Health Care: Supply Chain Meltdowns
by Tom aka Rusty Rustbelt
Health Care: Supply Chain Meltdowns
First:
Counterfeit vials of the cancer drug Avastin have been found in three states. The vials, sold directly to physician offices, lack the active ingredients to make the drug effective. Somewhat luckily, the packaging was so sloppy the vials were spotted, although some of the medication was likely used. We might not be so lucky next time.
Then:
The drug common Methotrexate, used to treat several kinds of cancers, is in short supply. Methotrexate is considered essential in battling acute lymphoblastic leukemia in adults and in children.
As drugs become generic the cost goes down, but generic drug makers are not especially adept at making injectable medications, being better at mass production of pills. The closure of just a few plants can cause a shortage, as we have now.
More than 250 meds have been on the shortage list in the last year or two, as the lower costs of production are offset by lower reimbursements leading to less capital investment and production.
And Finally:
The Johnson and Johnson Depuy subsidiary is in hot water with the FDA for joint replacements failing too early too often (15 years is the hoped for life of joint replacement surgeons, results vary by patient). Depuy recently received some bad publicity for selling the same joint replacements in Europe.
Meanwhile U.S. malpractice lawyers are having a field day, and a fake internet artificial joint registry disappeared when registrants were hustled by lawyers they had never heard of (the feds are working to start a legitimate registry).
So:
Most of the medical supply chain is efficient and provides quality goods, but a few meltdowns can have horrendous impacts.
“…horrendous impacts.” AND record breaking profits!
This is where the line between business efficiency and negative impact come into play. There are so many opinions when it comes to healthcare and medical supply and equipment. I’m interested to see how much further the debate can expand.
http://www.taycorfinancial.com/industry/medical-equipment-financing
Hmmmm:
The number of reported drug shortages annually has tripled from 61 in 2005 to 178 in 2010.Of the 127 studied shortages in 2010-11, 80 percent involved drugs delivered to patients by sterile injection, including oncology drugs, antibiotics, and electrolyte/nutrition drugs.The leading reasons for the reported shortages were problems at the manufacturing facility (43%), delays in manufacturing or shipping (15%), and active pharmaceutical ingredient shortages (10%). Manufacturing quality problems that have resulted in shortages can be serious, including findings of glass shards, metal filings, and fungal or other contamination in products meant for injection into patients.Sterile injectable drugs have unique manufacturing and market features which make shortages of these products more likely to occur and harder to prevent or mitigate,including: Manufacturing them is complex and can more easily lead to problems that affect safety,Dedicated manufacturing lines are often required,The top three generic injectable manufacturers hold 71% of the market by volume,Most sterile injectables have one manufacturer that produces at least 90% of the drug, and“Just in time” manufacturing and inventorying practices leave little margin for error.
Having worked for a Medical Manufacturing company making CF and CD Dialyzers, Dialysates, Intravenous blags and needles, blood bags and the associated raw material, pharnaceuticals; I can safely say these reasons are true. Demand has outsripped capacity for sterile injectibles.