleming, President, Logistyx, encour- ages people to cut the administrators and the seemingly convoluted processes some slack. “The scale of the oper- ation is massive and requires a great deal of coordination from end to end,” Fleming said. “With 50 states employing indi- vidual approaches, the lack of a unified system introduces unique variables.” Fleming urges people to think positive. “With all of that accounted for, the suc- cess of the effort to get vaccines into arms has been rather impressive,” he indicated. “From a distribution and logistics stand- point, manufacturers have implemented new strategies – like shipping directly from manufacturing sites instead of central dis- tribution warehouses – and created custom shipping containers for cold-chain storage requirements. Carriers have prioritized vaccine shipments, ensuring they have capacity and the cold-chain capabilities to rapidly deliver fresh vaccines when and where they’re needed. Vaccination sites have ensured they have the necessary
Ken Fleming Page 44
hpnonline.com • HEALTHCARE PURCHASING NEWS • May 2021 43
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52
