19 - Pharmaverse

When pharma products make positive national headlines, the stories fall into two categories – ‘dramatic discovery’ (by a company or country) or ‘dramatic recovery’ (by a patient or patients). Each relies on the unrelenting human fascination with ‘triumph over adversity’, an appetite frequently satisfied by groundbreaking work in the life sciences.

Within the postcode of those two narratives, however, is a largely unheralded aspect of the product pilgrimage, namely, the manufacturing, delivery and constant supplyline of treatments. It is an exorbitantly intricate and increasingly futuristic operation, motivated not by fanfare, but patient needs and defying the laws of what is possible.

Manufacturing and delivery may not be as sexy as other plot points but, without the prowess of companies to apply sophisticated logistics to pharma, the entire healthcare labyrinth would rapidly spiral into a dystopian nightmare. Indeed, as the global community tries to negotiate a raging pandemic, the stealth-like ability to move mountains of pharma products has never been more crucial.

It’s also evidence of growing cooperation. In the era-shaping cyberscape of 2020, patients have had a major influence on the expanding pharmaverse. The ultra modern ‘selfcare’ citizens are now a force to be reckoned with – they can tell you about treatment options, what their prescribed drug does or provide handy updates about a current Phase III product.

Increasingly, Patient 2.0 will even know how, when and at what temperature products should arrive.
This totally upgraded symbiotic relationship between pharma and patient is now indispensable in the arena of innovative logistics.

As digital dynamism and overall demand has increased during the last 10 years, medicines have become much more specialised and advanced, requiring pharmaceutical manufacturers to adopt flexible models in order to keep up with the astonishing pace of change.

Tony Cordrey, vice president of European Strategic Operations at Accord Healthcare, explains: “Manufacturers are not only modifying to accommodate more complex molecules and product types, but also scaling up and down in response to fast-changing market dynamics. We have had to adapt as regulations covering emerging medicines and patient safeguarding become more demanding.”

The Falsified Medicines Directive (FMD) came into force in February 2019 and, as Tony points out, it has been a significant logistical challenge, placing greater emphasis on the condition, quantities and temperature of medicines. Consequently, validated transit routes have become common practice with evermore sophisticated data loggers and trackers.

Brian Duggan, general manager and Superintendent Pharmacist at Polar Speed – a subsidiary of UPS Healthcare – has seen at first hand the power that real-time data can provide. “At any given moment, our control tower will know the location of vehicles and even the temperature inside every compartment,” he says. “We can determine whether a driver is at a specific address, due to the geo-fence location of handheld devices, while also communicating updated arrivals in real-time to customers and patients.”

Driven by the multifaceted information at their fingertips, logistics experts have clearly risen to the challenge of rebooting their infrastructures and improving the quality of services exponentially.

The constant bar-raising of regulators is bringing the activities of pharma logistics solutions into sharper focus, a trend that has undoubtedly been triggered by the upsurge in patient curiosity. Historically, they were passive bystanders, but today they’re keymasters of their healthcare destiny.

“Patients are consumers and, like in any other sector, there is an expectation that products – in this case medicines – should be available when required, with high standards of trust, integrity and quality,” observes Tony. “Retailers can deliver items on the same or next day, and patients expect this level of service from their pharmacies. The major difference is that we don’t expect returns or complaints!”

While many pharmacies have been offering home delivery for several years, recent events have increased demand, prompting patients to utilise online pharmacies. Innovative pharma logistics have been fundamental to the rising success of these offerings which – at the turn of the century – would have been impossible.

Brian said: “If patients receive the right medicine, at the right time, with the right level of counselling and guidance, it provides them with an empowering confidence in their treatment, encouraging compliance and adherence. Despite logistics often feeling detached from clinical care, in reality, it’s integral to delivering better health outcomes.”
“In future, data and information transparency will become the norm,” adds Tony. “The ability to know the quality, integrity and pedigree of products cannot be underestimated.”

Smooth delivery mechanisms also offer healthcare professionals much-needed salvation, particularly at the sharp end of treatment delivery. Brian believes that forming an environment that appreciates all the moving parts of healthcare has substantial benefits. He notes: “As someone with a pharmacy background, I recognise the need to develop a culture within pharma logistics that enables team members to understand the implications of everything they do, recognising that we have a pivotal role in supporting, and providing reassurance to, frontline clinical teams.”

Accord’s automated system has already boosted its ability to deliver medicines quickly and correctly, but Tony would also like to see an even more ambitious communication and tracking system in the coming years. He says: “We want to digitally update wholesalers about our stock situation and when our supplies will arrive, enabling them to relay this information to pharmacists and help them make critical decisions that will ultimately benefit patients.”

It’s true, there is plenty of room for further modernising. When you consider all the lab-based wizardry that goes into producing an effective therapy, not to mention the assault course of trials it has to go through, it seems anachronistic that vast consignments of medication are held up while minor text amendments are made to patient information leaflets (PIL).

The FMD, however, has also brought with it ‘2D matrix technology’, which could signal the end of paper PIL. In the past, there have been concerns about how patients would access the information online, but the matrix code can now be scanned by a smartphone. Not only would patients have up to date information, but an additional tool to report adverse events.

Of course, transferring from paper to digital has environmental benefits, but there are also advantages when it comes to verification and patient empowerment. Ultimately, patients are more likely to engage with an app that provides tracking information and prescription records than PILs that rarely make it out of the box.

The term ‘it’s not an exact science’ is bandied around at will in other industries, but not in the pharma logistics game. After all, it is an exact science! This indisputable fact encourages companies dealing with manufacturing and delivery to relentlessly pursue new levels of excellence. It’s an unending challenge that goes with the territory.

“In my experience, designing new services with end-users tends to produce the best results,” enthuses Brian. “Polar Speed has worked with clients to provide unpacking, inventory and date-checking services. Innovating effectively requires a logistics company to recognise that it is part of the overall healthcare team, and the information captured on the ground has an impact on every patient.”

Tony also sees the virtues of studying the behaviour of other industry leaders. Following the creation of its Didcot storage facility, the company linked up with long-term partner, DHL. “They are experts in distributing packages around the world and our operations have benefited from the collaboration,” he says. “We have also studied the way multinationals, such as Primark, are able to handle huge consignments and dispatch them quickly.”

As the entire planet wrestles with the two titanic battles of our times – saving the planet from ourselves and saving ourselves from the damned coronavirus – pharma has a moral stake in the former and a professional responsibility in the latter. Neither is being taken lightly.

Tony has witnessed a sea change in the approach of pharma logistics to the environment, with much more focus on sustainability. “We are doing everything we can to minimise our footprint on the environment,” insists Tony. “Accord aims to be a zero-waste company and we have key objectives to ensure we recycle, not only the waste from our manufacturing processes, but at every level of the organisation.”

Meanwhile, the performance of pharma in maintaining supplies during the era of COVID-19 has been remarkable, but it hasn’t occurred by accident. Although the industry could not have foreseen the crisis, its historical focus on product delivery has, in many ways, always prepared it for such an event.

“COVID-19 led to an increase in the usage of telemedicine, decreasing the need for patients to go to a hospital to receive effective healthcare. This evolution has thus paved the way for expanding home delivery of medicines; a source of reassurance for many elderly and immunocompromised people. With the right funding and support, expansion of home-based healthcare can be a permanent part of patient care,” says Brian.

In conclusion, logistics is, perhaps, the absolute embodiment of the pharma paradigm – rarely indulging in retrospect, but always looking forward, setting the pace and reaching further. With industry working every second of every day to find a vaccine to slay the corona-villain, logistics teams are poised for their greatest challenge to date. And when tomorrow comes, they’ll be ready.

Star tracking across the pharmaverse

Star tracking across
the pharmaverse